title: Prediction error and somatosensory insula activation in women recovered from anorexia nervosa.
abstract: Previous research in patients with anorexia nervosa showed heightened brain response during a taste reward conditioning task and heightened sensitivity to rewarding and punishing stimuli. Here we tested the hypothesis that individuals recovered from anorexia nervosa would also experience greater brain activation during this task as well as higher sensitivity to salient stimuli than controls.
  
  
  
  Women recovered from restricting-type anorexia nervosa and healthy control women underwent fMRI during application of a prediction error taste reward learning paradigm.
  
  
  
  Twenty-four women recovered from anorexia nervosa (mean age 30.3 ± 8.1 yr) and 24 control women (mean age 27.4 ± 6.3 yr) took part in this study. The recovered anorexia nervosa group showed greater left posterior insula activation for the prediction error model analysis than the control group (family-wise error- and small volume-corrected p < 0.05). A group × condition analysis found greater posterior insula response in women recovered from anorexia nervosa than controls for unexpected stimulus omission, but not for unexpected receipt. Sensitivity to punishment was elevated in women recovered from anorexia nervosa.
  
  
  
  This was a cross-sectional study, and the sample size was modest.
  
  
  
  Anorexia nervosa after recovery is associated with heightened prediction error-related brain response in the posterior insula as well as greater response to unexpected reward stimulus omission. This finding, together with behaviourally increased sensitivity to punishment, could indicate that individuals recovered from anorexia nervosa are particularly responsive to punishment. The posterior insula processes somatosensory stimuli, including unexpected bodily states, and greater response could indicate altered perception or integration of unexpected or maybe unwanted bodily feelings. Whether those findings develop during the ill state or whether they are biological traits requires further study.
authors.affiliation: From the Department of Psychiatry, University of Colorado, Denver, Aurora, CO, USA (Frank, Collier, Shott); the Department of Neuroscience, University of Colorado Denver; Anschutz Medical Campus, Aurora (Frank); and the Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA (O'Reilly).
authors.forename: Guido K W
authors.initials: GK
authors.lastname: Frank
authors.affiliation: From the Department of Psychiatry, University of Colorado, Denver, Aurora, CO, USA (Frank, Collier, Shott); the Department of Neuroscience, University of Colorado Denver; Anschutz Medical Campus, Aurora (Frank); and the Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA (O'Reilly).
authors.forename: Shaleise
authors.initials: S
authors.lastname: Collier
authors.affiliation: From the Department of Psychiatry, University of Colorado, Denver, Aurora, CO, USA (Frank, Collier, Shott); the Department of Neuroscience, University of Colorado Denver; Anschutz Medical Campus, Aurora (Frank); and the Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA (O'Reilly).
authors.forename: Megan E
authors.initials: ME
authors.lastname: Shott
authors.affiliation: From the Department of Psychiatry, University of Colorado, Denver, Aurora, CO, USA (Frank, Collier, Shott); the Department of Neuroscience, University of Colorado Denver; Anschutz Medical Campus, Aurora (Frank); and the Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA (O'Reilly).
authors.forename: Randall C
authors.initials: RC
authors.lastname: O'Reilly
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000503:physiopathology* / Q000523:psychology* / Q000628:therapy; D059031:Anticipation, Psychological / Q000502:physiology*; D001245:Association Learning / Q000502:physiology; D001931:Brain Mapping; D003198:Computer Simulation; D003213:Conditioning, Psychological / Q000502:physiology; D003430:Cross-Sectional Studies; D019422:Dietary Sucrose; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008959:Models, Neurological; D008960:Models, Psychological; D009483:Neuropsychological Tests; D012201:Reward; D013003:Somatosensory Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology*; D055697:Taste Perception / Q000502:physiology*; D014796:Visual Perception / Q000502:physiology
chemical_list: D019422:Dietary Sucrose
references.citation: Biol Psychiatry. 2006 Aug 15;60(4):402-9
references.pmid: 16919527
references.citation: PLoS One. 2014 Oct 10;9(10):e110087
references.pmid: 25303480
references.citation: Biol Psychiatry. 2011 Oct 15;70(8):736-743
references.pmid: 21714958
references.citation: Behav Brain Res. 2013 Nov 1;256:273-8
references.pmid: 23948214
references.citation: Int J Obes (Lond). 2011 Apr;35(4):550-61
references.pmid: 20680018
references.citation: Neuropsychopharmacology. 2008 Feb;33(3):513-23
references.pmid: 17487228
references.citation: Int J Eat Disord. 2013 Jul;46(5):425-32
references.pmid: 23658085
references.citation: Nat Neurosci. 2013 Nov;16(11):1551-2
references.pmid: 24077565
references.citation: Arch Gen Psychiatry. 1961 Jun;4:561-71
references.pmid: 13688369
references.citation: Int J Eat Disord. 2006 Nov;39(7):550-5
references.pmid: 16791851
references.citation: Biol Psychiatry. 2011 Oct 15;70(8):728-735
references.pmid: 21718969
references.citation: BMC Psychiatry. 2012 Jul 06;12:76
references.pmid: 22770364
references.citation: Brain. 1983 Sep;106 (Pt 3):643-53
references.pmid: 6640274
references.citation: Arch Gen Psychiatry. 1984 Apr;41(4):350-5
references.pmid: 6200083
references.citation: J Neurophysiol. 1998 Jul;80(1):1-27
references.pmid: 9658025
references.citation: Biol Psychiatry. 2002 Nov 1;52(9):896-906
references.pmid: 12399143
references.citation: Psychiatry Res. 2006 Jun 15;142(2-3):253-5
references.pmid: 16626809
references.citation: Brain Struct Funct. 2010 Jun;214(5-6):519-34
references.pmid: 20512376
references.citation: Arch Gen Psychiatry. 2005 Sep;62(9):1032-41
references.pmid: 16143735
references.citation: Eat Behav. 2008 Dec;9(4):381-8
references.pmid: 18928900
references.citation: Am J Psychiatry. 2013 Oct;170(10):1143-51
references.pmid: 23732817
references.citation: Int J Eat Disord. 2015 Nov;48(7):889-97
references.pmid: 25712775
references.citation: J Neurosci. 2008 Mar 12;28(11):2745-52
references.pmid: 18337404
references.citation: J Neurosci. 2002 May 1;22(9):3306-11
references.pmid: 11978804
references.citation: Physiol Behav. 2007 Aug 15;91(5):459-72
references.pmid: 17081571
references.citation: Front Hum Neurosci. 2013 Feb 04;7:14
references.pmid: 23382714
references.citation: Acta Psychiatr Scand. 2013 Apr;127(4):269-78
references.pmid: 22747702
references.citation: Int J Eat Disord. 2012 Mar;45(2):227-32
references.pmid: 21495057
references.citation: Neurosci Biobehav Rev. 2012 Sep;36(8):1839-47
references.pmid: 22613629
references.citation: Am J Psychiatry. 2013 Oct;170(10):1152-60
references.pmid: 23680873
references.citation: Int J Eat Disord. 2013 Jan;46(1):23-33
references.pmid: 22836447
references.citation: Eur Eat Disord Rev. 2013 Mar;21(2):89-98
references.pmid: 23348964
references.citation: Neuropsychopharmacology. 2012 Aug;37(9):2031-46
references.pmid: 22549118
references.citation: Nat Rev Neurosci. 2009 Aug;10(8):573-84
references.pmid: 19603056
references.citation: Neuroimage. 2007 Mar;35(1):105-20
references.pmid: 17239619
references.citation: Neuron. 2003 Apr 24;38(2):329-37
references.pmid: 12718865
references.citation: J Psychiatr Res. 2011 Mar;45(3):395-403
references.pmid: 20709330
references.citation: Psychother Psychosom. 2012;81(6):394-5
references.pmid: 23007944
references.citation: Expert Opin Med Diagn. 2012 May 1;6(3):235-244
references.pmid: 22936952
references.citation: Biol Psychiatry. 2015 Apr 1;77(7):602-3
references.pmid: 25766685
references.citation: Biol Psychiatry. 2005 Dec 1;58(11):908-12
references.pmid: 15992780
references.citation: Nat Neurosci. 1998 Aug;1(4):304-9
references.pmid: 10195164
references.citation: Psychiatry Res. 2012 Dec 30;200(2-3):482-8
references.pmid: 22494704
references.citation: Neuron. 2002 Oct 10;36(2):241-63
references.pmid: 12383780
references.citation: Science. 1997 Mar 14;275(5306):1593-9
references.pmid: 9054347
references.citation: Nat Rev Neurosci. 2002 Aug;3(8):655-66
references.pmid: 12154366
references.citation: Int J Eat Disord. 2011 May;44(4):317-24
references.pmid: 21472750