title: Altered structural and effective connectivity in anorexia and bulimia nervosa in circuits that regulate energy and reward homeostasis.
abstract: Anorexia and bulimia nervosa are severe eating disorders that share many behaviors. Structural and functional brain circuits could provide biological links that those disorders have in common. We recruited 77 young adult women, 26 healthy controls, 26 women with anorexia and 25 women with bulimia nervosa. Probabilistic tractography was used to map white matter connectivity strength across taste and food intake regulating brain circuits. An independent multisample greedy equivalence search algorithm tested effective connectivity between those regions during sucrose tasting. Anorexia and bulimia nervosa had greater structural connectivity in pathways between insula, orbitofrontal cortex and ventral striatum, but lower connectivity from orbitofrontal cortex and amygdala to the hypothalamus (P<0.05, corrected for comorbidity, medication and multiple comparisons). Functionally, in controls the hypothalamus drove ventral striatal activity, but in anorexia and bulimia nervosa effective connectivity was directed from anterior cingulate via ventral striatum to the hypothalamus. Across all groups, sweetness perception was predicted by connectivity strength in pathways connecting to the middle orbitofrontal cortex. This study provides evidence that white matter structural as well as effective connectivity within the energy-homeostasis and food reward-regulating circuitry is fundamentally different in anorexia and bulimia nervosa compared with that in controls. In eating disorders, anterior cingulate cognitive-emotional top down control could affect food reward and eating drive, override hypothalamic inputs to the ventral striatum and enable prolonged food restriction.
authors: Department of Psychiatry, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.|Neuroscience Program, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA.
authors: G K W
authors: GK
authors: Frank
authors: Department of Psychiatry, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
authors: M E
authors: ME
authors: Shott
authors: Department of Psychiatry, University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
authors: J
authors: J
authors: Riederer
authors: Eating Disorders Center Denver, Denver, CO, USA.
authors: T L
authors: TL
authors: Pryor
mesh_terms: D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D001921:Brain / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D001931:Brain Mapping; D052018:Bulimia Nervosa / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D038524:Diffusion Magnetic Resonance Imaging; D017352:Echo-Planar Imaging; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006706:Homeostasis / Q000502:physiology*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D064847:Multimodal Imaging; D009415:Nerve Net / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D010100:Oxygen / Q000097:blood; D012016:Reference Values; D012201:Reward; D013649:Taste / Q000502:physiology*; D066127:White Matter / Q000000981:diagnostic imaging / Q000503:physiopathology; D055815:Young Adult
chemical_list: D010100:Oxygen