Reward-Based Spatial Learning in Teens With Bulimia Nervosa.
To assess the functioning of mesolimbic and fronto-striatal areas involved in reward-based spatial learning in teenaged girls with bulimia nervosa (BN) that might be involved in the development and maintenance of maladaptive behaviors characteristic of the disorder.



We compared functional magnetic resonance imaging blood oxygen level-dependent response in 27 adolescent girls with BN to that of 27 healthy, age-matched control participants during a reward-based learning task that required learning to use extra-maze cues to navigate a virtual 8-arm radial maze to find hidden rewards. We compared groups in their patterns of brain activation associated with reward-based spatial learning versus a control condition in which rewards were unexpected because they were allotted pseudo-randomly to experimentally prevent learning.



Both groups learned to navigate the maze to find hidden rewards, but group differences in brain activity associated with maze navigation and reward processing were detected in the fronto-striatal regions and right anterior hippocampus. Unlike healthy adolescents, those with BN did not engage the right inferior frontal gyrus during maze navigation, activated the right anterior hippocampus during the receipt of unexpected rewards (control condition), and deactivated the left superior frontal gyrus and right anterior hippocampus during expected reward receipt (learning condition). These patterns of hippocampal activation in the control condition were significantly associated with the frequency of binge-eating episodes.



Adolescents with BN displayed abnormal functioning of the anterior hippocampus and fronto-striatal regions during reward-based spatial learning. These findings suggest that an imbalance in control and reward circuits may arise early in the course of BN. Clinical trial registration information-An fMRI Study of Self-Regulation in Adolescents With Bulimia Nervosa; https://clinicaltrials.gov/; NCT00345943.
Division of Child and Adolescent Psychiatry, the New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, New York.
Marilyn
M
Cyr
Division of Translational Imaging, the New York State Psychiatric Institute and College of Physicians and Surgeons, Columbia University.
Zhishun
Z
Wang
Division of Child and Adolescent Psychiatry, the New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, New York.
Gregory Z
GZ
Tau
Division of Child and Adolescent Psychiatry, the New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, New York; School of Information Science and Engineering, Central South University, Changsha, China.
Guihu
G
Zhao
Division of Child and Adolescent Psychiatry, the New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, New York.
Eve
E
Friedl
Division of Child and Adolescent Psychiatry, the New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, New York.
Mihaela
M
Stefan
Division of Child and Adolescent Psychiatry, the New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, New York.
Kate
K
Terranova
Division of Child and Adolescent Psychiatry, the New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, New York. Electronic address: MarshR@nyspi.columbia.edu.
Rachel
R
Marsh
D000293:Adolescent; D052018:Bulimia Nervosa / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006624:Hippocampus / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D017072:Neostriatum / Q000000981:diagnostic imaging / Q000503:physiopathology*; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012201:Reward; D065853:Spatial Learning / Q000502:physiology*
bulimia nervosa; fMRI; learning; reward; virtual reality