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Control of Eating Behavior Using a Novel Feedback System

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Altered temporal difference learning in bulimia nervosa.

Guido K W Frank¹, Jeremy R Reynolds², Megan E Shott³

¹Department of Psychiatry, University of Colorado Denver, The Children's Hospital, Aurora, Colorado; Department of Neuroscience, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado.

Biological Psychiatry

|July 2, 2011

Summary

This summary is machine-generated.

Individuals with bulimia nervosa exhibit altered dopamine reward learning in key brain regions. Reduced brain responses to reward prediction errors correlate with binge-purge frequency, suggesting dopamine pathways as a potential treatment target.

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Area of Science:

Neuroscience
Psychiatry
Neuroimaging

Background:

The neurobiology of bulimia nervosa (BN) remains unclear.
Animal studies link binge eating to altered dopamine (DA) reward function.
This study investigates DA-related reward learning in BN.

Purpose of the Study:

To examine brain reward learning in individuals with bulimia nervosa.
To investigate the role of dopamine pathways in BN.
To correlate brain responses with binge-purge behavior.

Main Methods:

Functional magnetic resonance imaging (fMRI) was used in 20 women with BN and 23 healthy controls (CW).
A temporal difference (TD) model assessed DA-related reward learning involving visual-taste stimuli associations and violations.
Participants completed the Sensitivity to Reward and Punishment Questionnaire.

Main Results:

BN individuals showed reduced brain responses in the insula, ventral putamen, amygdala, and orbitofrontal cortex to unexpected taste stimuli and TD model reward values.
These findings persisted in non-depressed, unmedicated BN participants.
Higher binge/purge frequency inversely predicted reduced TD model response in BN.
BN individuals reported significantly higher Sensitivity to Reward and Punishment scores.

Conclusions:

This study is the first to link reduced brain DA responses in BN to altered learning of associations between visual stimuli and taste rewards.
The attenuated DA response is associated with the frequency of binge/purge episodes in BN.
The brain's DA neurotransmitter system may represent a crucial therapeutic target for BN.