Impaired prefrontal cognitive control over interference by food images in binge-eating disorder and bulimia nervosa

Binge-eating disorder (BED)characterized by recurrent episodes of binge-eating without inappropriate compensatory behaviors is classified as an official diagnosis in DSM-5. However, the neural bases that differentiate BED from other eating disorders such as bulimia nervosa (BN), are still under debate. Thirty-nine participants (HC, n=14; BN, n=13; BED, n=12) underwent functional MRI while performing a Stroop-Match-to-Sample task. This pilot study investigated how food images interfered with the behavioral performances and blood-oxygenation-level-dependent neuronal activity. Compared to healthy controls, participants with BN showed lower accuracy indicating impaired cognitive control over interference. Compared to healthy controls, participants with BED demonstrated stronger activations in the ventral striatum in response to food images. By contrast, participants with BN exhibited stronger activations in the premotor cortex and dorsal striatum. These aberrant ventral and dorsal frontostriatal activations in response to food images are associated with increased reward sensitivity and habitual binge-eating/purging behaviors in BED and BN.