Prefrontal Responses during Proactive and Reactive Inhibition Are Differentially Impacted by Stress in Anorexia and Bulimia Nervosa.
Gorka, Adam X
The Journal of neuroscience : the official journal of the Society for Neuroscience
Society for Neuroscience
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Westwater-Wozniak, M., Mancini, F., Gorka, A. X., Shapleske, J., Serfontein, J., Grillon, C., Ernst, M., et al. (2021). Prefrontal Responses during Proactive and Reactive Inhibition Are Differentially Impacted by Stress in Anorexia and Bulimia Nervosa.. The Journal of neuroscience : the official journal of the Society for Neuroscience, 41 (20), 4487-4499. https://doi.org/10.1523/jneurosci.2853-20.2021
Binge-eating is a distressing, transdiagnostic eating disorder symptom associated with impulsivity, particularly in negative mood states. Neuroimaging studies of bulimia nervosa (BN) report reduced activity in fronto-striatal regions implicated in self-regulatory control, and an influential theory posits that binge-eating results from self-regulation failures under stress. However, there is no direct evidence that psychological stress impairs self-regulation in binge-eating disorders, or that any such self-regulatory deficits generalize to binge-eating in underweight individuals (i.e., the anorexia nervosa bingeing/purging subtype; AN-BP). We therefore determined the effect of acute stress on inhibitory control in 85 women (33 BN, 22 AN-BP, 30 controls). Participants underwent repeated functional MRI scanning, during performance of the stop-signal anticipation task, a validated measure of proactive (i.e., anticipation of stopping) and reactive (outright stopping) inhibition. Neural and behavioral responses to induced stress and a control task were evaluated on two, consecutive days. Women with BN had reduced proactive inhibition while prefrontal responses were increased in both AN-BP and BN. Reactive inhibition was neurally and behaviorally intact in both diagnostic groups. Both AN-BP and BN groups showed distinct, stress-induced changes in inferior and superior frontal activity during both proactive and reactive inhibition. However, task performance was unaffected by stress. These results offer novel evidence of reduced proactive inhibition in BN, yet inhibitory control deficits did not generalize to AN-BP. Our findings identify intriguing alterations of stress responses and inhibitory function associated with binge-eating, but they counsel against stress-induced failures of inhibitory control as a comprehensive explanation for loss-of-control eating.
Funding was provided by the Bernard Wolfe Health Neuroscience Fund to PCF and HZ and a Wellcome Trust Investigator Award to PCF (Reference No. 206368/Z/17/Z). MLW was supported through the NIH-Oxford-Cambridge Scholars Program and a Cambridge Trust fellowship. FM was supported by research grants from Versus Arthritis, the Experimental Psychological Society and a Career Development Award from the Medical Research Council (MR/T010614/1). AG, CG and ME were supported by the Intramural Research Program of the NIMH (Ref. ZIAMH002798). The Wellcome Trust/NIHR Clinical and Translational Research Facilities and the Wolfson Brain Imaging Centre provided equipment and support staff for the study. This research was supported by the NIHR Cambridge Biomedical Research Centre (BRC-1215-20014).
Wellcome Trust (100574/Z/12/Z)
Wellcome Trust (206368/Z/17/Z)
Wellcome Trust (100574/B/12/Z)
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External DOI: https://doi.org/10.1523/jneurosci.2853-20.2021
This record's URL: https://www.repository.cam.ac.uk/handle/1810/318462
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