Altered brain activity in women recovered from bulimic-type eating disorders after a glucose challenge: A pilot study

Authors

  • Guido K. Frank MD,

    1. Department of Psychiatry, School of Medicine, University of Pittsburgh, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania
    2. Department of Psychiatry, University of California, San Diego, La Jolla, California
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  • Angela Wagner MD,

    1. Department of Psychiatry, School of Medicine, University of Pittsburgh, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania
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  • Sarah Achenbach BSc,

    1. Department of Psychiatry, School of Medicine, University of Pittsburgh, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania
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  • Claire McConaha BSN,

    1. Department of Psychiatry, School of Medicine, University of Pittsburgh, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania
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  • Kellie Skovira BA,

    1. Department of Psychiatry, School of Medicine, University of Pittsburgh, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania
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  • Howard Aizenstein MD,

    1. Department of Psychiatry, School of Medicine, University of Pittsburgh, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania
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  • Cameron S. Carter MD,

    1. Department of Psychiatry and Behavioral Sciences, Imaging Center/UDCMC, University of California, Davis, Davis, California
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  • Walter H. Kaye MD

    Corresponding author
    1. Department of Psychiatry, School of Medicine, University of Pittsburgh, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania
    • University of Pittsburgh Western Psychiatric Institute and Clinic, Iroquois Building, Suite 600, 3811 O'Hara Street, Pittsburgh, PA 15213
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Abstract

Objective

It is not known whether individuals with bulimic-type eating disorders have a dysregulation of brain pathways that modulate appetite. Taste plays a role in the regulation of appetite and the purpose of the current study was to determine whether bulimic women have alterations in the physiologic response to the blind administration of glucose.

Method

To avoid the confounding effects of a current eating disorder, and to assess possibly trait-related disturbances, we studied 10 subjects recovered (≥1 year) from a bulimic-type eating disorder and 6 control women. Subjects were administered a solution of glucose or artificial saliva (control solution) in alternating blocks during a functional magnet resonance imaging scan.

Results

Individuals who recovered from a bulimic-type eating disorder had significantly lower activation in the right anterior cingulate cortex (ACC; Montreal Neurological Institute [MNI] coordinates x = 8, y = 22, z = 28; cluster size = 18 voxels, T = 5.11, Z-score = 3.78) and in the left cuneus (occipital cortex; MNI coordinates x = −12, y = −78, z = 10; cluster size = 21 voxels, T = 4.27, Z-score = 3.36), when glucose was compared with artificial saliva.

Conclusion

The ACC plays a role in the anticipation of reward. Individuals with bulimic-type eating disorders may have a reduced reward response to nutrients, and thus may be vulnerable to overeating. However, this is a small sample and the current study will need replication in a larger sample size with investigation of additional regions of interest. © 2005 by Wiley Periodicals, Inc.

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