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A pilot study linking reduced fronto–Striatal recruitment during reward processing to persistent bingeing following treatment for binge-eating disorder

Authors

  • Iris M. Balodis,

    1. Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
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  • Carlos M. Grilo,

    1. Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
    2. Department of Psychology, Yale University School of Medicine, New Haven, Connecticut
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  • Hedy Kober,

    1. Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
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  • Patrick D. Worhunsky,

    1. Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
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  • Marney A. White,

    1. Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
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  • Michael C. Stevens,

    1. Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
    2. Institute of Living/Hartford Hospital & Olin Neuropsychiatry Research Center, Hartford, Connecticut
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  • Godfrey D. Pearlson,

    1. Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
    2. Institute of Living/Hartford Hospital & Olin Neuropsychiatry Research Center, Hartford, Connecticut
    3. Department of Neurobiology, Yale University School of Medicine, New Haven, Connecticut
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  • Marc N. Potenza

    Corresponding author
    1. Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
    2. Institute of Living/Hartford Hospital & Olin Neuropsychiatry Research Center, Hartford, Connecticut
    3. Child Study Center, Yale University School of Medicine, New Haven, Connecticut
    • Correspondence to: Marc N. Potenza; Yale University School of Medicine, 1 Church Street, Rm 726, New Haven, CT 06519. E-mail: marc.potenza@yale.edu

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  • The authors report that they have no financial conflicts of interest with respect to the content of this manuscript. Dr. Potenza has received financial support or compensation for the following: Dr. Potenza has consulted for and advised Boehringer Ingelheim and Lundbeck; has consulted for and has financial interests in Somaxon; has received research support from the National Institutes of Health, Veteran's Administration, Mohegan Sun Casino, the National Center for Responsible Gaming and its affiliated Institute for Research on Gambling Disorders, and Forest Laboratories, Psyadon, Ortho-McNeil, Oy-Control/Biotie, and Glaxo-SmithKline pharmaceuticals; has participated in surveys, mailings or telephone consultations related to drug addiction, impulse control disorders or other health topics; has consulted for law offices and the federal public defender's office in issues related to impulse control disorders; provides clinical care in the Connecticut Department of Mental Health and Addiction Services Problem Gambling Services Program; has performed grant reviews for the National Institutes of Health and other agencies; has given academic lectures in grand rounds, CME events and other clinical or scientific venues; and has generated books or book chapters for publishers of mental health texts. Dr. Grilo reports research grants from the National Institutes of Health, has given academic lectures in grand rounds and scientific conference venues, and has authored or co-authored academic books.

  • The contents of the manuscript are solely the responsibility of the authors and do not necessarily represent the official views of any of the funding agencies.

ABSTRACT

Objective

The primary purpose of this study was to examine neurobiological underpinnings of reward processing that may relate to treatment outcome for binge-eating disorder (BED).

Method

Prior to starting treatment, 19 obese persons seeking treatment for BED performed a monetary incentive delay task during functional magnetic resonance imaging (fMRI). Analyses examined how the neural correlates of reward processing related to binge-eating status after 4-months of treatment.

Results

Ten individuals continued to report binge-eating (BEpost-tx) following treatment and 9 individuals did not (NBEpost-tx). The groups did not differ in body mass index. The BEpost-tx group relative to the NBEpost-tx group showed diminished recruitment of the ventral striatum and the inferior frontal gyrus during the anticipatory phase of reward processing and reduced activity in the medial prefrontal cortex during the outcome phase of reward processing.

Discussion

These results link brain reward circuitry to treatment outcome in BED and suggest that specific brain regions underlying reward processing may represent important therapeutic targets in BED. © 2013 Wiley Periodicals, Inc. (Int J Eat Disord 2014; 47:376–384)

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