Neural effects of deep brain stimulation on reward and loss anticipation and food viewing in anorexia nervosa: a pilot study
Abstract Background Anorexia nervosa (AN) is a severe and life-threatening psychiatric disorder. Initial studies on deep brain stimulation (DBS) in severe, treatment-refractory AN have shown clinical effects. However, the working mechanisms of DBS in AN remain largely unknown. Here, we used a task-b...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | Journal of Eating Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40337-023-00863-3 |
| _version_ | 1827725182587895808 |
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| author | M. S. Oudijn J. T. W. Linders A. Lok P. R. Schuurman P. van den Munckhof A. A. van Elburg G. A. van Wingen R. J. T. Mocking D. Denys |
| author_facet | M. S. Oudijn J. T. W. Linders A. Lok P. R. Schuurman P. van den Munckhof A. A. van Elburg G. A. van Wingen R. J. T. Mocking D. Denys |
| author_sort | M. S. Oudijn |
| collection | DOAJ |
| description | Abstract Background Anorexia nervosa (AN) is a severe and life-threatening psychiatric disorder. Initial studies on deep brain stimulation (DBS) in severe, treatment-refractory AN have shown clinical effects. However, the working mechanisms of DBS in AN remain largely unknown. Here, we used a task-based functional MRI approach to understand the pathophysiology of AN. Methods We performed functional MRI on four AN patients that participated in a pilot study on the efficacy, safety, and functional effects of DBS targeted at the ventral limb of the capsula interna (vALIC). The patients and six gender-matched healthy controls (HC) were investigated at three different time points. We used an adapted version of the monetary incentive delay task to probe generic reward processing in patients and controls, and a food-specific task in patients only. Results At baseline, no significant differences for reward anticipation were found between AN and HC. Significant group (AN and HC) by time (pre- and post-DBS) interactions were found in the right precuneus, right putamen, right ventral and medial orbitofrontal cortex (mOFC). No significant interactions were found in the food viewing task, neither between the conditions high-calorie and low-calorie food images nor between the different time points. This could possibly be due to the small sample size and the lack of a control group. Conclusion The results showed a difference in the response of reward-related brain areas post-DBS. This supports the hypotheses that the reward circuitry is involved in the pathogenesis of AN and that DBS affects responsivity of reward-related brain areas. Trial registration Registered in the Netherlands Trial Register ( https://www.trialregister.nl/trial/3322 ): NL3322 (NTR3469). |
| first_indexed | 2024-03-10T22:24:54Z |
| format | Article |
| id | doaj.art-279f6f9240164329b9efdc7e1b90af85 |
| institution | Directory Open Access Journal |
| issn | 2050-2974 |
| language | English |
| last_indexed | 2024-03-10T22:24:54Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Eating Disorders |
| spelling | doaj.art-279f6f9240164329b9efdc7e1b90af852023-11-19T12:07:43ZengBMCJournal of Eating Disorders2050-29742023-08-0111111210.1186/s40337-023-00863-3Neural effects of deep brain stimulation on reward and loss anticipation and food viewing in anorexia nervosa: a pilot studyM. S. Oudijn0J. T. W. Linders1A. Lok2P. R. Schuurman3P. van den Munckhof4A. A. van Elburg5G. A. van Wingen6R. J. T. Mocking7D. Denys8Department of Psychiatry and Neurosurgery, Amsterdam University Medical Centers (AUMC)-Academic Medical Center (AMC), University of Amsterdam (UvA)Department of Psychiatry and Neurosurgery, Amsterdam University Medical Centers (AUMC)-Academic Medical Center (AMC), University of Amsterdam (UvA)Department of Psychiatry and Neurosurgery, Amsterdam University Medical Centers (AUMC)-Academic Medical Center (AMC), University of Amsterdam (UvA)Department of Psychiatry and Neurosurgery, Amsterdam University Medical Centers (AUMC)-Academic Medical Center (AMC), University of Amsterdam (UvA)Department of Psychiatry and Neurosurgery, Amsterdam University Medical Centers (AUMC)-Academic Medical Center (AMC), University of Amsterdam (UvA)Faculty of Social Sciences, University of UtrechtDepartment of Psychiatry and Neurosurgery, Amsterdam University Medical Centers (AUMC)-Academic Medical Center (AMC), University of Amsterdam (UvA)Department of Psychiatry and Neurosurgery, Amsterdam University Medical Centers (AUMC)-Academic Medical Center (AMC), University of Amsterdam (UvA)Department of Psychiatry and Neurosurgery, Amsterdam University Medical Centers (AUMC)-Academic Medical Center (AMC), University of Amsterdam (UvA)Abstract Background Anorexia nervosa (AN) is a severe and life-threatening psychiatric disorder. Initial studies on deep brain stimulation (DBS) in severe, treatment-refractory AN have shown clinical effects. However, the working mechanisms of DBS in AN remain largely unknown. Here, we used a task-based functional MRI approach to understand the pathophysiology of AN. Methods We performed functional MRI on four AN patients that participated in a pilot study on the efficacy, safety, and functional effects of DBS targeted at the ventral limb of the capsula interna (vALIC). The patients and six gender-matched healthy controls (HC) were investigated at three different time points. We used an adapted version of the monetary incentive delay task to probe generic reward processing in patients and controls, and a food-specific task in patients only. Results At baseline, no significant differences for reward anticipation were found between AN and HC. Significant group (AN and HC) by time (pre- and post-DBS) interactions were found in the right precuneus, right putamen, right ventral and medial orbitofrontal cortex (mOFC). No significant interactions were found in the food viewing task, neither between the conditions high-calorie and low-calorie food images nor between the different time points. This could possibly be due to the small sample size and the lack of a control group. Conclusion The results showed a difference in the response of reward-related brain areas post-DBS. This supports the hypotheses that the reward circuitry is involved in the pathogenesis of AN and that DBS affects responsivity of reward-related brain areas. Trial registration Registered in the Netherlands Trial Register ( https://www.trialregister.nl/trial/3322 ): NL3322 (NTR3469).https://doi.org/10.1186/s40337-023-00863-3Anorexia nervosaDeep brain stimulationTreatment-refractoryBody Mass IndexNeurosurgeryClinical trial |
| spellingShingle | M. S. Oudijn J. T. W. Linders A. Lok P. R. Schuurman P. van den Munckhof A. A. van Elburg G. A. van Wingen R. J. T. Mocking D. Denys Neural effects of deep brain stimulation on reward and loss anticipation and food viewing in anorexia nervosa: a pilot study Journal of Eating Disorders Anorexia nervosa Deep brain stimulation Treatment-refractory Body Mass Index Neurosurgery Clinical trial |
| title | Neural effects of deep brain stimulation on reward and loss anticipation and food viewing in anorexia nervosa: a pilot study |
| title_full | Neural effects of deep brain stimulation on reward and loss anticipation and food viewing in anorexia nervosa: a pilot study |
| title_fullStr | Neural effects of deep brain stimulation on reward and loss anticipation and food viewing in anorexia nervosa: a pilot study |
| title_full_unstemmed | Neural effects of deep brain stimulation on reward and loss anticipation and food viewing in anorexia nervosa: a pilot study |
| title_short | Neural effects of deep brain stimulation on reward and loss anticipation and food viewing in anorexia nervosa: a pilot study |
| title_sort | neural effects of deep brain stimulation on reward and loss anticipation and food viewing in anorexia nervosa a pilot study |
| topic | Anorexia nervosa Deep brain stimulation Treatment-refractory Body Mass Index Neurosurgery Clinical trial |
| url | https://doi.org/10.1186/s40337-023-00863-3 |
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