BackgroundAdolescence is a critical developmental period for the study of anorexia nervosa (AN), an illness characterized by extreme restriction of food intake. The maturation of the reward system during adolescence combined with recent neurobiological models of AN led to the hypothesis that early on in illness, restrictive food choices would be associated with activity in nucleus accumbens reward regions, rather than caudate regions identified among adults with AN.MethodsHealthy adolescents (HC, n = 41) and adolescents with AN or atypical AN (atypAN, n = 76) completed a Food Choice Task during fMRI scanning. Selection of high‐fat foods and choice‐related activation in nucleus accumbens and anterior caudate regions‐of‐interest (ROIs) were compared between individuals with AN/atypAN and HC. Associations were examined between choice‐related activation and choice preferences among the AN group. Exploratory analyses examined associations between choice‐related activation and psychological assessments among the patient group.ResultsAdolescents with AN or atypAN selected fewer high‐fat foods than HC (t = −5.92, p < .001). Counter to predictions, there were no significant group differences in choice‐related activation in the ROIs. Among individuals with AN or atypAN, choice‐related neural activity in the anterior caudate was significantly negatively associated with high‐fat food selections in the task (r = −.32, p = .024). In exploratory analyses, choice‐related anterior caudate activation was positively associated with psychological measures of illness severity among patients (p's < .05, uncorrected).ConclusionsIn this large cohort of adolescents with AN/atypAN, there was no evidence of altered reward system engagement during food choice. While there was no group difference in choice‐related caudate activation, the associations with choices and psychological measures continue to suggest that this neural region is implicated in illness. Longitudinal analyses will clarify whether neural variability relates to longer‐term course.

中文翻译：

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青少年神经性厌食症和非典型神经性厌食症的食物选择和神经奖励系统


背景青春期是研究神经性厌食症 （AN） 的关键发育时期，神经性厌食症是一种以极度限制食物摄入为特征的疾病。青春期奖励系统的成熟与最近的 AN 神经生物学模型相结合，导致假设在疾病早期，限制性食物选择与伏隔核奖励区的活动有关，而不是与成年 AN 患者中发现的尾状核区有关。方法健康青少年 （HC， n = 41） 和患有 AN 或非典型 AN 的青少年 （atypAN， n = 76） 在 fMRI 扫描期间完成了一项食物选择任务。比较了 AN/atypAN 和 HC 个体中伏隔核和前尾状核感兴趣区域 （ROI） 中的高脂肪食物选择和选择相关激活。研究了 AN 组中与选择相关的激活与选择偏好之间的关联。探索性分析检查了患者组中与选择相关的激活与心理评估之间的关联。结果患有 AN 或 atypAN 的青少年选择的高脂肪食物比 HC 少 （t = -5.92，p < .001）。与预测相反，ROI 中与选择相关的激活没有显着的组差异。在患有 AN 或 atypAN 的个体中，尾状状核前部与选择相关的神经活动与任务中的高脂肪食物选择呈显著负相关 （r = −.32，p = .024）。在探索性分析中，选择相关的前尾状核激活与患者疾病严重程度的心理测量呈正相关 （p's < .05，未校正）。结论在这一大群患有 AN/atypAN 的青少年中，没有证据表明在食物选择过程中奖励系统参与度发生了变化。 虽然在选择相关的尾状核激活方面没有组别差异，但与选择和心理测量的关联继续表明该神经区域与疾病有关。纵向分析将阐明神经变异性是否与长期病程有关。