Self-regulatory control of eating: an fnir study of bulimia nervosa

Laura A. Berner

doi:10.17918/etd-7030

Bulimia nervosa (BN) is a serious disorder associated with significant medical complications and high rates of comorbid psychopathology. Evidence suggests that individuals with BN exhibit deficits in self-regulatory control; however, research directly linking self-regulatory deficits and neural activation to clinically meaningful behaviors in BN is lacking. The present study used functional near-infrared spectroscopy (fNIR) to measure prefrontal cortical (PFC) neural activation in 23 women with BN and 23 group-matched healthy controls during performance of a standard go/no-go task and a novel, eating-specific go/no-go task that requires participants to inhibit a prepotent tendency to sip and swallow a palatable shake. Multilevel models were used to examine between-group differences in performance and neural activation and to investigate, within the BN group, the relationship between inhibitory control-associated PFC activation and illness severity. Women with BN made more errors on both the standard and eating-specific tasks than control participants did. BN women demonstrated deficient medial prefrontal activation compared with controls when engaging self-regulatory control on the standard go/no-go task, and deactivated medial and right ventrolateral PFC when engaging self-regulatory control over sipping responses on the eating task. More frequent binge eating was associated with greater deactivation in medial and ventrolateral PFC on the sipping task. Between-group activation differences remained statistically significant after correction for multiple comparisons only in sipping-task analyses and only when BN participants with comorbid depression or generalized anxiety disorder or those taking psychotropic medications at the time of study were excluded. Results lend further support to a growing body of evidence that both general and eating-specific self-regulation is impaired in BN. In addition, they preliminarily suggest that deficient engagement of medial and lateral PFC is associated with general inhibitory control deficits in this population, while deactivation of these regions may contribute to binge eating. These initial findings enhance our understanding of prefrontal neural mechanisms that may contribute to the development and maintenance of BN and could serve as useful targets for intervention.

Self-regulatory control of eating: an fnir study of bulimia nervosa

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Self-regulatory control of eating: an fnir study of bulimia nervosa

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