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Dorsolateral prefrontal cortex and amygdala function during cognitive reappraisal predicts weight restoration and emotion regulation impairment in anorexia nervosa

Published online by Cambridge University Press:  23 July 2020

Trevor Steward
Affiliation:
Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III, Barcelona, Spain Department of Psychiatry, Bellvitge University Hospital -IDIBELL, Barcelona, Spain
Ignacio Martínez-Zalacaín
Affiliation:
Department of Psychiatry, Bellvitge University Hospital -IDIBELL, Barcelona, Spain Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
Gemma Mestre-Bach
Affiliation:
Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III, Barcelona, Spain Department of Psychiatry, Bellvitge University Hospital -IDIBELL, Barcelona, Spain Facultad de Ciencias de la Salud, Universidad Internacional de La Rioja, La Rioja, Spain
Isabel Sánchez
Affiliation:
Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III, Barcelona, Spain Department of Psychiatry, Bellvitge University Hospital -IDIBELL, Barcelona, Spain
Nadine Riesco
Affiliation:
Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III, Barcelona, Spain Department of Psychiatry, Bellvitge University Hospital -IDIBELL, Barcelona, Spain
Susana Jiménez-Murcia
Affiliation:
Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III, Barcelona, Spain Department of Psychiatry, Bellvitge University Hospital -IDIBELL, Barcelona, Spain Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
Jose A Fernández-Formoso
Affiliation:
Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III, Barcelona, Spain
Misericordia Veciana de las Heras
Affiliation:
Neurology Department, Bellvitge University Hospital-IDIBELL, Barcelona, Spain
Nuria Custal
Affiliation:
Department of Psychiatry, Bellvitge University Hospital -IDIBELL, Barcelona, Spain
Jose M Menchón
Affiliation:
Department of Psychiatry, Bellvitge University Hospital -IDIBELL, Barcelona, Spain Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain Ciber Mental Health (CIBERSAM), Instituto Salud Carlos III, Barcelona, Spain
Carles Soriano-Mas*
Affiliation:
Department of Psychiatry, Bellvitge University Hospital -IDIBELL, Barcelona, Spain Ciber Mental Health (CIBERSAM), Instituto Salud Carlos III, Barcelona, Spain Department of Psychobiology and Methodology, Universitat Autònoma de Barcelona, Barcelona, Spain
Fernando Fernandez-Aranda*
Affiliation:
Ciber Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto Salud Carlos III, Barcelona, Spain Department of Psychiatry, Bellvitge University Hospital -IDIBELL, Barcelona, Spain Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
*
Author for correspondence: Fernando Fernández-Aranda, E-mail: ffernandez@bellvitgehospital.cat, Carles Soriano-Mas, E-mail: csoriano@idibell.cat
Author for correspondence: Fernando Fernández-Aranda, E-mail: ffernandez@bellvitgehospital.cat, Carles Soriano-Mas, E-mail: csoriano@idibell.cat

Abstract

Background

Although deficits in affective processing are a core component of anorexia nervosa (AN), we lack a detailed characterization of the neurobiological underpinnings of emotion regulation impairment in AN. Moreover, it remains unclear whether these neural correlates scale with clinical outcomes.

Methods

We investigated the neural correlates of negative emotion regulation in a sample of young women receiving day-hospital treatment for AN (n = 21) and healthy controls (n = 21). We aimed to determine whether aberrant brain activation patterns during emotion regulation predicted weight gain following treatment in AN patients and were linked to AN severity. To achieve this, participants completed a cognitive reappraisal paradigm during functional magnetic resonance imaging. Skin conductance response, as well as subjective distress ratings, were recorded to corroborate task engagement.

Results

Compared to controls, patients with AN showed reduced activation in the dorsolateral prefrontal cortex (dlPFC) during cognitive reappraisal [pFWE<0.05, threshold-free cluster enhancement (TFCE) corrected]. Importantly, psycho–physiological interaction analysis revealed reduced functional connectivity between the dlPFC and the amygdala in AN patients during emotion regulation (pFWE<0.05, TFCE corrected), and dlPFC-amygdala uncoupling was associated with emotion regulation deficits (r = −0.511, p = 0.018) and eating disorder severity (r = −0.565, p = .008) in the AN group. Finally, dlPFC activity positively correlated with increases in body mass index (r = 0.471, p = 0.042) and in body fat mass percentage (r = 0.605, p = 0.008) following 12 weeks of treatment.

Conclusions

Taken together, our findings indicate that individuals with AN present altered fronto-amygdalar response during cognitive reappraisal and that this response may serve as a predictor of response to treatment and be linked to clinical severity.

Type
Original Articles
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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Footnotes

*

These authors contributed equally to this work.

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Dorsolateral prefrontal cortex and amygdala function during cognitive reappraisal predicts weight restoration and emotion regulation impairment in anorexia nervosa
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