Hunger does not motivate reward in women remitted from anorexia nervosa

Christina E. Wierenga, Amanda Bischoff-Grethe, A. James Melrose, Zoe Irvine, Laura Torres, Ursula F. Bailer, Alan Simmons, Julie L. Fudge, Samuel McClure, Alice Ely, Walter H. Kaye

Research output: Contribution to journalArticle

67 Citations (Scopus)

Abstract

Background Hunger enhances sensitivity to reward, yet individuals with anorexia nervosa (AN) are not motivated to eat when starved. This study investigated brain response to rewards during hunger and satiated states to examine whether diminished response to reward could underlie food restriction in AN. Methods Using a delay discounting monetary decision task known to discriminate brain regions contributing to processing of immediate rewards and cognitive control important for decision making regarding future rewards, we compared 23 women remitted from AN (RAN group; to reduce the confounding effects of starvation) with 17 healthy comparison women (CW group). Monetary rewards were used because the rewarding value of food may be confounded by anxiety in AN. Results Interactions of Group (RAN, CW) × Visit (hunger, satiety) revealed that, for the CW group, hunger significantly increased activation in reward salience circuitry (ventral striatum, dorsal caudate, anterior cingulate cortex) during processing of immediate reward, whereas satiety increased activation in cognitive control circuitry (ventrolateral prefrontal cortex, insula) during decision making. In contrast, brain response in reward and cognitive neurocircuitry did not differ during hunger and satiety in the RAN group. A main effect of group revealed elevated response in the middle frontal gyrus for the RAN group compared with the CW group. Conclusions Women remitted from AN failed to increase activation of reward valuation circuitry when hungry and showed elevated response in cognitive control circuitry independent of metabolic state. Decreased sensitivity to the motivational drive of hunger may explain the ability of individuals with AN to restrict food when emaciated. Difficulties in valuating emotional salience may contribute to inabilities to appreciate the risks inherent in this disorder.

Original languageEnglish (US)
Article number12353
Pages (from-to)642-652
Number of pages11
JournalBiological Psychiatry
Volume77
Issue number7
DOIs
StatePublished - Apr 1 2015
Externally publishedYes

Fingerprint

Hunger
Anorexia Nervosa
Reward
Food
Decision Making
Brain
Aptitude
Gyrus Cinguli
Starvation
Prefrontal Cortex
Anxiety

Keywords

  • Anorexia nervosa
  • Decision making
  • Delay discounting
  • Eating disorders
  • Functional MRI
  • Reward processing

ASJC Scopus subject areas

  • Biological Psychiatry

Cite this

Wierenga, C. E., Bischoff-Grethe, A., Melrose, A. J., Irvine, Z., Torres, L., Bailer, U. F., ... Kaye, W. H. (2015). Hunger does not motivate reward in women remitted from anorexia nervosa. Biological Psychiatry, 77(7), 642-652. [12353]. https://doi.org/10.1016/j.biopsych.2014.09.024

Hunger does not motivate reward in women remitted from anorexia nervosa. / Wierenga, Christina E.; Bischoff-Grethe, Amanda; Melrose, A. James; Irvine, Zoe; Torres, Laura; Bailer, Ursula F.; Simmons, Alan; Fudge, Julie L.; McClure, Samuel; Ely, Alice; Kaye, Walter H.

In: Biological Psychiatry, Vol. 77, No. 7, 12353, 01.04.2015, p. 642-652.

Research output: Contribution to journalArticle

Wierenga, CE, Bischoff-Grethe, A, Melrose, AJ, Irvine, Z, Torres, L, Bailer, UF, Simmons, A, Fudge, JL, McClure, S, Ely, A & Kaye, WH 2015, 'Hunger does not motivate reward in women remitted from anorexia nervosa', Biological Psychiatry, vol. 77, no. 7, 12353, pp. 642-652. https://doi.org/10.1016/j.biopsych.2014.09.024
Wierenga CE, Bischoff-Grethe A, Melrose AJ, Irvine Z, Torres L, Bailer UF et al. Hunger does not motivate reward in women remitted from anorexia nervosa. Biological Psychiatry. 2015 Apr 1;77(7):642-652. 12353. https://doi.org/10.1016/j.biopsych.2014.09.024
Wierenga, Christina E. ; Bischoff-Grethe, Amanda ; Melrose, A. James ; Irvine, Zoe ; Torres, Laura ; Bailer, Ursula F. ; Simmons, Alan ; Fudge, Julie L. ; McClure, Samuel ; Ely, Alice ; Kaye, Walter H. / Hunger does not motivate reward in women remitted from anorexia nervosa. In: Biological Psychiatry. 2015 ; Vol. 77, No. 7. pp. 642-652.
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abstract = "Background Hunger enhances sensitivity to reward, yet individuals with anorexia nervosa (AN) are not motivated to eat when starved. This study investigated brain response to rewards during hunger and satiated states to examine whether diminished response to reward could underlie food restriction in AN. Methods Using a delay discounting monetary decision task known to discriminate brain regions contributing to processing of immediate rewards and cognitive control important for decision making regarding future rewards, we compared 23 women remitted from AN (RAN group; to reduce the confounding effects of starvation) with 17 healthy comparison women (CW group). Monetary rewards were used because the rewarding value of food may be confounded by anxiety in AN. Results Interactions of Group (RAN, CW) × Visit (hunger, satiety) revealed that, for the CW group, hunger significantly increased activation in reward salience circuitry (ventral striatum, dorsal caudate, anterior cingulate cortex) during processing of immediate reward, whereas satiety increased activation in cognitive control circuitry (ventrolateral prefrontal cortex, insula) during decision making. In contrast, brain response in reward and cognitive neurocircuitry did not differ during hunger and satiety in the RAN group. A main effect of group revealed elevated response in the middle frontal gyrus for the RAN group compared with the CW group. Conclusions Women remitted from AN failed to increase activation of reward valuation circuitry when hungry and showed elevated response in cognitive control circuitry independent of metabolic state. Decreased sensitivity to the motivational drive of hunger may explain the ability of individuals with AN to restrict food when emaciated. Difficulties in valuating emotional salience may contribute to inabilities to appreciate the risks inherent in this disorder.",
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N2 - Background Hunger enhances sensitivity to reward, yet individuals with anorexia nervosa (AN) are not motivated to eat when starved. This study investigated brain response to rewards during hunger and satiated states to examine whether diminished response to reward could underlie food restriction in AN. Methods Using a delay discounting monetary decision task known to discriminate brain regions contributing to processing of immediate rewards and cognitive control important for decision making regarding future rewards, we compared 23 women remitted from AN (RAN group; to reduce the confounding effects of starvation) with 17 healthy comparison women (CW group). Monetary rewards were used because the rewarding value of food may be confounded by anxiety in AN. Results Interactions of Group (RAN, CW) × Visit (hunger, satiety) revealed that, for the CW group, hunger significantly increased activation in reward salience circuitry (ventral striatum, dorsal caudate, anterior cingulate cortex) during processing of immediate reward, whereas satiety increased activation in cognitive control circuitry (ventrolateral prefrontal cortex, insula) during decision making. In contrast, brain response in reward and cognitive neurocircuitry did not differ during hunger and satiety in the RAN group. A main effect of group revealed elevated response in the middle frontal gyrus for the RAN group compared with the CW group. Conclusions Women remitted from AN failed to increase activation of reward valuation circuitry when hungry and showed elevated response in cognitive control circuitry independent of metabolic state. Decreased sensitivity to the motivational drive of hunger may explain the ability of individuals with AN to restrict food when emaciated. Difficulties in valuating emotional salience may contribute to inabilities to appreciate the risks inherent in this disorder.

AB - Background Hunger enhances sensitivity to reward, yet individuals with anorexia nervosa (AN) are not motivated to eat when starved. This study investigated brain response to rewards during hunger and satiated states to examine whether diminished response to reward could underlie food restriction in AN. Methods Using a delay discounting monetary decision task known to discriminate brain regions contributing to processing of immediate rewards and cognitive control important for decision making regarding future rewards, we compared 23 women remitted from AN (RAN group; to reduce the confounding effects of starvation) with 17 healthy comparison women (CW group). Monetary rewards were used because the rewarding value of food may be confounded by anxiety in AN. Results Interactions of Group (RAN, CW) × Visit (hunger, satiety) revealed that, for the CW group, hunger significantly increased activation in reward salience circuitry (ventral striatum, dorsal caudate, anterior cingulate cortex) during processing of immediate reward, whereas satiety increased activation in cognitive control circuitry (ventrolateral prefrontal cortex, insula) during decision making. In contrast, brain response in reward and cognitive neurocircuitry did not differ during hunger and satiety in the RAN group. A main effect of group revealed elevated response in the middle frontal gyrus for the RAN group compared with the CW group. Conclusions Women remitted from AN failed to increase activation of reward valuation circuitry when hungry and showed elevated response in cognitive control circuitry independent of metabolic state. Decreased sensitivity to the motivational drive of hunger may explain the ability of individuals with AN to restrict food when emaciated. Difficulties in valuating emotional salience may contribute to inabilities to appreciate the risks inherent in this disorder.

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KW - Reward processing

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