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Open AccessArticle

Strengthened Default Mode Network Activation During Delay Discounting in Adolescents with Anorexia Nervosa After Partial Weight Restoration: A Longitudinal fMRI Study

1
Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Dresden University of Technology, 01069 Dresden, Germany
2
Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Faculty of Medicine, Dresden University of Technology, 01069 Dresden, Germany
3
Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, 01069 Dresden, Germany
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
J. Clin. Med. 2020, 9(4), 900; https://doi.org/10.3390/jcm9040900
Received: 24 February 2020 / Revised: 17 March 2020 / Accepted: 21 March 2020 / Published: 25 March 2020
The capacity of patients with anorexia nervosa (AN) to resist food-based rewards is often assumed to reflect excessive self-control. Previous cross-sectional functional magnetic resonance imaging (fMRI) studies utilizing the delay discounting (DD) paradigm, an index of impulsivity and self-control, suggested altered neural efficiency of decision-making in acutely underweight patients (acAN) and a relative normalization in long-term, weight-recovered individuals with a history of AN (recAN). The current longitudinal study tested for changes in functional magnetic resonance imaging (fMRI) activation during DD associated with intensive weight restoration treatment. A predominately adolescent cohort of 22 female acAN patients (mean age—15.5 years) performed an established DD paradigm during fMRI at the beginning of hospitalization and again after partial weight restoration (≥12% body mass index (BMI) increase). Analyses investigated longitudinal changes in both reward valuation and executive decision-making processes. Additional exploratory analyses included comparisons with data acquired in aged-matched healthy controls (HC) as well as probes of functional connectivity between empirically identified nodes of the “task-positive” frontoparietal control network (FPN) and “task-negative” default-mode network (DMN). While treatment was not associated with changes in behavioral DD parameters or activation, specific to reward processing, deactivation of the DMN during decision-making was significantly less pronounced following partial weight restoration. Strengthened DMN activation during DD might reflect a relative relaxation of cognitive overcontrol or improved self-referential, decision-making. Together, our findings present further evidence that aberrant decision-making in AN might be remediable by treatment and, therefore, might constitute an acute effect rather than a core trait variable of the disorder. View Full-Text
Keywords: anorexia nervosa; eating disorders; delay discounting; intertemporal choice; reward processing; self-control; functional magnetic resonance imaging; longitudinal; functional connectivity; weight restoration treatment anorexia nervosa; eating disorders; delay discounting; intertemporal choice; reward processing; self-control; functional magnetic resonance imaging; longitudinal; functional connectivity; weight restoration treatment
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Doose, A.; King, J.A.; Bernardoni, F.; Geisler, D.; Hellerhoff, I.; Weinert, T.; Roessner, V.; Smolka, M.N.; Ehrlich, S. Strengthened Default Mode Network Activation During Delay Discounting in Adolescents with Anorexia Nervosa After Partial Weight Restoration: A Longitudinal fMRI Study. J. Clin. Med. 2020, 9, 900.

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