neural correlates of reward and symptom expression in anorexia nervosa

Conditions: Anorexia Nervosa

Summary: the objective of this study is to identify the patterns of brain activity in reward circuitry that promote symptoms of anorexia nervosa. this project will compare weight-restored individuals with anorexia nervosa to a non-eating disorder control group on reward brain circuitry patterns in response to typically rewarding cues (i.e., entertaining videos) and disorder-specific restrictive eating cues (i.e., low-fat food choice) using fmri. in addition, this study will examine which neurobiological reward responses among weight-restored individuals with anorexia nervosa predict objective restrictive eating (measured by laboratory meal intake) and longitudinal risk of relapse one year later.

aim 1: to compare patterns of brain activity in reward circuits to typically rewarding cues and disorder-specific cues between weight-restored individuals with anorexia nervosa and non-eating disorder controls hypothesis 1a: activity in reward circuitry will be elevated in response to typically rewarding cues in the non-eating disorder control group versus weight-restored anorexia nervosa group. hypothesis 1b: activity in reward circuitry will be elevated in response to disorder-specific in the weight-restored anorexia nervosa group versus the non-eating disorder control group. aim 2: to specify the relationship between brain patterns related to reward and restrictive eating among weight-restored individuals with anorexia nervosa hypothesis 2a: lower reward circuit activity in response to typically rewarding cues will predict lower test meal intake for weight-restored anorexia nervosa group versus the non-eating disorder control group. hypothesis 2b: higher reward circuit activity in response to disorder-specific cues will predict lower test meal intake for the weight-restored anorexia nervosa group versus the non-eating disorder control group. aim 3: to identify the brain patterns in reward circuitry associated with the risk of relapse among weight-restored individuals with anorexia nervosa in the year following weight-restoration. hypothesis 3a: lower reward circuit activity in response to typically rewarding cues will predict relapse in the weight-restored anorexia nervosa group. hypothesis 3b: higher reward circuit activity in response to disorder-specific cues will predict relapse in the weight-restored anorexia nervosa group.

Eligibility criteria:
inclusion criteria: * age \> 18 years old * current bmi \> 18.5 kg/m2 * ability to read and speak in english * right-handed * weight restored anorexia nervosa group: 1) dsm-5 diagnosis of an in the past 6 months, with the exception of body image disturbance and intense fear of weight gain criteria; 2) bmi \< 18.5 kg/m2 within past 6 months exclusion criteria: * medical instability or current pregnancy * current substance use disorder, psychosis, or bipolar-i disorder * contraindication for fmri * history of neurological disorder/injury (e.g., stroke; head injury with \> 10 minutes loss of consciousness) * food allergy that cannot be accommodated through substitutions to the laboratory test meal * lacking capacity to consent * non-eating disorder control group: current dsm-5 axis-i diagnosis or current or past eating disorder diagnosis