Exposure to food in anorexia nervosa and brain correlates of food-related anxiety: findings from a pilot study

Katherine S. Young; Samantha J. Rennalls; Jenni Leppanen; David Mataix-Cols; Andrew Simmons; Masashi Suda; Iain C. Campbell; Owen O'Daly; Valentina Cardi

doi:10.1016/j.jad.2020.05.077

Exposure to food in anorexia nervosa and brain correlates of food-related anxiety: findings from a pilot study

Katherine S. Young, Samantha J. Rennalls, Jenni Leppanen, David Mataix-Cols, Andrew Simmons, Masashi Suda, Iain C. Campbell, Owen O'Daly, Valentina Cardi^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

11 Citations (Scopus)

Abstract

Background: Although the primary target of treatment for anorexia nervosa (AN) is weight gain, established psychological interventions focus on maintaining factors of AN, and do not specifically address eating behaviours. We have previously reported results of a case series investigating in-vivo food exposure in AN, demonstrating the feasibility and acceptability of this treatment together with evidence of significant clinical change (Cardi, Leppanen, Mataix‐Cols, Campbell, & Treasure, 2019). The current study examined the neural circuitry of food-related anxiety. Methods: We examined neural reactivity (fMRI) to food images pre- and post-food exposure therapy (n=16), and compared it to a group of healthy control participants (HC n=21) who were scanned on two occasions. Results: Prior to treatment, the AN group (compared to HC) showed less reactivity in the anterior cingulate cortex (ACC). Following exposure treatment, patients (compared to HC), show increased activity in the dorsolateral prefrontal cortex, decreased activity in the superior parietal lobe and no differences in the ACC. The level of activation of the insula (pre-treatment) predicted the degree of post-treatment reduction in self-reported food anxiety in AN. Changes in food-related anxiety were also associated with changes in neural activation in a cluster located in the middle temporal gyrus/lateral parietal cortex. Limitations: The primary limitations of this work are the small sample size and lack of patient comparison group. Conclusions: Exposure to food in AN may be associated with changes in neural circuitries implicated in emotion regulation and attentional processes. However, these findings need replication in larger and controlled studies.

Original language	English
Pages (from-to)	1068-1075
Number of pages	8
Journal	Journal of Affective Disorders
Volume	274
DOIs	https://doi.org/10.1016/j.jad.2020.05.077
Publication status	Published - 1 Sept 2020

Keywords

Anorexia Nervosa
Anxiety
Exposure
fMRI
Food
Treatment

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jad.2020.05.077

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@article{402106397b224df7865adcc217efe9ae,

title = "Exposure to food in anorexia nervosa and brain correlates of food-related anxiety: findings from a pilot study",

abstract = "Background: Although the primary target of treatment for anorexia nervosa (AN) is weight gain, established psychological interventions focus on maintaining factors of AN, and do not specifically address eating behaviours. We have previously reported results of a case series investigating in-vivo food exposure in AN, demonstrating the feasibility and acceptability of this treatment together with evidence of significant clinical change (Cardi, Leppanen, Mataix‐Cols, Campbell, & Treasure, 2019). The current study examined the neural circuitry of food-related anxiety. Methods: We examined neural reactivity (fMRI) to food images pre- and post-food exposure therapy (n=16), and compared it to a group of healthy control participants (HC n=21) who were scanned on two occasions. Results: Prior to treatment, the AN group (compared to HC) showed less reactivity in the anterior cingulate cortex (ACC). Following exposure treatment, patients (compared to HC), show increased activity in the dorsolateral prefrontal cortex, decreased activity in the superior parietal lobe and no differences in the ACC. The level of activation of the insula (pre-treatment) predicted the degree of post-treatment reduction in self-reported food anxiety in AN. Changes in food-related anxiety were also associated with changes in neural activation in a cluster located in the middle temporal gyrus/lateral parietal cortex. Limitations: The primary limitations of this work are the small sample size and lack of patient comparison group. Conclusions: Exposure to food in AN may be associated with changes in neural circuitries implicated in emotion regulation and attentional processes. However, these findings need replication in larger and controlled studies.",

keywords = "Anorexia Nervosa, Anxiety, Exposure, fMRI, Food, Treatment",

author = "Young, {Katherine S.} and Rennalls, {Samantha J.} and Jenni Leppanen and David Mataix-Cols and Andrew Simmons and Masashi Suda and Campbell, {Iain C.} and Owen O'Daly and Valentina Cardi",

year = "2020",

month = sep,

day = "1",

doi = "10.1016/j.jad.2020.05.077",

language = "English",

volume = "274",

pages = "1068--1075",

journal = "Journal of Affective Disorders",

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T1 - Exposure to food in anorexia nervosa and brain correlates of food-related anxiety

T2 - findings from a pilot study

AU - Young, Katherine S.

AU - Rennalls, Samantha J.

AU - Leppanen, Jenni

AU - Mataix-Cols, David

AU - Simmons, Andrew

AU - Suda, Masashi

AU - Campbell, Iain C.

AU - O'Daly, Owen

AU - Cardi, Valentina

PY - 2020/9/1

Y1 - 2020/9/1

N2 - Background: Although the primary target of treatment for anorexia nervosa (AN) is weight gain, established psychological interventions focus on maintaining factors of AN, and do not specifically address eating behaviours. We have previously reported results of a case series investigating in-vivo food exposure in AN, demonstrating the feasibility and acceptability of this treatment together with evidence of significant clinical change (Cardi, Leppanen, Mataix‐Cols, Campbell, & Treasure, 2019). The current study examined the neural circuitry of food-related anxiety. Methods: We examined neural reactivity (fMRI) to food images pre- and post-food exposure therapy (n=16), and compared it to a group of healthy control participants (HC n=21) who were scanned on two occasions. Results: Prior to treatment, the AN group (compared to HC) showed less reactivity in the anterior cingulate cortex (ACC). Following exposure treatment, patients (compared to HC), show increased activity in the dorsolateral prefrontal cortex, decreased activity in the superior parietal lobe and no differences in the ACC. The level of activation of the insula (pre-treatment) predicted the degree of post-treatment reduction in self-reported food anxiety in AN. Changes in food-related anxiety were also associated with changes in neural activation in a cluster located in the middle temporal gyrus/lateral parietal cortex. Limitations: The primary limitations of this work are the small sample size and lack of patient comparison group. Conclusions: Exposure to food in AN may be associated with changes in neural circuitries implicated in emotion regulation and attentional processes. However, these findings need replication in larger and controlled studies.

AB - Background: Although the primary target of treatment for anorexia nervosa (AN) is weight gain, established psychological interventions focus on maintaining factors of AN, and do not specifically address eating behaviours. We have previously reported results of a case series investigating in-vivo food exposure in AN, demonstrating the feasibility and acceptability of this treatment together with evidence of significant clinical change (Cardi, Leppanen, Mataix‐Cols, Campbell, & Treasure, 2019). The current study examined the neural circuitry of food-related anxiety. Methods: We examined neural reactivity (fMRI) to food images pre- and post-food exposure therapy (n=16), and compared it to a group of healthy control participants (HC n=21) who were scanned on two occasions. Results: Prior to treatment, the AN group (compared to HC) showed less reactivity in the anterior cingulate cortex (ACC). Following exposure treatment, patients (compared to HC), show increased activity in the dorsolateral prefrontal cortex, decreased activity in the superior parietal lobe and no differences in the ACC. The level of activation of the insula (pre-treatment) predicted the degree of post-treatment reduction in self-reported food anxiety in AN. Changes in food-related anxiety were also associated with changes in neural activation in a cluster located in the middle temporal gyrus/lateral parietal cortex. Limitations: The primary limitations of this work are the small sample size and lack of patient comparison group. Conclusions: Exposure to food in AN may be associated with changes in neural circuitries implicated in emotion regulation and attentional processes. However, these findings need replication in larger and controlled studies.

KW - Anorexia Nervosa

KW - Anxiety

KW - Exposure

KW - fMRI

KW - Food

KW - Treatment

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SN - 0165-0327

VL - 274

SP - 1068

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JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

ER -

Exposure to food in anorexia nervosa and brain correlates of food-related anxiety: findings from a pilot study

Abstract

Keywords

UN SDGs

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