Abstract
Anorexia nervosa (AN) is a difficult to treat, pernicious psychiatric disorder that has been linked to decision-making abnormalities. We examined the structural characteristics of habitual and goal-directed decision-making circuits and their connecting white matter tracts in 32 AN and 43 healthy controls across two independent data sets of adults and adolescents as an explanatory sub-study. Total bilateral premotor/supplementary motor area-putamen tracts in the habit circuit had a significantly higher volume in adults with AN, relative to controls. Positive correlations were found between both the number of tracts and white matter volume (WMV) in the habit circuit, and the severity of ritualistic/compulsive behaviors in adults and adolescents with AN. Moreover, we found a significant influence of the habit circuit WMV on AN ritualistic/compulsive symptom severity, depending on the preoccupations symptom severity levels. These findings suggest that AN is associated with white matter plasticity alterations in the habit circuit. The association between characteristics of habit circuit white matter tracts and AN behavioral symptoms provides support for a circuit based neurobiological model of AN, and identifies the habit circuit as a focus for further investigation to aid in development of novel and more effective treatments based on brain-behavior relationships.
Highlights
Anorexia nervosa (AN) is a difficult to treat, pernicious psychiatric disorder that has been linked to decision-making abnormalities
In the adolescent study, where Yale-Brown-Cornell Eating Disorder Scale (YBC-EDS) was used to quantify preoccupations and rituals severity for both AN and healthy groups, the AN group showed significantly higher YBC-EDS scores compared with controls
We assessed the biophysical characteristics of gray matter regions and connecting white matter tracts within habit and goal-directed decision-making neurocircuitries in two groups of adults and adolescents with AN
Summary
Anorexia nervosa (AN) is a difficult to treat, pernicious psychiatric disorder that has been linked to decision-making abnormalities. We examined the structural characteristics of habitual and goal-directed decision-making circuits and their connecting white matter tracts in 32 AN and 43 healthy controls across two independent data sets of adults and adolescents as an explanatory sub-study. A theory posits that the behavioral symptoms in many with AN originally manifest as goal-directed weight loss behavior, which is operantly maintained by weight loss; over time and with significant repetition, these become habit-based, persisting irrespective of the presence of rewards, and even in the context of potentially lethal medical sequelae. A theory posits that the behavioral symptoms in many with AN originally manifest as goal-directed weight loss behavior, which is operantly maintained by weight loss; over time and with significant repetition, these become habit-based, persisting irrespective of the presence of rewards, and even in the context of potentially lethal medical sequelae10,11 Those with AN generally demonstrate high self-reported habit strength, relative to healthy c ontrols[12]. In this study functional connectivity between the dorsal striatum and dorsolateral prefrontal cortex was negatively associated with actual food intake in a lab setting, suggesting that maladaptive food choices in AN may implicate circuitry underlying habitual behavior[23].Alongside these mixed results from fMRI studies, a noteworthy absence in the current literature in AN is any examination of white matter tracts related to habitual behaviors
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