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Altered Medial Frontal Feedback Learning Signals in Anorexia Nervosa

  • Fabio Bernardoni
    Affiliations
    Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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  • Daniel Geisler
    Affiliations
    Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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  • Joseph A. King
    Affiliations
    Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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  • Amir-Homayoun Javadi
    Affiliations
    School of Psychology, University of Kent, Canterbury, United Kingdom
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  • Franziska Ritschel
    Affiliations
    Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany

    Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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  • Julia Murr
    Affiliations
    Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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  • Andrea M.F. Reiter
    Affiliations
    Institute of General Psychology, Biopsychology and Methods of Psychology, Department of Psychology, Technische Universität Dresden, Dresden, Germany

    Lifespan Developmental Neuroscience, Technische Universität Dresden, Dresden, Germany
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  • Veit Rössner
    Affiliations
    Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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  • Michael N. Smolka
    Affiliations
    Department of Psychiatry and Neuroimaging, Technische Universität Dresden, Dresden, Germany
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  • Stefan Kiebel
    Affiliations
    Institute of General Psychology, Biopsychology and Methods of Psychology, Department of Psychology, Technische Universität Dresden, Dresden, Germany

    Department of Psychiatry and Neuroimaging, Technische Universität Dresden, Dresden, Germany
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  • Stefan Ehrlich
    Correspondence
    Address correspondence to Stefan Ehrlich, M.D., Faculty of Medicine, Technische Universität Dresden, Division of Psychological and Social Medicine and Developmental Neuroscience, University Hospital C. G. Carus, Fetscherstraße 74, 01307 Dresden, Germany.
    Affiliations
    Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany

    Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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      Abstract

      Background

      In their relentless pursuit of thinness, individuals with anorexia nervosa (AN) engage in maladaptive behaviors (restrictive food choices and overexercising) that may originate in altered decision making and learning.

      Methods

      In this functional magnetic resonance imaging study, we employed computational modeling to elucidate the neural correlates of feedback learning and value-based decision making in 36 female patients with AN and 36 age-matched healthy volunteers (12–24 years). Participants performed a decision task that required adaptation to changing reward contingencies. Data were analyzed within a hierarchical Gaussian filter model that captures interindividual variability in learning under uncertainty.

      Results

      Behaviorally, patients displayed an increased learning rate specifically after punishments. At the neural level, hemodynamic correlates for the learning rate, expected value, and prediction error did not differ between the groups. However, activity in the posterior medial frontal cortex was elevated in AN following punishment.

      Conclusions

      Our findings suggest that the neural underpinning of feedback learning is selectively altered for punishment in AN.

      Keywords

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