Hyperactivation in Neurobiological Circuit Found in Restrictive Food Disorder

A novel neurobiological circuit may be associated with generalized hyperactivation of multisensory processing, attention, and aversive conditioning among individuals with avoidant/restrictive food intake disorder (ARFID), according to study findings published in JAMA Network Open.

Researchers assessed whether individuals with ARFID exhibit disruptions in appetite, fear, and disgust brain regions when shown images of objects and food.

The researchers conducted a case-control study at a single academic medical center from July 2016 to January 2021 that included 110 children, adolescents, and young adults completing structured interviews and a validated functional magnetic resonance imaging (fMRI) food cue paradigm.

Participants with ARFID (n=75; mean [SD] age, 16.2 [3.8] years; 55% girls/women; 92% White) were recruited and age-matched with healthy control participants (n=35; mean [SD] age, 17.3 [4.0] years; 69% girls/women; 79% White).

Participants with ARFID vs healthy control individuals had greater activation of the anterior cingulate cortex (ACC) (mean difference [MD], 0.48; 95% CI, 0.19-0.77; P=.009), sensory association cortex (MD left side, 0.54; 95% CI, 0.29-0.79; P=.005; MD right side, 0.52; 95% CI, 0.28-0.76; P=.02), and supplementary motor cortex (MD, 0.81; 95% CI, 0.47-1.15; P=.040). No difference was found between the ARFID and the control groups for activation in response to food vs non-food images in the amygdala, hypothalamus, and insula.

Greater lack of interest was associated with lower right hypothalamus activation in the ARFID–lack of interest group (r=-0.38; 95% CI, -0.69 to -0.11; P=.03). While viewing food vs nonfood images, the ARFID–lack of interest group did not show lower hypothalamus activation vs the control group.

The ARFID-fear group showed greater amygdala activation vs the control group while viewing food vs nonfood images (MD, 0.49; 95% CI, 0.16-0.82; P =.040). No significant association was found between amygdala activation and the PARDI (Pica, ARFID, and Rumination Disorder Interview) fear of aversive consequences subscale within the ARFID-fear group.

Greater insula activation was not noted in the ARFID–sensory sensitivity group vs control group, although greater activation of the ACC was (MD, 0.48; 95% CI, 0.22-0.74; P =.005), as was greater activation of the somatosensory cortex (MD left side, 0.60; 95% CI, 0.33-0.87; P=.001; MD right side, 0.54, 95% CI, 0.29-0.80; P=.03).

“Results indicate generalized hyperactivation of ACC, sensory association cortex, and supplementary motor cortex in response to visual food stimuli in children, adolescents, and young adults with ARFID, suggesting a novel neurobiological circuit associated with this disorder,” the investigators concluded.

Study limitations include underpowered sample size for certain phenotype comparisons, wide age range and psychotropic medication use added to sample heterogeneity, and a preponderance of non-Hispanic White participants lacks generalizability to other groups.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

This article originally appeared on Psychiatry Advisor