Anterior cingulate activity in bulimia nervosa: A fMRI case study

Introduction Eating disordered patients (EDp) who binge-eat appear to present impulse control deficits that influence treatment outcome. The present bulimia nervosa (BN) study tests the function of brain areas involved in top-down control of behavior, associated with the anterior cingulate cortex (ACC), at the individual level. Methods ACC activity was analyzed in two women with BN and one matched control with a reliable and simple cue imperative target paradigm for response anticipation and response conflict processing using an event-related functional magnetic resonance imaging (fMRI) design. Results Patients showed meaningful ACC patterns of activation, less recruitment for response anticipation, and abnormal for response conflict, when they had to suppress an inappropriate response. Discussion Preliminary evidence suggests a BN neurocognitive model of impaired executive control-related brain activity. Reliable fMRI paradigms may be clinically useful to determine ACC dysfunction in EDp, to inform treatment and track changes.