Anorexia nervosa (AN) is characterized by a relentless pursuit of thinness, despite serious implications for health and social relations. In a previous study wielding the power of computational psychiatry, we found alterations in learning from negative feedback and in neural activity in the posterior medial frontal cortex (pMFC) in young acutely underweight AN patients (acAN). Here we ask whether these abnormalities are merely a state-related consequence of the illness or whether they might constitute a trait marker predisposing individuals to AN. To address this question, we employed the same reinforcement learning paradigm during fMRI with 31 female former AN patients after complete weight-recovery (recAN) and 31 age-matched healthy volunteers (15-28 years). Participants performed a decision task that required adaptation to changing reward contingencies. Data were analyzed within a hierarchical Gaussian filter model, which captures interindividual variability in feedback learning and decision-making under uncertainty. Similar to acute patients, individuals recovered from AN appear to emphasize negative over positive feedback when updating expectations regarding changing reward-punishment contingencies (difference in learning rate between punished and rewarded trials was increased in recAN: p = .006, d = .70. This behavioral pattern was mirrored in hyperactivation of the pMFC following negative feedback (FWE p < .001). Because the previously observed alterations in acANs are also evident after recovery and do not correlate with state variables like weight, altered feedback learning might be a trait marker of AN. The neural underpinnings of these alterations may lie in the pMFC. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

中文翻译：

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更多的是坚持而不是胡萝卜：一种根植于神经性厌食症内侧额叶皮层的强化学习风格。

尽管对健康和社会关系有严重影响，但神经性厌食症 (AN) 的特点是对瘦的不懈追求。在之前的一项利用计算精神病学的力量进行的研究中，我们发现年轻的急性体重不足 AN 患者 (acAN) 的负反馈学习和后内侧额叶皮层 (pMFC) 的神经活动发生了变化。在这里，我们询问这些异常是否仅仅是疾病的状态相关后果，或者它们是否可能构成使个体易患 AN 的特征标记。为了解决这个问题，我们在 fMRI 期间对 31 名完全体重恢复 (recAN) 的女性前 AN 患者和 31 名年龄匹配的健康志愿者（15-28 岁）采用了相同的强化学习范式。参与者执行了一项决策任务，需要适应不断变化的奖励突发事件。在分层高斯滤波器模型中分析数据，该模型捕捉不确定性下反馈学习和决策的个体差异。与急性患者类似，从 AN 中恢复的个体在更新有关不断变化的奖励-惩罚偶然性的预期时似乎强调负面反馈而不是正面反馈（recAN 中惩罚和奖励试验之间的学习率差异增加：p = .006，d = .70。这种行为模式反映在负反馈后 pMFC 的过度激活中（FWE p < .001）。因为之前观察到的 acAN 的变化在恢复后也很明显，并且与体重等状态变量无关，改变的反馈学习可能是 AN 的特征标记。这些改变的神经基础可能在于 pMFC。（PsycInfo 数据库记录 (c) 2021 APA，保留所有权利）。