Neural Correlates of Impaired Reward-Effort Integration in Remitted Bulimia Nervosa.

Müller, Stefanie Verena; Morishima, Yosuke; Schwab, Simon; Wiest, Roland; Federspiel, Andrea; Hasler, Gregor (2018). Neural Correlates of Impaired Reward-Effort Integration in Remitted Bulimia Nervosa. Neuropsychopharmacology, 43(4), pp. 868-876. Nature Publishing Group 10.1038/npp.2017.277

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The integration of reward magnitudes and effort costs is required for an effective behavioral guidance. This reward-effort integration was reported to be dependent on dopaminergic neurotransmission. As bulimia nervosa has been associated with a dysregulated dopamine system and catecholamine depletion led to reward processing deficits in remitted bulimia nervosa, the purpose of this study was to identify the role of catecholamine dysfunction and its relation to behavioral and neural reward-effort integration in bulimia nervosa. To investigate the interaction between catecholamine functioning and behavioral, and neural responses directly, 17 remitted bulimic (rBN) and 21 healthy individuals (HC) received alpha-methyl-paratyrosine (AMPT) over 24 h to achieve catecholamine depletion in a randomized, crossover study design. We used functional magnetic resonance imaging (fMRI) and the Monetary Incentive Delay (MID) task to assess reward-effort integration in relation to catecholaminergic neurotransmission at the behavioral and neural level. AMPT reduced the ability to integrate rewards and efforts effectively in HC participants. In contrast, in rBN participants, the reduced reward-effort integration was associated with illness duration in the sham condition and unrelated to catecholamine depletion. Regarding neural activation, AMPT decreased the reward anticipation-related neural activation in the anteroventral striatum. This decrease was associated with the AMPT-induced reduction of monetary earning in HC in contrast to rBN participants. Our findings contributed to the theory of a desensitized dopaminergic system in bulimia nervosa. A disrupted processing of reward magnitudes and effort costs might increase the probability of maintenance of bulimic symptoms.Neuropsychopharmacology accepted article preview online, 06 November 2017. doi:10.1038/npp.2017.277.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > Translational Research Center
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Müller, Stefanie Verena, Morishima, Yosuke, Schwab, Simon Gabriel, Wiest, Roland Gerhard Rudi, Federspiel, Andrea, Hasler, Gregor


600 Technology > 610 Medicine & health




Nature Publishing Group


[4] Swiss National Science Foundation




Martin Zbinden

Date Deposited:

06 Dec 2017 15:54

Last Modified:

02 Mar 2023 23:29

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

bulimia nervosa; catecholamine depletion; alpha-methyl-paratyrosine; monetary incentive delay task; anteroventral striatum; reward


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