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Published August 5, 2021 | Published
Journal Article Open

White matter tracts characteristics in habitual decision-making circuit underlie ritual behaviors in anorexia nervosa


Anorexia nervosa (AN) is a difficult to treat, pernicious psychiatric disorder that has been linked to decision-making abnormalities. We examined the structural characteristics of habitual and goal-directed decision-making circuits and their connecting white matter tracts in 32 AN and 43 healthy controls across two independent data sets of adults and adolescents as an explanatory sub-study. Total bilateral premotor/supplementary motor area-putamen tracts in the habit circuit had a significantly higher volume in adults with AN, relative to controls. Positive correlations were found between both the number of tracts and white matter volume (WMV) in the habit circuit, and the severity of ritualistic/compulsive behaviors in adults and adolescents with AN. Moreover, we found a significant influence of the habit circuit WMV on AN ritualistic/compulsive symptom severity, depending on the preoccupations symptom severity levels. These findings suggest that AN is associated with white matter plasticity alterations in the habit circuit. The association between characteristics of habit circuit white matter tracts and AN behavioral symptoms provides support for a circuit based neurobiological model of AN, and identifies the habit circuit as a focus for further investigation to aid in development of novel and more effective treatments based on brain-behavior relationships.

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© The Author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Received 03 June 2021; Accepted 16 July 2021; Published 05 August 2021. This work was supported by National Institute of Mental Health (JDF and MS, R01MH105662 and R01MH093535). RT research is supported by National Institute of Mental Health (K23MH116117, R01MH121089) and Brain & Behavior Research Foundation (NARSAD-27111). Author Contributions: R.T.N., J.P.O. and J.D.F. contributed to the conception and design of the work. R.T.N., F.P., W.M.P. and G.C. contributed to the data analysis. R.T.N., S.B.M., A.A.B., J.P.O. and J.D.F. contributed to the interpretation of the results. R.T.N., S.B.M., A.A.B., M.S. and J.D.F. wrote the main manuscript text. All authors reviewed the manuscript. The authors declare no competing interests.

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