Neural Correlates of Failed Inhibitory Control as an Early Marker of Disordered Eating in Adolescents

Background: Binge eating and other forms of disordered eating behavior (DEB) are associated with failed inhibitory control. This study investigated the neural correlates of failed inhibitory control as a potential biomarker for DEB.
Methods: The study used prospective longitudinal data from the European IMAGEN adolescent cohort. Participants completed baseline assessments (questionnaires and a brain scan [functional magnetic resonance imaging, fMRI]) at age 14, and a follow-up assessment (questionnaires) at 16. Self-reported binge eating and/or purging were used to indicate presence of DEB. Neural correlates of failed inhibition were assessed using the stop signal task. Participants were categorized as: Healthy Controls (reported no DEB at both time-points); Maintainers (reported DEB at both time-points); Recoverers (reported DEB at baseline only); and Developers (reported DEB at follow-up only). Forty-three individuals per group with complete scanning data were matched on gender, age, puberty and intelligence (N=172).
Results: At baseline, despite similar task performance, incorrectly responding to stop signals (failed inhibitory control) was associated with greater recruitment of the medial prefrontal cortex and anterior cingulate cortex in the Developers compared to Healthy Controls and Recoverers.
Conclusion: Greater recruitment of medial prefrontal and anterior cingulate regions during failed inhibition accords with abnormal evaluation of errors contributing to DEB development. As this precedes symptom onset, and is evident despite normal task performance, neural responses during failed inhibition may be a useful biomarker of vulnerability for DEB. This study highlights the potential value of prospective neuroimaging studies for identifying markers of illness before the emergence of behavior changes.