Altered anticipatory brain responses in eating disorders: A neuroimaging meta-analysis

Eur Eat Disord Rev. 2023 May;31(3):363-376. doi: 10.1002/erv.2967. Epub 2023 Jan 13.


Objective: Functional neuroimaging studies have found differential neural activation patterns during anticipation-related paradigms in participants with eating disorders (EDs) compared to controls. However, publications reported conflicting results on the directionality and location of the abnormal activations. There is an urgent need to integrate our existing knowledge of anticipation, both rewarding and aversive, to elucidate these differences.

Method: We conducted an activation likelihood estimation (ALE) meta-analysis to quantitatively review functional neuroimaging studies that evaluated differences between brain correlates of anticipation in participants with and without disordered eating. PubMed, Web of Sciences, PsycINFO, Medline and EMBASE were searched for studies published up to November 2022. Exploratory sub-analyses to check for differences between reward and non-reward anticipation among all anticipation paradigms.

Results: Twenty-one references met the inclusion criteria for meta-analysis. The meta-analysis across anticipation all tasks identified a significant hyperactivation cluster in the right putamen in participants with disordered eating (n = 17 experiments) and a significant hypoactivation cluster in the left inferior parietal lobule (n = 13 experiments), in participants with disordered eating compared to controls.

Conclusions: These findings and sub-analyses of reward- and non-reward-related cues suggest potential pathophysiological mechanisms underlying anticipatory responses to rewarding and aversive cues in ED.

Keywords: ALE meta-analysis; anticipation; aversion; disordered eating; reward.

Publication types

  • Meta-Analysis
  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Affect
  • Brain
  • Feeding and Eating Disorders* / diagnostic imaging
  • Functional Neuroimaging
  • Humans
  • Magnetic Resonance Imaging*