Reward Systems and Food Avoidance in Adolescents with Low Weight Eating Disorders

低体重饮食失调青少年的奖励制度和食物避免

基本信息

批准号：
9334942
负责人：
THOMAS B HILDEBRANDT
金额：
$ 59.42万
依托单位：
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-08-19 至 2020-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9334942
关键词：
Acute Adolescence Adolescent Affective Amygdaloid structure Anorexia Nervosa Behavior Behavior Therapy Behavioral Biological Brain Brain region Characteristics Chronic Clinical Control Groups Corpus striatum structure Cues Data Dimensions Disease Down-Regulation Eating Eating Behavior Eating Disorders Electromyography Emotions Exposure to Extinction (Psychology)Family Food Food Aversion Functional Magnetic Resonance Imaging Future Hypersensitivity Impairment Incentives Individual Insula of Reil Intervention Laboratories Learning Maps Measures Mental disorders Modeling Neurobiology Neurons Palate Panic Disorder Pathologic Patients Physiological Population Population Intervention Positioning Attribute Prefrontal Cortex Process Psyche structure Psychophysiology Public Health Regulation Research Domain Criteria Resistance Reversal Learning Rewards Safety Stimulus System Target Populations Testing Ventral Striatum Visceral Weight Weight Gain Work addiction adolescent patient base behavior measurement causal model conditioning contingency management experience mortality neuroimaging novel pleasure prevent reinforcer response restoration theories treatment response

项目摘要

Project Summary Low weight eating disorders are severe psychiatric disorders that most often develop in adolescence, have a chronic course, and evidence poor response to treatment. A core feature of these disorders is food avoidance; which can be conceptualized in the research domain criteria (RDoC) framework as dysregulation in the dimensional expression of acute threat (i.e., food aversion) and reward learning (i.e., pleasurable response to food absence). Emerging neuroimaging evidence suggests that deficits in insula-amygdala-ventral striatum (IAVS) neurocircuitry contribute to individual variability in aversive and reward learning, and that these brain regions demonstrate abnormal responses to food/eating stimuli. Our pilot data suggest that patients with low weight eating disorder (LW-ED) experience difficulty extinguishing food-cue associations in a reversal learning paradigm compared to healthy controls, a difficulty that is related to psychophysiological measures of aversive- disgust (not fear). Additionally, our data indicate the presence of a pleasure response to food avoidance or ‘cued safety’ that may further impair reversal of food-cue associations because it prevents reappraisal of the threatening stimuli. We have also successfully piloted an interoceptive exposure intervention for this population that targets visceral sensitivity and seeks to increase ‘top-down’ regulation of the IAVS neurocircuit. This intervention is distinguishable from existing contingency management based behavioral interventions that are standard for this population and target the reward value of food and eating. Further, simultaneously acquired fMRI-electromyography(EMG) pilot data from our team suggests that an elevated aversive-disgust response is associated with increased connectivity between insula and amygdala, and the cued absence of the food reward is associated with elevated connectivity between amygdala and ventral striatum that is associated with elevated pleasure response. The proposed project will (a) use novel fMRI-EMG to test the relationship between effective connectivity within amygdala-insula-ventral striatum network and its relationship to psychophysiological and behavioral measures of acute threat and reward learning in 60 adolescents with LW- EDs and 30 healthy controls, (b) test the sensitivity of this network to an experimental interoceptive exposure paradigm relative to patients receiving family based therapy for weight restoration using dynamic causal modeling of fMRI-EMG data pre-post experimental conditions, (c) validate this model against objective measures of laboratory and real world eating behavior. The results of this study will help us better understand the core neurocircuitry that underlies both threat processing and reward/aversive learning and how this circuit relates to objective behavior. Further, we will determine the modifiability of this neurocircuitry via two distinct behavioral interventions chosen to target different aspects of affective processing and reward learning. These data will be used to inform future clinical interventions targeting aversive/reward learning within this population and dysregulation in insula-amygdala-ventral striatum subcircuits.

项目摘要低体重饮食障碍是严重的精神疾病，在青少年中最常发展，有一个慢性课程和对治疗的反应不佳。这些疾病的核心特征是避免食物。可以在研究领域标准（RDOC）框架中概念化为失调急性威胁（即食物厌恶）和奖励学习的维度表达（即，对食物缺席）。新兴的神经影像证据表明，在岛 - 杏仁核纹状体中定义（iavs）神经记录在厌恶和奖励学习中有助于个人变异性，并且这些大脑地区表现出对食物/饮食刺激的异常反应。我们的飞行员数据表明低体重饮食失调（LW-ED）经历了逆向学习中的困难扑灭食物库联合与健康对照相比厌恶（不要害怕）。此外，我们的数据表明对避免食物的愉悦反应或 “提示安全性”可能会进一步损害食品库协会的逆转，因为它可以防止重新评估威胁刺激。为此，我们还成功地试用了感官的暴露干预措施靶向内脏敏感性并试图增加IAVS神经电路的“自上而下”调节的种群。这种干预措施与现有的基于应急管理的行为干预措施可区分是该人群的标准，目标是食物和饮食的奖励价值。进一步，简单地从我们团队获得的FMRI-Electromography（EMG）飞行员数据表明，厌恶性较高响应与岛岛和杏仁核之间的连通性提高有关，并且没有提示的缺失食物奖励与杏仁核和腹侧纹状体之间的连通性提升有关随着愉悦的反应提升。拟议的项目将（a）使用新颖的fmri-emg测试关系在杏仁核和腹膜纹状体网络中的有效连通性及其与之的关系之间 LW-的60名青少年的急性威胁和奖励学习的心理生理和行为措施 EDS和30个健康对照，（b）测试该网络对实验性接触的敏感性相对于接受基于家庭治疗的患者，使用动态催化剂范式恢复体重恢复 FMRI-EMG数据的建模前孔前实验条件，（c）验证该模型针对客观实验室和现实世界饮食行为的度量。这项研究的结果将帮助我们更好地理解既是威胁处理和奖励/厌恶学习以及该电路的核心神经循环系统与客观行为有关。此外，我们将通过两个不同的选择针对情感处理和奖励学习的不同方面的行为干预措施。这些数据将用于告知未来的临床干预措施，针对该人群中的厌恶/奖励学习岛 - 杏仁核 - 腹纹状体子电路的失调。