Neural response to food stimuli: fMRI changes following cognitive behavioral therapy for binge eating disorder

对食物刺激的神经反应：暴食症认知行为治疗后功能磁共振成像的变化

• 批准号: 9901563
• 负责人: ARIANA MARIE CHAO
• 金额: $ 15.79万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-04-05 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9901563
• 关键词: Active Learning; Address; Adult; Affect; Aftercare; Behavior Therapy; Behavioral; Behavioral Sciences; Binge Eating; Binge eating disorder; Biological; Biological Sciences; Body Weight decreased; Brain; Calories; Categories; Cognitive; Cognitive Therapy; Development; Diet; Disease; Disease remission; Disinhibition; Eating; Eating Disorders; Educational workshop; Elements; Feeling; Female; Food; Functional Magnetic Resonance Imaging; Functional disorder; Goals; Gur; Health; Hour; Imagery; Impairment; Individual; Inferior frontal gyrus; Insula of Reil; Intervention; Knowledge; Maintenance; Mental disorders; Mentors; Mentorship; National Institute of Nursing Research; Neurologic; Neurosciences; Nurses; Obesity; Obesity Epidemic; Outcome; Participant; Pathway interactions; Patient-Focused Outcomes; Patients; Prediction of Response to Therapy; Prefrontal Cortex; Prevention strategy; Preventive Intervention; Psychotherapy; Public Health; Randomized; Randomized Controlled Trials; Reporting; Research; Research Personnel; Research Training; Rewards; Scanning; Self Management; Signal Transduction; Stimulus; Symptoms; Testing; Therapeutic Intervention; Ventral Striatum; Ventral Tegmental Area; Waiting Lists; base; biobehavior; blood oxygen level dependent; blood treatment; brain dysfunction; effective therapy; experience; functional MRI scan; improved; individualized prevention; innovation; interest; male; neural circuit; neurobehavioral; neuroimaging; neuromechanism; new technology; novel; patient oriented; psychosocial; relating to nervous system; responders and non-responders; response; skills; treatment effect; treatment strategy

PROJECT SUMMARY Binge eating disorder (BED) is a debilitating condition that is strongly associated with obesity and is the most common eating disorder in the US. Little is known about mechanisms underlying BED, hampering development of more efficacious treatment approaches. In particular, few studies have examined neural mechanisms related to BED, and how treatment effects neural activity. Building upon Dr. Ariana Chao's previous research and training experiences, this K23 application prepares the candidate to become an independent,patient-oriented nurse researcher. Her long-term goal is to contribute to efforts to reduce the obesity epidemic by investigating biobehavioral pathways associated with BED and obesity, and developing precisely targeted and innovative interventions for prevention and treatment. In the short-term, the current proposal will allow Dr. Chao to obtain new knowledge and skills through a seminars, (Mentor: Richmond tailored set of formal courses, workshops and experiential learning guided by an accomplished, interdisciplinary mentorship team Dr. Thomas Wadden; Co-Mentors: Dr. Ruben Gur nd Dr. Carlos Grilo; Consultants: Dr. Therese and Dr. Russell Shinohara). In addition, Dr. Chao will , a conduct a randomized controlled trial (RCT) assessing the impact of CBT on neural responses to binge eating stimuli. Females who are obese with BED will be randomized to either a 16-week, one-on-one CBT intervention (n=20) or a waitlist control (WL; n=20). Both groups will have blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) scans at baseline and after the 16-week intervention. During the scans, participants will complete two tasks: one to assess inhibition to food (i.e., food-specific stop signal task (SST)) and one to evaluate reward response to recall of binge foods (i.e., script-driven imagery). The primary aims of the study are to: 1) compare differences between the CBT and WL groups at week 16 in changes in BOLD fMRI response to food-specific SST; 2) compare differences between the CBT and WL groups at week 16 in changes in BOLD fMRI response to script-driven imagery of binge foods; and 3) determine whether pre-treatment neural activation on the SST and script-driven imagery task predict differences between CBT responders and non-responders (>1 binge eating episode in the past 28 days). Our exploratory aim is to: 4) assess the associations between pre- to post- treatment behavioral changes in reported binge eating episodes (percent reduction and categorical response), in reward-based eating drive, and in dietary inhibition, and pre- to post-treatment neural changes on the SST and script-driven imagery task. This study will provide an important foreground to improve the precision of prevention and treatment strategies for BED and obesity. The research and training plans are responsive to the National Institute of Nursing Research's goals of integrating biological and behavioral sciences to promote personalized health strategies and applying new technologies to promote self-management interventions that improve health and patient outcomes.

项目摘要 暴饮暴食障碍（床）是一种使人衰弱的疾病，与肥胖密切相关，是最大的 美国常见的饮食失调。关于床下的机制，不知所措，阻碍 开发更有效的治疗方法。特别是，很少有研究检查神经 与床有关的机制以及治疗如何影响神经活动。在Ariana Chao博士的基础上 以前的研究和培训经验，该K23应用程序为候选人做好准备成为一种 独立，面向患者的护士研究人员。她的长期目标是为减少的努力做出贡献 通过研究与床和肥胖相关的生物行为途径，并发展 精确针对预防和治疗的针对性和创新干预措施。在短期内 提案将使Chao博士能够通过 研讨会， （导师： 里士满 量身定制的正式课程， 讲习班和经验学习由成就的，跨学科的指导团队指导 托马斯·沃登（Thomas Wadden）博士；联合官员：Ruben Gur博士Carlos Grilo博士；顾问：Therese博士 还有罗素·什诺哈拉（Russell Shinohara）博士）。此外，Chao博士将 ，，，， 一个 进行随机对照试验（RCT） 评估CBT对神经反应对暴饮暴食刺激的影响。肥胖的床 将随机分为16周，一对一的CBT干预（n = 20）或候补控制（WL; n = 20）。 两组将具有血氧水平依赖性（粗体）功能磁共振成像（fMRI） 在基线和16周干预之后进行扫描。在扫描过程中，参与者将完成两个任务： 一种评估对食物的抑制（即食品特定停止信号任务（SST）），一个评估奖励响应 回忆暴饮食品（即脚本驱动的图像）。研究的主要目的是：1）比较 在第16周，CBT组和WL组之间的差异在BOLD FMRI对食品特异性的反应的变化中 SST; 2）比较第16周的CBT和WL组之间的差异在BOLD FMRI响应的变化中 以脚本为导向的暴饮暴食图像； 3）确定是否在SST上进行预处理神经激活 和脚本驱动的图像任务预测CBT响应者和非反应者之间的差异（> 1个暴饮暴食 在过去的28天里吃插曲）。我们的探索目的是：4）评估前与 报道的暴饮暴食发作的治疗行为变化（减少和分类反应百分比）， 在基于奖励的饮食驱动器以及饮食抑制以及SST治疗后神经变化中 和脚本驱动的图像任务。这项研究将为提高精确度提供一个重要的前景 床和肥胖的预防和治疗策略。研究和培训计划对 美国国家护理研究所的目标是整合生物学和行为科学以促进 个性化的健康策略并应用新技术来促进自我管理干预措施 改善健康和患者的结果。