The Influences of Eating and Fasting on Inhibitory Control in Bulimia Nervosa: A Computational Neuroimaging Study

饮食和禁食对神经性贪食症抑制控制的影响：一项计算神经影像学研究

• 批准号: 10208679
• 负责人: Laura A. Berner
• 金额: $ 19.19万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10208679
• 关键词: Adult; Anterior; Base of the Brain; Bayesian Modeling; Bayesian Prediction; Behavior; Behavioral; Binge Eating; Biological Markers; Brain; Bulimia; Cessation of life; Characteristics; Chronic; Clinical Data; Clinical Investigator; Computer Models; Corpus striatum structure; Dangerousness; Data; Diagnosis; Diagnostic; Disease; Disinhibition; Eating; Eating Behavior; Eating Disorders; Environment; Fasting; Functional Magnetic Resonance Imaging; Functional disorder; Future; Goals; Hyperphagia; Impairment; Individual; Intake; Interruption; Intervention; Knowledge; Lateral; Learning; Life; Link; Matched Group; Measurement; Measures; Mental disorders; Mentored Patient-Oriented Research Career Development Award; Mentorship; Metabolic; Methodology; Methods; Modeling; Neurobiology; Neurocognitive; Obesity; Pattern; Performance; Perfusion; Periodicity; Persons; Phenotype; Prefrontal Cortex; Process; Psychiatry; Psychophysiology; Psychotherapy; Research; Research Training; Resistance; Resources; Rest; Risk; Satiation; Scanning; Severities; Signal Transduction; Standardization; Symptoms; Testing; Time; Training; Update; Woman; Work; base; career; clinically significant; cost; design; dietary restriction; disability; effective therapy; expectation; experience; ideal observer (Bayesian); improved; neurobiological mechanism; neuroimaging; neurotransmission; novel; outcome prediction; premature; psychologic; psychosocial; purge; purging behavior; relating to nervous system; response; skills; substance use; symptomatology; theories; tool; translational neuroscience; treatment optimization; treatment response

PROJECT SUMMARY/ABSTRACT Bulimia nervosa (BN) is an often-chronic eating disorder associated with high rates of disability and premature death. There is a critical need to identify brain-based factors that perpetuate BN symptoms and that may serve as mechanistic targets for novel treatments. Most studies have focused on binge eating and purging behaviors in BN and have linked these symptoms to inhibitory control deficits and reduced frontostriatal activation. However, individuals with BN typically oscillate between states of problematic under- and over-control— excessive eating and restricted intake/fasting. Neurobiological research to date has failed to account for this oscillation. The goal of this mentored patient-oriented research career development award is to better understand the computational underpinnings of inhibitory control in these two states in BN. Specifically, the proposed study combines functional magnetic resonance imaging (fMRI) with dynamic Bayesian modeling to examine whether eating and fasting abnormally impact how the brains of women with BN prepare for and exert inhibitory control. This study will compare neural responses of 30 women with BN to those of 30 group- matched controls during an inhibitory control paradigm after a 16-h fast and after a standardized meal. This well-controlled design will test the following hypotheses: 1) In BN, frontostriatal signals for the expected need to inhibit, Bayesian prediction error signals, and activation during response inhibition are abnormally blunted in a fed state, and abnormally enhanced in a fasted state (Aim 1); 2) Altered response to the fed state promotes out-of-control eating and purging, whereas altered response to the fasted state perpetuates prolonged restriction between binge/purge episodes (Aim 2). Data from this project will substantiate an explanatory model of BN symptoms, pinpoint which components of the inhibition process are altered in BN, and identify states in which control-focused interventions may be most effective. This work ultimately will inform precisely targeted and context-dependent interventions that can more effectively interrupt the cycle of binge eating, purging, and restriction. The study will also serve as a vehicle for mentorship and hands-on training in concepts and skills critical to the candidate’s next steps. Specifically, within a resource-rich environment, the proposed training will give the candidate new expertise in three domains: 1) repeated-measures neuroimaging methods and associated analyses, 2) neurocomputational modeling and computational psychiatry, and 3) the neurobiology of the full spectrum of disordered eating symptomatology in BN. This project and the completion of training goals will launch the candidate’s independent career in the translational neuroscience of eating disorders and lay groundwork for high-impact studies that combine neuroimaging and sophisticated analytic approaches to improve eating disorder diagnosis and treatment.

项目摘要/摘要 贪食症神经（bn）是一种与高残疾率和过早相关的经常智饮食障碍 死亡。迫切需要确定基于大脑的因素，以使BN症状永存，并且可能服务 作为新型治疗的机械目标。大多数研究都集中于暴饮暴食和清除行为 在BN中，将这些症状与抑制性控制联系起来定义和减少额叶激活。 但是，有BN的个体通常在问题不足和过度控制状态之间振荡 - 饮食过多和摄入量/禁食。迄今为止的神经生物学研究未能解决这个问题 振荡。这个重要的面向患者的研究职业发展奖的目标是更好 了解BN这两个状态中抑制性控制的计算基础。具体来说， 拟议的研究将功能性磁共振成像（fMRI）与动态贝叶斯建模相结合 检查饮食和禁食绝对会影响BN女性的大脑如何准备和运动 抑制控制。这项研究将比较30名有BN女性的神经反应与30个组的神经反应 - 在16小时后和标准化餐后，在抑制控制范式中匹配对照。这 控制良好的设计将测试以下假设：1）在BN中 为了抑制，贝叶斯预测误差信号和响应抑制过程中的激活绝对钝化 美联储状态，在禁食状态下绝对增强（AIM 1）； 2）改变对美联储促进的反应 控制和清除饮食和清除，而对禁食状态的反应改变了延长 暴饮暴食/吹扫事件之间的限制（AIM 2）。该项目的数据将证实爆炸性的模型 在BN症状中，确定了BN抑制过程的哪些组成部分发生了变化，并确定 哪种以控制为中心的干预措施可能最有效。这项工作最终将为精确的目标提供信息 以及与上下文有关的干预措施，可以更有效地中断暴饮暴食，清除和 限制。这项研究还将作为心态和动手训练的工具 对于候选人的下一步至关重要。特别是，在资源丰富的环境中，拟议的培训将 在三个领域中赋予候选人的新专业知识：1）重复测量神经影像学方法和 相关分析，2）神经计算建模和计算精神病学，以及3）神经生物学 BN中的全部饮食症状症症状。这个项目和培训的完成 目标将启动候选人在饮食失调的转化神经科学方面的独立职业和 高影响研究的基础，结合了神经影像学和复杂的分析方法 改善饮食失调症的诊断和治疗。