Subcortical Shape Abnormalities in Bulimia Nervosa
Subcortical Shape Abnormalities in Bulimia Nervosa
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DOI：
10.1016/j.bpsc.2018.12.011
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发表时间：
2019-12-01
影响因子：
5.9
通讯作者：
Marsh, Rachel
中科院分区：
文献类型：
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作者：
Berner, Laura A.;Wang, Zhishun;Marsh, Rachel
背景：神经性贪食症（BN）与额纹状体和额边缘回路的功能异常有关。虽然已经观察到这些回路的额叶部分的结构改变，但这是第一次对BN的皮质下表面形态学进行研究，也是对BN皮质下体积进行的最大研究。解剖磁共振扫描获得了62名女性参与者与充分和亚阈值BN（平均年龄+/- SD，18.7 +/- 4.0岁）和65名组匹配的健康对照参与者（平均年龄+/- SD，19.3 +/- 5.7岁）。一般线性模型用于比较组和评估组与年龄的相互作用对15个皮质下结构的形状和总体积的显著性（p <0.05，家族误差校正）。与疾病的严重程度和持续时间的协会进行了评估，在BN group.Results：皮质下体积没有不同的各组，但顶点分析显示向内的形状变形的苍白球的前表面BN相对于对照组参与者，与暴饮暴食的频率和疾病的持续时间。在BN组中，随着年龄的增长，丘脑腹外侧区和杏仁核背侧区的向内变形更为明显，尾状核、壳核和杏仁核的向内变形与自我诱发的呕吐频率相关。结论：我们的研究结果指向皮质下结构表面的局部变形，这些结构包括奖励和认知控制回路。这些变形在年龄较大的BN参与者和症状最严重的参与者中更为明显。皮质下形态测量学改变的这种精确定位可能最终有助于识别风险和BN持续性的标志物。
BACKGROUND: Bulimia nervosa (BN) is associated with functional abnormalities in frontostriatal and frontolimbic circuits. Although structural alterations in the frontal portions of these circuits have been observed, this is the first study of subcortical surface morphometry and the largest study of subcortical volume in BN.METHODS: Anatomical magnetic resonance scans were acquired from 62 female participants with full and sub-threshold BN (mean age +/- SD, 18.7 +/- 4.0 years) and 65 group-matched healthy control participants (mean age +/- SD, 19.3 +/- 5.7 years). General linear models were used to compare groups and assess the significance of group-by-age interactions on the shape and total volume of 15 subcortical structures (p < .05, familywise error corrected). Associations with illness severity and duration were assessed in the BN group.RESULTS: Subcortical volumes did not differ across groups, but vertexwise analyses revealed inward shape deformations on the anterior surface of the pallidum in BN relative to control participants that were associated with binge-eating frequency and illness duration. Inward deformations on the ventrolateral thalamus and dorsal amygdala were more pronounced with advancing age in the BN group, and inward deformations on the caudate, putamen, and amygdala were associated with self-induced vomiting frequency.CONCLUSIONS: Our findings point to localized deformations on the surface of subcortical structures in areas that comprise both reward and cognitive control circuits. These deformations were more pronounced among older BN participants and among those with the most severe symptoms. Such precise localization of alterations in subcortical morphometry may ultimately aid in efforts to identify markers of risk and BN persistence.