Altered cortical thickness and attentional deficits in adolescent girls and women with bulimia nervosa
Altered cortical thickness and attentional deficits in adolescent girls and women with bulimia nervosa
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DOI：
10.1503/jpn.170070
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发表时间：
2018-05-01
影响因子：
4.3
通讯作者：
Marsh, Rachel
中科院分区：
文献类型：
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作者：
Berner, Laura A.;Stefan, Mihaela;Marsh, Rachel
背景：额纹状体和额顶叶异常可能导致神经性贪食症个体的控制和注意力过程缺陷，以及整个发育过程中饮食失调的持续存在。这项研究评估了大量患有神经性贪食症的青春期女孩和妇女与健康对照者的这些过程和皮质厚度。方法：我们收集了患有完全或阈值以下神经性贪食症的青春期女孩和女性（12-38 岁）以及年龄匹配的健康对照者的解剖 MRI 数据，这些对照者也完成了康纳斯连续性能测试 II (CPT-II)。比较各组的任务表现和皮质厚度。中介分析探讨了皮质厚度、CPT-II 变量、神经性贪食症症状和年龄之间的关联。结果：我们在分析中纳入了 60 名患有神经性贪食症的女孩和妇女以及 54 名对照者。与健康参与者相比，神经性贪食症患者在 CPT-II 上表现出冲动性和注意力不集中，以及右侧三角部、右侧顶叶和左侧背侧后扣带皮层厚度减少。在神经性贪食症组中，探索性分析显示，暴食频率与额顶叶和岛叶区域的皮质厚度呈负相关，而额顶叶厚度的减少介导了年龄与症状严重程度和注意力不集中增加之间的关联。暴饮暴食频率也介导了年龄和下前额皮质厚度之间的关联。局限性：这些发现仅适用于患有神经性贪食症的女孩和女性，并且我们的横断面设计无法理解皮质厚度的变化是否先于神经性贪食症症状或由神经性贪食症症状引起。结论：额顶叶和后扣带回区域的结构异常（包括支持控制和注意力过程的回路）应作为维持神经性贪食症的潜在因素和新干预措施的有用目标进行研究。
Background: Frontostriatal and frontoparietal abnormalities likely contribute to deficits in control and attentional processes in individuals with bulimia nervosa and to the persistence of dysregulated eating across development. This study assessed these processes and cortical thickness in a large sample of adolescent girls and women with bulimia nervosa compared with healthy controls. Methods: We collected anatomical MRI data from adolescent girls and women (ages 12-38 yr) with full or subthreshold bulimia nervosa and age-matched healthy controls who also completed the Conners Continuous Performance Test-II (CPT-II). Groups were compared on task performance and cortical thickness. Mediation analyses explored associations among cortical thickness, CPT-II variables, bulimia nervosa symptoms and age. Results: We included 60 girls and women with bulimia nervosa and 54 controls in the analyses. Compared with healthy participants, those with bulimia nervosa showed increased impulsivity and inattention on the CPT-II, along with reduced thickness of the right pars triangularis, right superior parietal and left dorsal posterior cingulate cortices. In the bulimia nervosa group, exploratory analyses revealed that binge eating frequency correlated inversely with cortical thickness of frontoparietal and insular regions and that reduced frontoparietal thickness mediated the association between age and increased symptom severity and inattention. Binge eating frequency also mediated the association between age and lower prefrontal cortical thickness. Limitations: These findings are applicable to only girls and women with bulimia nervosa, and our cross-sectional design precludes understanding of whether cortical thickness alterations precede or result from bulimia nervosa symptoms. Conclusion: Structural abnormalities in the frontoparietal and posterior cingulate regions comprising circuits that support control and attentional processes should be investigated as potential contributors to the maintenance of bulimia nervosa and useful targets for novel interventions.