Abnormal reward circuitry in anorexia nervosa: A longitudinal, multimodal MRI study.
Abnormal reward circuitry in anorexia nervosa: A longitudinal, multimodal MRI study.
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DOI：
10.1002/hbm.23279
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发表时间：
2016-11
影响因子：
4.8
通讯作者：
Steinglass JE
中科院分区：
文献类型：
--
作者：
Cha J;Ide JS;Bowman FD;Simpson HB;Posner J;Steinglass JE
神经性厌食症（AN）是一种使人衰弱的疾病，现有的干预措施效果有限。本研究旨在确定AN的病理生理学是否与额叶皮层回路内改变的连接相关，从而促进奖励处理。收集了年龄在16至25岁之间的AN女性住院患者（n =22）和健康对照组（HC; n =18）的弥散和静息状态功能MRI扫描。AN患者在疾病的急性期、体重不足期和住院体重恢复后再次接受扫描。在相同的时间范围内对HC进行了两次扫描。基于额-颞叶神经回路的单变量和多变量分析，发现体重不足的AN患者结构连接性增加（扩散概率纤维束成像），白色物质各向异性增加（基于束的空间统计），功能连接性增加（静息状态fMRI中基于种子的相关性），有效连接性改变（光谱动态因果模型）。体重恢复后，额颞叶结构连接继续异常增加，双侧效应量大（部分η2 =0.387;右侧NAcc-OFC）和中等（部分η2 =0.197;左侧NAcc-OFC）。在体重不足状态下，额颞叶神经回路的结构连接性增加与进食障碍症状的严重程度相关。总的来说，这项纵向多模式神经影像学研究的结果提供了AN非典型额颞叶回路的证据。
Anorexia nervosa (AN) is a debilitating illness and existing interventions are only modestly effective. This study aimed to determine whether AN pathophysiology is associated with altered connections within fronto-accumbal circuitry subserving reward processing. Diffusion and resting-state functional MRI scans were collected in female inpatients with AN (n =22) and healthy controls (HC; n =18) between the ages of 16 and 25 years. Individuals with AN were scanned during the acute, underweight phase of the illness and again following inpatient weight restoration. HC were scanned twice over the same timeframe. Based on univariate and multivariate analyses of fronto-accumbal circuitry, underweight individuals with AN were found to have increased structural connectivity (diffusion probabilistic tractography), increased white matter anisotropy (tract-based spatial statistics), increased functional connectivity (seed-based correlation in resting-state fMRI), and altered effective connectivity (spectral dynamic causal modeling). Following weight restoration, fronto-accumbal structural connectivity continued to be abnormally increased bilaterally with large (partial η2 =0.387; right NAcc-OFC) and moderate (partial η2 =0.197; left NAcc-OFC) effect sizes. Increased structural connectivity within fronto-accumbal circuitry in the underweight state correlated with severity of eating disorder symptoms. Taken together, the findings from this longitudinal, multimodal neuroimaging study offer converging evidence of atypical fronto-accumbal circuitry in AN.