A longitudinal functional magnetic resonance imaging study of task control circuits and bulimic symptoms over adolescence.
A longitudinal functional magnetic resonance imaging study of task control circuits and bulimic symptoms over adolescence.
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青春期任务控制回路和贪食症症状的纵向功能磁共振成像研究。
DOI：
10.1111/jcpp.12840
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Marsh,Rachel
中科院分区：
文献类型：
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作者：
Cyr,Marilyn;Fontaine,Martine;Stefan,Mihaela;Terranova,Kate;Kopala-Sibley,DanielC;Attia,Evelyn;Marsh,Rachel
背景先前对神经性贪食症（BN）青少年和成人的横断面研究结果表明，支持自我调节过程（包括解决认知冲突）的额纹状体和扣带盖任务控制回路存在紊乱。在此，我们使用纵向数据来检查此类障碍的发展轨迹，以及这些回路的功能如何与青春期 BN 症状的变化相关。方法 32 名患有 BN 症状的青春期女性和 28 名健康对照 (HC) 青少年参与了这项研究。在执行西蒙任务期间，在青春期期间每隔两年的三个时间点采集功能磁共振图像 (fMRI)。从最初的样本来看，70% 和 30% 的参与者分别完成了第二个和第三个时间点。完成所有研究时间点的参与者与基线人口特征或任何结果指标上因自然减员而损失的参与者没有差异。使用感兴趣区域方法，增长曲线模型测试了任务控制回路中冲突相关激活轨迹随时间的组间差异。交叉滞后面板模型检查了同一区域的冲突相关激活与 BN 症状随时间的变化关系。结果生长曲线模型揭示了 BN 和 HC 青少年右侧任务控制区域的冲突相关激活的不同轨迹，使得 HC 而 BN 青少年则没有表现出激活随着时间的推移而减少。当仅包括症状随时间缓解的 BN 青少年时，这些群体差异最大。交叉滞后面板模型显示，首次随访时暴食症发作的频率较低，预示着双边任务控制区域冲突相关激活的增加。结论这些纵向研究结果表明，BN 青少年的任务控制回路过度参与，尤其是那些对持续性疾病最有抵抗力的青少年。这种过度参与可能会补偿调节紊乱，使它们能够在发育过程中调节饮食行为。因此，任务控制回路可能构成增强自我调节控制的早期干预的目标。
BackgroundPrevious cross‐sectional findings from adolescents and adults with Bulimia Nervosa (BN) suggest disturbances in fronto‐striatal and cingulo‐opercular task control circuits that support self‐regulatory processes, including the resolution of cognitive conflict. Herein, we used longitudinal data to examine the developmental trajectories of such disturbances and how the functioning of these circuits relates to changes in BN symptoms over adolescence.MethodsThirty‐two adolescent females with BN symptoms and 28 healthy control (HC) adolescents participated in the study. Functional magnetic resonance images (fMRI) during performance of a Simon task were acquired at three time points within 2‐year intervals over adolescence. From the initial sample, 70% and 30% of the participants completed the second and third time points, respectively. Participants who completed all study time points did not differ from those lost to attrition on baseline demographic characteristics or any outcome measures. Using a region‐of‐interest approach, growth curve models tested group differences in the trajectory of conflict‐related activation in task control circuits over time. Cross‐lagged panel models examined transactional relationships between conflict‐related activation in the same regions and BN symptoms over time.ResultsGrowth curve models revealed different trajectories of conflict‐related activation in right task control regions across BN and HC adolescents, such that HC but not BN adolescents showed activation decreases over time. These group differences were greatest when including only the BN adolescents whose symptoms remitted over time. Cross‐lagged panel models revealed that less frequent bulimic episodes at first follow‐up predicted later increases in conflict‐related activation in bilateral task control regions.ConclusionsThese longitudinal findings suggest overengagement of task control circuits in BN adolescents, especially those most resilient to persistent illness. Such overengagement may compensate for regulatory disturbances, allowing them to regulate eating behaviors over development. Thus, task control circuits may constitute targets for early interventions that enhance self‐regulatory control.