Reward Systems and Food Avoidance in Adolescents with Low Weight Eating Disorders

项目摘要 低体重饮食障碍是一种严重的精神障碍，最常发生在青春期，有 慢性病程，且有证据显示治疗反应差。这个项目检验了一种假设，即 脑岛-杏仁核-腹侧纹状体(IAVS)神经回路与可恶的食物线索学习有关 青少年患有LW-EDS，这种学习是避免食物的核心结构。我们测试了这个 假说通过实验操纵这个神经回路的功能连接，利用 新的临床治疗，基于家庭的伤害间暴露(FBT-IE)与标准的家庭治疗。至 为了描绘这个厌恶的神经回路，我们使用了一种新的计算方法来整合面部 肌电进入fmri食物-线索反转学习任务。这个fMRI-EMG被设计成 经验性地在患者中建立对食物提示的厌恶反应和对食物的愉快反应 回避。我们试图区分IAVS神经回路的病理反应及其与 来自健康对照组的情感反应，将神经回路确立为导致差异的关键来源 进食、临床症状和组间行为。此外，我们还试图测试FBT-IE导联 以区分临床、实验室进食、神经回路和对食物提示的行为反应的变化。对此 点，我们已经完成了60例LW-EDS患者和22名健康对照的数据收集。我们已经开始了 对临床资料进行分析。然而，我们的控制组中有2人因COVID感染而失去，其余20人中有7人 数据不完整或遭到破坏。由于活动暂停，我们将在此之前耗尽资金。 NCE的结束是因为我们努力通过与COVID相关的停职来支付员工工资。因此， 这项拟议的补充方案寻求资金支持工作人员完成健康控制的数据收集 受试者(8名新受试者，2名因COVID丢失而被替换，7名替换受损的现有数据， 共17名健康对照新受试者。)

Project Summary Low weight eating disorders are severe psychiatric disorders that most often develop in adolescence, have a chronic course, and evidence poor response to treatment. This project examined the hypothesis that the insula-amygdala-ventral striatum (IAVS) neurocircuit is responsible for abhorrent food-cue learning in adolescents with LW-EDs and that this learning underlies the core construct of food avoidance. We tested this hypothesis by experimentally manipulating the functionally connectivity of this neurocircuit by utilization of novel clinical treatment, family based interoceptive exposure (FBT-IE) vs. standard family therapy. To delineate this aversive neurocircuit, we utilized novel computational approach integrating facial electromyography into the fMRI of food-cue reversal learning task. This fMRI-EMG was designed to empirically establish aversive responses to food-cues among patients and pleasurable responses to food avoidance. We sought to distinguish pathological responses of the IAVS neurocircuit and its relationship to affective response from healthy controls, establishing the neurocircuit as a key source for divergences in eating, clinical symptoms, and behavior between groups. In addition, we sought to test weather FBT-IE leads to differential changes in clinical, laboratory eating, neurocircuit, and behavioral responses to food cues. At this point, we have completed data collection on 60 patients with LW-EDs and 22 health controls. We have begun analyzing the clinical data. However, 2 of our controls were lost to COVID disruption and 7 of the remaining 20 have incomplete or compromised data. Due to the suspension of activities, we will run out of funding before the end of the NCE because of our efforts to pay staff through the COVID related suspensions. Consequently, this proposed supplement seeks funds to support to staff to complete data collection for the healthy control subjects (8 new subjects, 2 replaced from COVID loss, and 7 replacement of compromised existing data, totaling 17 new healthy control subjects.)