NEURAL CORRELATES OF RESPONSE ANTICIPATION & COGNITIVE CONTROL IN ED

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。很高比例的厌食症或神经性贪食症的进食障碍（艾德）患者对当前选择的治疗没有反应。这组患者更容易退出，使用更多的临床资源，并遵循疾病的慢性演变，包括死亡。其影响对患者和家庭是毁灭性的，并给社会带来高昂的代价。研究可能解释持续性艾德精神病理学的病因和维持的机制对于改善其诊断、治疗和最终预防具有重要意义。暴饮暴食是艾德诊断类别中最常见的行为。暴饮暴食的显著特征是对进食事件失去控制。暴饮暴食的ED患者治疗反应较差的预测因素是高度的饮食限制加上高度的负面影响。这两者的结合与较低的冲动控制，更大的进食和共病的精神病理学有关。相反，持续的恢复或治疗的早期改善似乎与更能控制冲动的个体的纯饮食亚型有关。然而，严格的饮食控制模式也可能导致严重的体重减轻，如急性神经性厌食症。参与情绪和行为的灵活认知控制的神经系统位于大脑前额叶皮层。然而，这个系统的有效运作是由纹状体介导的。据我们所知，有没有研究的直接贡献皮质纹状体功能的病因和饮食失调的维护，虽然最近的临床，行为和神经影像学研究的审查显示间接证据的损害饮食失调的个人。因此，本研究的目的是映射活动的皮质-纹状体电路在志愿者与ED患者，并将其与从健康成人收集的数据进行比较，在执行的认知任务的反应预期，旨在挖掘这个神经网络的功能磁共振成像（fMRI）实验。 假设：1.当在任务中呈现准备与放松提示条件时，艾德患者将表现出比对照组更大的尾状核和壳核激活（纹状体）。2.在反应预期任务的准备试验中，当呈现不一致与一致的目标条件时，艾德患者在自愿抑制冲突的能力方面表现出更大的低效率，这可以通过更少的LPFC激活和更大的ACC激活来证明。3.纹状体和ACC的活性越高，艾德抑郁症越严重，消极情绪越严重，冲动控制能力越低。4.与对照组相比，艾德患者在反应预期任务的目标条件下的准确性和快速性较差。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. A high percentage of patients with an eating disorder (ED) diagnosis of anorexia or bulimia nervosa do not respond to current treatments of choice. This group of patients is more prone to drop out, use more clinical resources, and follow a chronic evolution of the disorder including death. The effects are devastating to patients and families and involve a high cost to society. Research into mechanisms that may explain the etiology and maintenance of persistent ED psychopathology is of great importance in order to improve its diagnosis, treatment and ultimately prevention. Binge eating is the most common behavior across ED diagnostic categories. The salient feature of a binge is loss of control over the eating episode. A predictor of poorer treatment response in individuals with EDs who binge-eat is high dietary restraint plus high negative affect. The combination of these two is related to lower impulse control, greater eating and comorbid psychopathology. Conversely, sustained recovery or early improvement from therapy seems related to a pure dietary subtype with individuals who are more able to control their impulses. However, a rigid pattern of dietary control may also lead to severe weight loss as in acute anorexia nervosa. Neural systems involved in flexible cognitive control of emotions and behaviors are located in the brain prefrontal cortex. However, an efficient functioning of this system is mediated by the striatum. To our knowledge, there are no studies on the direct contribution of cortico-striatal functioning to the etiology and maintenance of eating disorders, though a recent review of clinical, behavioral and neuroimaging studies shows indirect evidence of impairment in eating disordered individuals. Therefore, the aim of the present study is to map the activity of the cortico-striatal circuit in volunteered patients with EDs and compare it with data gathered from healthy adults during performance of a cognitive task of response anticipation designed to tap this neural network in a functional Magnetic Resonance Imaging (fMRI) experiment. Hypotheses: 1. When presented with ready versus relax cue condition in the task, ED patients will exhibit greater caudate and putamen activation (striatum) than controls. 2. When presented with incongruent versus congruent target conditions in the ready trials of the response anticipation task, ED patients will exhibit greater inefficiency in their ability to voluntary suppress the conflict as evidenced by less LPFC activation and greater ACC activation. 3. Greater striatal and ACC activity will correlate with greater ED symptomatology, negative affect and with lower impulse control. 4. ED patients will perform less accurately and rapidly in the target conditions of the response anticipation task than controls.