Cognitive Neuroscience of Anorexia Nervosa

描述（由申请人提供）：神经性厌食症（AN）是一种严重的精神疾病，其特征是对变胖的无情但非理性的担忧，以及对体型和体重的感知的极端扭曲。AN患者与饮食相关的想法和行为是重复的，刻板的，并且非常抗拒改变，即使在体重正常化之后。这些思维和行为模式的持续存在可能与这种疾病的高复发率有关。这个指导以患者为导向的研究职业发展奖（MPORCDA）的目的是开发和执行一项研究计划，调查AN的神经认知过程，重点是内隐学习。广泛的目的是探讨是否与AN个人有内隐学习的干扰，可能构成一个脆弱性的发展AN及其持久性。该奖项支持的研究将检验以下特定假设：1）AN患者存在内隐学习缺陷，并且当突发事件发生变化时，转移反应尤其受损; 2）即使在短期体重恢复后，这些干扰仍然存在，尽管程度较低; 3）内隐学习任务的表现与临床过程相关; 3）内隐学习的异常与神经回路异常相关，类似于在强迫症中观察到的那些; 4）体重恢复患者中认知缺陷的改善与临床过程的改善相关。更全面地了解AN的混乱思想和行为特征的显著持续性的基础应该为开发更有效的治疗方法提供基础。在B博士的大力指导下。Timothy沃尔什（神经性厌食症的临床研究培训和专业知识）、Yaakov Stern博士（认知神经科学培训）和布拉德利彼得森博士（功能性神经影像学培训），该MPORCDA将为主要研究者提供技能和进一步的研究经验，将转化认知神经科学的进展应用于AN研究。该奖项的长期目标是使候选人成为专家和独立研究人员，专注于饮食失调发展和持续的潜在机制，特别适用于神经性厌食症。

DESCRIPTION (provided by applicant): Anorexia Nervosa (AN) is a serious psychiatric illness characterized by a relentless but irrational concern about becoming fat, and extreme distortions in the perception of body shape and weight. The eating-related thoughts and behaviors of individuals with AN are repetitive, stereotyped, and extremely resistent to change, even after weight normalization. The persistence of these patterns of thought and behavior are likely related to the high relapse rate seen in this illness. The purpose of this Mentored Patient-Oriented Research Career Development Award (MPORCDA) is to develop and execute a program of research investigating neurocognitive processes in AN, focusing on implicit learning. The broad aim is to explore whether individuals with AN have a disturbance in implicit learning that may constitute a vulnerability to the development of AN and its persistence. The research supported by this award will examine the specific hypothesis that 1) patients with AN have a deficit in implicit learning and are particularly impaired at shifting responses when contingencies change; 2) these disturbances persist, albeit to a lesser degree, even after short-term weight recovery; 3) performance on implicit learning tasks correlates with clinical course; 3) abnormalities in implicit learning are correlated with neural circuitry abnormalities, similar to those seen in OCD; 4) improvement in cognitive deficits in weight restored patients is associated with improved clinical course. A fuller understanding of the basis of the remarkable persistence of the disordered thought and behavior characteristics of AN should provide a foundation for the development of more effective treatments. Under the strong mentorship of Dr. B. Timothy Walsh (for clinical research training and expertise in Anorexia Nervosa), Dr. Yaakov Stern (for training in cognitive neuroscience), and Dr. Bradley Peterson (for training in functional neuroimaging) this MPORCDA will provide the principal investigator with the skills and further research experience to apply advances in translational cognitive neuroscience to the study of AN. The long- term goal of this award is for the candidate to become an expert and independent researcher focusing on mechanisms underlying the development and persistence of eating disorders, with special application to anorexia nervosa.