Cognitive Neuroscience of Anorexia Nervosa

描述(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，以及对身体形状和体重的极度扭曲。患有AN的人与饮食有关的想法和行为是重复的、刻板的，即使在体重正常化之后也极难改变。这些思维和行为模式的持续可能与这种疾病的高复发率有关。这个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，调查神经认知过程，重点是内隐学习。研究的主要目的是探讨AN患者在内隐学习方面是否存在障碍，这可能对AN的发展及其持续性构成脆弱性。该奖项支持的研究将检验这一特定假设：1)内隐学习障碍患者存在内隐学习缺陷，当意外情况发生变化时，这些患者在转换反应时尤其受损；2)这些障碍持续存在，尽管程度较轻，即使在短期体重恢复后也是如此；3)内隐学习任务的表现与临床病程相关；3)内隐学习异常与神经回路异常有关，与强迫症的情况类似；4)体重恢复患者认知障碍的改善与临床病程的改善有关。更充分地了解AN的思维和行为紊乱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.Timothy Walsh博士(厌食症临床研究培训和专业知识)、Yaakov Stern博士(认知神经科学培训)和Bradley Peterson博士(功能神经成像培训)的大力指导下，MPORCDA将为首席研究员提供技能和进一步的研究经验，将翻译认知神经科学的进步应用于厌食症研究。该奖项的长期目标是让候选人成为一名专家和独立研究人员，专注于饮食失调的发展和持久性的潜在机制，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.