Self-regulatory Control and Eating: A Neuroimaging Study of Bulimia Nervosa

描述(由申请人提供)：有相当多的证据表明，患有神经性暴食症(BN)的人在自我调节控制方面存在缺陷。参与这些过程的大脑区域已经通过功能磁共振成像(FMRI)研究确定。然而，将自我调节缺陷和神经活动与BN的临床有意义的行为直接联系起来的研究明显缺乏，这在很大程度上是因为运动伪影排除了用fMRI测量参与者开始进食期间的神经活动。建议的Ruth L.Kirschstein国家研究服务奖(NRSA)是一个为期两年的研究和培训计划，重点是调节BN中一般和与饮食相关的自我调节控制过程的神经系统。功能性近红外光谱(FNIR)是一种便携和廉价的神经成像设备，允许在更生态和临床有效的环境中评估皮质活动。这项拟议的项目将检查35名符合BN临时DSM-5诊断标准的女性和35名匹配的健康对照组在标准任务和与进食相关的Go/No Go任务期间的大脑活动。该项目的目的首先是确认和交叉验证先前的调查结果。这将包括检验以下假设：1)与健康对照组相比，患有BN的女性在标准的Go/no-Go任务中，在抑制优先反应时，会表现出表现受损和前额神经活动减少(由fnir测量)；2)在BN女性中，前额叶区域的活动程度将与自我报告的暴食行为频率呈负相关。在参与者的子集(n=28)中，这一标准任务的FNIR数据将使用fMRI进行交叉验证。然后，这项研究旨在通过一种新颖的、去/不去的流质餐饮任务和可口的酸奶奶昔来扩展研究结果。同样的假设将在第二个GO/NO-GO任务中进行测试，该任务需要在“NO-GO”试验期间抑制优先的啜饮反应。这项拟议的研究结果不仅将证实在BN的反应抑制任务中前额叶激活缺陷的重要性，而且通过展示类似的、或许更深刻的活动缺陷来扩展这些先前的发现，该行为任务需要在进食时进行自我调节控制。重要的是，与以前只包括症状激发任务或一般认知神经科学范式的研究不同，AIMS的组合允许区分特定与进食抑制相关的激活与那些与一般反应抑制相关的激活。这项NRSA将为申请者提供所需的技能和研究经验，以在BN的神经基质研究中整合成像和行为数据。神经成像与认知神经科学范式和进食任务的新结合将阐明与暴饮暴食相关的神经行为联系，以及可能有助于疾病发展和维持的前额叶神经机制。

DESCRIPTION (provided by applicant): There is considerable evidence to suggest that individuals with bulimia nervosa (BN) exhibit deficits in self- regulatory control. The brain regios involved in these processes have been identified by functional magnetic resonance imaging (fMRI) studies. However, research directly linking self-regulatory deficits and neural activity to clinically meaningful behaviors in BN is notably lacking, largely because motion artifact precludes measurement with fMRI of neural activity during participant-initiated eating. The proposed Ruth L. Kirschstein National Research Service Award (NRSA) is a two-year program of research and training focused on the neural systems mediating general and eating-related self-regulatory control processes in BN. Functional near- infrared spectroscopy (fNIR), a portable and inexpensive neuroimaging modality, allows for assessment of cortical activity in more ecologically- and clinically-valid settings. The proposed project will examine brain activity during a standard and an eating-related go/no-go task in 35 women meeting provisional DSM-5 diagnostic criteria for BN and 35 matched healthy controls. The project aims first to confirm and cross-validate previous findings. This will include testing the hypotheses that 1) compared to healthy controls, women with BN will demonstrate impaired performance and reduced prefrontal neural activity (as measured by fNIR) during the inhibition of prepotent responses in a standard go/no-go task; 2) among women with BN, the magnitude of activity in prefrontal regions will correlate inversely with self-reported frequency of bulimic behaviors. In a subset of participants (n = 28), the fNIR data for this standard task will be cross-validated using fMRI. The study then aims to extend findings using a novel, go/no-go liquid-meal sipping task and a palatable yogurt shake. The same hypotheses will be tested during this second go/no-go task, which requires inhibition of a prepotent sipping response during "no-go" trials. The results of the proposed study would not only confirm the importance of deficits in prefrontal activation during response inhibition tasks in BN, but extend these previous findings by demonstrating similar, and perhaps more profound, deficiencies in activity during a behavioral task that requires self-regulatory control during eating. Importantly, unlike previous studies that have included only symptom-provocation tasks or general cognitive neuroscience paradigms, the combination of aims allows for distinction of activations related specifically to the inhibition of eating from those related o general response inhibition. This NRSA will provide the applicant with the skills and research experience needed to integrate imaging and behavioral data in the investigation of the neural substrates of BN. The novel integration of neuroimaging with a cognitive neuroscience paradigm and an eating task will elucidate the neurobehavioral connections associated with binge eating and the prefrontal neural mechanisms that may contribute to the development and maintenance of the disorder.