Multimodal Neuroimaging of Adolescents and Young Adults with Anorexia Nervosa

描述（由申请人提供）：神经性厌食症（AN）是一种危及生命的精神疾病，其特征是严重的体重减轻，对体重和外观的扭曲思考，以及健康和情绪问题的最小化。通常，AN患者还表现出回避、僵化和强迫性的思维方式，这通常限制了患者对治疗的反应能力。越来越多的文献表明，这种认知风格反映在几个领域的神经心理学缺陷中，特别是，受损的集转移（可理解性），弱的中央连贯性（过分关注细节而忽视了细节）， （1）对奖励和惩罚的敏感性。考虑到潜在的大脑异常，这些效率低下可能会增加AN的风险，并影响对治疗的反应。对AN核心认知效率低下的神经基础的全面调查可能会建议认知治疗的靶点，以增强对治疗的反应并预防复发。有有限数量的神经影像学研究的认知功能的AN。本申请提出了一种多模态神经成像分析，利用现有的神经成像数据收集的种子资金，调查神经相关的认知过程中的AN。24名年龄在16-25岁之间的AN女性先前被招募作为NIMH资助的治疗试验的一部分。从这些受试者中收集了基线时的结构和功能脑图像，沿着还有一组匹配的14名健康女性对照。该申请要求提供所需资金，以收集额外8例AN患者的神经影像学数据，并对这些现有数据进行全面的多模式神经影像学分析。最先进的分析将包括在集合移位、中枢一致性和奖励处理的标准任务期间获得的功能性MRI的多变量模式分析。将对高分辨率解剖脑图像进行FreeSurfer分析，分析整个大脑的区域体积和皮质厚度。扩散张量成像数据将用于研究整个大脑的白色物质完整性，以及感兴趣纤维的纤维束成像。这些分析将有助于在现有的AN文献的神经心理过程的神经基础的最全面的评估。

DESCRIPTION (provided by applicant): Anorexia Nervosa (AN) is a life-threatening psychiatric disorder characterized by severe weight loss, distorted thinking about weight and appearance, and minimization of health and emotional problems. Typically, patients with AN also display a thinking style that is avoidant, rigid, and obsessive, which often limits the abilit of patients to respond to treatment. A growing body of literature demonstrates that this cognitive style is reflected in neuropsychological deficits in several domains, particularly, impaired set shifting (inflexibility), weak central coherence (exaggerated focus on detail to the neglect of the whole), and heightened sensitivity to reward and punishment. These inefficiencies may increase risk for AN given underlying brain abnormalities, and influence response to treatments. A comprehensive investigation of the neural basis of core cognitive inefficiencies in AN may suggest targets for cognitive treatments that enhance response to therapy and prevent relapse. There are a limited number of neuroimaging studies of cognitive function in AN. This application proposes a multimodal neuroimaging analysis, leveraging existing neuroimaging data collected with seed monies, to investigate the neural correlates of cognitive processes in AN. Twenty-four females with AN, ages 16-25, were previously recruited as part of an NIMH funded treatment trial. Structural and functional brain images were collected from these subjects at baseline, along with a matched group of 14 healthy female controls. This application requests funding needed to collect neuroimaging data from an additional 8 patients with AN, and to perform a comprehensive multimodal neuroimaging analysis of these existing data. State-of-the-art analyses will include multivariate pattern analysis of functional MRI acquired during standard tasks of set- shifting, central coherence, and reward processing. High resolution anatomical brain images will be subjected to a FreeSurfer analysis of regional volumes and cortical thickness throughout the brain. Diffusion tensor imaging data will be used to investigate white matter integrity throughout the brain, and tractography of fibers of interest. These analyses will contribute the most comprehensive assessment of the neural basis of neuropsychological processes in the existing AN literature.