Neural Correlates of Reward and Symptom Expression in Anorexia Nervosa

项目总结/摘要 此K23应用程序旨在支持Ann Haynos博士成为独立的 研究人员专注于：（a）确定饮食失调的生物和心理机制和（B） 利用这些信息为饮食失调症的新的和有针对性的治疗方法的发展提供信息。的 拟议的应用程序将加强候选人的能力，以满足这些目标，提供先进的 培训目的是：（a）发展跨部门、跨部门和跨部门工作所涉奖励机制的理论和评估方面的专门知识， 诊断精神病理学，并将这一知识转化为饮食失调的研究;（B）获得 进行独立的神经生物学研究所需的神经影像学知识和技能 饮食失调的基础;以及（c）获得纵向设计，方法和分析方面的专业知识 需要进行研究，检查饮食失调的维持情况。为了实现这些目标，专家 导师团队已经组建，包括主要导师Scott Crow博士（负责翻译培训） 饮食失调研究和纵向方法），共同导师，博士Jazmin Camcong（培训 跨诊断奖励模型），Kelvin Lim博士（神经成像培训）和James Hodges博士（ 培训的生物统计学和纵向分析），以及顾问博士安格斯麦克唐纳，三世和博士。 Joanna Steinglass（用于特定奖励和决策任务的培训）。 作为培训的一部分，Haynos博士将完成一个项目，该项目将识别中脑边缘奖励的反应， 用于典型地奖励刺激的电路（即，娱乐视频剪辑）和疾病特异性刺激（即，限制性 饮食线索）在最近体重恢复的神经性厌食症（AN）个体中。本研究将确定 中脑边缘回路对典型和/或疾病特异性奖励的反应是否预示着限制性饮食 和复发的风险。AN与极差的结局和高死亡率相关。虽然 强化治疗可以将体重恢复到健康范围，一半的AN患者在治疗后一年内复发。 体重恢复这些糟糕的结果部分是由于对限制性饮食的过度驱动 描述这种紊乱。关于保持限制性的心理生物学机制知之甚少 吃东西并促进复发。然而，有初步研究表明，赤字估值通常 奖励线索和对疾病特异性奖励的增强评价可能会影响AN症状。因此，我们认为， 除了帮助实现候选人的培训目标外，该项目还将通过确定 奖励机制预测AN的限制性饮食和复发。这些知识将最终促进 开发更有效的靶向治疗，促进AN的长期恢复。

PROJECT SUMMARY/ABSTRACT This K23 application aims to support Dr. Ann Haynos her overarching goal of becoming an independent researcher focused on: (a) identifying biological and psychological mechanisms of disordered eating and (b) using this information to inform the development of novel and targeted treatments for eating disorders. The proposed application will strengthen the candidate's abilities to meet these goals by providing advanced training to: (a) develop expertise in theory and assessment of reward mechanisms involved in the cross- diagnostic psychopathology, and to translate this knowledge to research for eating disorders; (b) gain knowledge and skills in neuroimaging necessary to conduct independent research investigating neurobiological underpinnings of disordered eating; and (c) obtain expertise in longitudinal design, methodology, and analysis needed to conduct research examining maintenance of disordered eating. To achieve these goals, an expert team of mentors has been assembled, consisting of primary mentor, Dr. Scott Crow (for training in translational eating disorder research and longitudinal methodology), co-mentors, Dr. Jazmin Camcong (for training in cross-diagnostic reward models), Dr. Kelvin Lim (for training in neuroimaging) and Dr. James Hodges (for training in biostatistics and longitudinal analyses), as well as consultants Dr. Angus MacDonald, III, and Dr. Joanna Steinglass (for training in specific reward and decision-making tasks). As part of this training, Dr. Haynos will complete a project that will identify responses in mesolimbic reward circuitry to typically rewarding stimuli (i.e., entertaining video clips) and disorder-specific stimuli (i.e., restrictive eating cues) among recently weight restored individuals with anorexia nervosa (AN). This study will determine whether responding in mesolimbic circuitry to typical and/or disorder-specific rewards predicts restrictive eating and risk of relapse. AN is associated with extremely poor outcomes and high mortality rates. Although intensive treatment can restore weight to a healthy range, half of individuals with AN relapse within one year of weight restoration. These poor outcomes are due, in part, to the excessive drive towards restrictive eating characterizing this disorder. Little is known regarding the psychobiological mechanisms that maintain restrictive eating and promote relapse. However, there is initial research suggesting that deficit valuation of typically rewarding cues and enhanced valuation of disorder-specific rewards may influence AN symptoms. Therefore, in addition to assisting towards the candidate's training goals, this project will meet a critical need by identifying reward mechanisms predicting restrictive eating and relapse in AN. This knowledge will ultimately promote the development of more effectively targeted treatments promoting long-term recovery from AN.