Neural Underpinnings of Anxiety in Relation to Eating Behaviors in Adolescence

项目摘要/摘要 进食失控(LOC)是暴饮暴食障碍的一个显著特征，涉及到 无法控制吃了什么或吃了多少。在青春期女孩中很常见，吃低碳水化合物是一个先兆 到部分或全部症状暴饮暴食障碍以及抑郁和焦虑症状的恶化， 超重和脂肪增加的风险更高，代谢综合征成分恶化。这些数据 提示儿童时期吃低碳水化合物可能是不良后果的一个前瞻性标志。青年时期的LoC饮食 与焦虑高度相关，并预示着焦虑症状会随着时间的推移而增加，这表明 神经基础和/或病因。事实上，至少有一项神经成像研究发现，超重的女孩 肥胖和报告的低脂饮食表现出与年轻人类似的对社交痛苦的神经反应 焦虑。这些数据表明，进食LOC的年轻人可能存在注意力偏向(优先分配注意力 对高度突出的刺激)到社会威胁刺激，类似于患有焦虑的年轻人。这种注意力偏向 这可以用饮食失调的人际模式来解释。根据人际关系理论，LOC进食 可能是由于不适应应对负面情绪状态的结果，如焦虑，这些情绪是由 社会上令人苦恼的情况。食物消费被触发为试图逃离不舒服的 情感状态。这种不适应的应对策略可能部分归因于对即将到来的社交活动的高度敏感。 焦虑处理中的线索和异常社会情绪神经回路。值得注意的是，有数据表明 具体地说，这种焦虑在社交暗示和暴饮暴食之间的关系中扮演着一个角色 据报道，年轻人进食低碳水化合物的食物非常可口。然而，人际关系模式并没有直接 测试利用一项任务来评估摄入LOC的年轻人对社交威胁线索的注意偏差。此外， 没有数据表明进食零食是否会影响注意偏向与社会威胁之间的关系 以及焦虑处理和随后的进食行为的神经方面。注意力的时间性 对社会威胁和参与焦虑处理的神经回路中的活动的偏见非常适合测量 脑磁图(MEG)，具有良好的时间和空间分辨率。脑磁图的效用 支持将注意力偏向的神经成分与社会威胁区分开来。因此， 利用脑磁图可以阐明注意力偏向威胁的神经基础，这可能有助于摄取低碳水化合物。 这项拟议的研究将考察对社会威胁线索的注意偏差与神经之间的关系 与社交焦虑有关的激活(即前扣带回皮质、杏仁核、背外侧前额叶皮质、 内侧前额叶皮质、腹外侧额叶皮质)和随后的实验室测试餐能量摄入量 在超重的年轻人中，有和没有进食低碳水化合物。更好地理解神经基础 参与低脂饮食和焦虑之间的联系可能有助于开发新的减少焦虑的目标 摄入过多会导致饮食紊乱和肥胖。

Project Summary/Abstract Loss of control (LOC) eating, a hallmark feature of binge eating disorder, involves the subjective experience of being unable to control what or how much is being eaten. Common in adolescent girls, LOC eating is a precursor to partial- or full-syndrome binge eating disorder as well as worsening of depressive and anxiety symptoms, higher risk for excess weight and fat gain, and worsening of metabolic syndrome components. These data indicate that LOC eating in childhood may be a prospective marker for adverse outcomes. LOC eating in youth is highly comorbid with anxiety, and is predictive of increases in anxiety symptoms over time, suggesting shared neural underpinnings and/or etiologies. Indeed, at least one neuroimaging study found that girls with overweight and obesity and reported LOC eating demonstrated a similar neural response to social distress as youth with anxiety. These data suggest youth with LOC eating may have an attention bias (preferential allocation of attention to highly salient stimuli) to socially threatening stimuli, similar to that of youth with anxiety. This attention bias may be explained by the interpersonal model of disordered eating. According to interpersonal theory, LOC eating may develop as a result of maladaptive coping with negative affective states, such as anxiety, that arise from socially distressing situations. Food consumption is triggered as an attempt to escape from the uncomfortable affective state. This maladaptive coping strategy may be due, in part, to heightened sensitivity to incoming social cues and abnormalities in anxiety processing socio-emotional neural circuits. Notably, there are data to suggest that anxiety, specifically, plays a role in the relationship between social cues and consumption of overeating highly palatable foods in youth with reported LOC eating. However, the interpersonal model has not been directly tested making use of a task to assess attention bias to social threat cues among youth with LOC eating. Further, there are no data to indicate whether LOC eating impacts the relationship between attention bias to social threat and neural aspects of anxiety processing and subsequent eating behaviors. The temporal nature of attention bias to social threat and activity in neural circuits involved in anxiety processing is ideally suited for measurement by magnetoencephalography (MEG), which has both excellent temporal and spatial resolution. Utility of MEG has been supported for differentiating between neural components of attention bias to social threat. Thus, utilizing MEG may elucidate the neural bases of attention bias toward threat that may contribute to LOC eating. The proposed study will examine the relationship between attention bias to social threat cues and neural activation implicated in social anxiety (i.e. anterior cingulate cortex, amygdala, dorsolateral prefrontal cortex, medial prefrontal cortex, ventrolateral prefrontal cortex) and subsequent energy intake at a laboratory test meal in youth with overweight, with and without LOC eating. A better understanding of the neural underpinnings involved in the links between LOC eating and anxiety may aid in the development of novel targets for reducing excess intake that leads to disordered eating and obesity.