Computational and neural signatures of interoceptive learning in anorexia nervosa

项目摘要 神经性厌食症（AN）是一种高度损害性、慢性且常常致命的疾病，然而其病因仍然不清楚 明白异常的厌恶性学习，特别是与内部身体信号有关的学习（即，厌恶 内感受性学习），可能是饮食失调病理学的一个关键特征，因为内感受性领域是相互关联的 更大的身体形象障碍，扭曲的饥饿/饱足的线索，和失调的情感处理在AN。 厌恶性内感受学习是由预期和观察到的感觉状态之间的差异驱动的（即， 预测误差），与由纹状体，纹状体， 前额叶皮层和杏仁核AN患者表现出难以区分预期的 和经验丰富的感觉，这表明他们从身体感觉中成功学习的能力受到了损害， 这可能会导致饮食失调。尽管如此，厌恶性内感受性学习的研究还相当不足。 饮食失调这是第一个研究1）AN患者如何从厌恶性内感受性学习 结果，2）支持厌恶性内感受性学习显示的神经解剖区域是否改变 AN中的功能连接，以及3）厌恶性内感受性学习的行为和神经特征如何 有联系32名诊断为AN的成年女性和32名人口统计学匹配的健康对照者将 利用厌恶性呼吸限制完成联想学习范例，并将经历休息状态 功能性磁共振成像内感受性学习将通过计算 跟踪逐个试验预测误差（PE）和刺激值估计的模型。目标1将审查模型- 在厌恶性内感受性学习中产生的潜在行为差异（例如，学习率）之间 参与者和健康对照，以及与临床饮食失调措施的关联。目标2将评估 与厌恶性学习和内感受性相关区域的神经功能连接的组差异 处理（即，杏仁核、纹状体、前额叶皮质）。目标3将探讨岛屿 连通性和学习率。揭示厌恶性内感受性学习的行为和神经特征 不仅将告知AN的风险和维护的病因学模型，而且还将标志着下一步的必要性 在开发新的治疗方法，目标是认知和感官过程有助于进食， 疾病病理学此外，该项目将提供计算和神经成像方面的宝贵培训 方法，技能急需加强饮食失调的研究和治疗的发展。

PROJECT SUMMARY Anorexia nervosa (AN) is a highly impairing, chronic, and often fatal disorder, however its etiology remains poorly understood. Aberrant aversive learning, particularly in relation to internal bodily signals (i.e., aversive interoceptive learning), may be a critical feature of eating disorder pathology, as interoceptive domains are linked to greater body image disturbance, distorted hunger/satiety cues, and dysregulated affective processing in AN. Aversive interoceptive learning is driven by discrepancies between anticipated and observed sensory states (i.e., prediction errors), brain-based computations associated with networks consisting of the insula, striatum, prefrontal cortex, and amygdala. Individuals with AN demonstrate difficulties distinguishing between expected and experienced sensations, suggesting their ability to successfully learn from body sensations is compromised, which may maintain disordered eating. Despite this, aversive interoceptive learning is considerably understudied in eating disorders. This is the first study to examine 1) how individuals with AN learn from aversive interoceptive outcomes, 2) whether neuroanatomical regions supporting aversive interoceptive learning display altered functional connectivity in AN, and 3) how behavioral and neural signatures of aversive interoceptive learning are linked. Thirty-two adult women diagnosed with AN and 32 demographically matched healthy controls will complete an associative learning paradigm utilizing aversive breathing restrictions and will undergo resting-state functional magnetic resonance imaging. Interoceptive learning will be operationalized using computational models that track trial-by-trial prediction errors (PE) and stimulus value estimates. Aim 1 will examine model- generated latent behavioral differences in aversive interoceptive learning (e.g., learning rates) between AN participants and healthy controls, as well as associations with clinical eating disorder measures. Aim 2 will assess group differences in insula functional connectivity with regions linked to aversive learning and interoceptive processing (i.e., amygdala, striatum, prefrontal cortex). Aim 3 will explore associations between insular connectivity and learning rates. Uncovering behavioral and neural signatures of aversive interoceptive learning will not only inform etiological models of risk and maintenance in AN, but will also signify an imperative next step in the development of novel treatments that target both cognitive and sensory processes contributing to eating disorder pathology. Moreover, this project will provide invaluable training in computational and neuroimaging methodology, skills critically needed to enhance eating disorder research and treatment development.