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，对体重和外表的扭曲思维，以及对健康和情绪问题的最小化。典型地，AN患者还表现出一种回避、僵化和强迫的思维方式，这往往限制了患者对治疗的反应能力。越来越多的文献表明，这种认知方式反映在几个领域的神经心理缺陷上，特别是，受损的集合转移（缺乏灵活性），弱的中心连贯（过分关注细节而忽视了细节）

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. PUBLIC HEALTH RELEVANCE: Anorexia Nervosa is a life-threatening psychiatric disorder with risk of serious complications from self-imposed starvation. The typical thinking styles of patients with AN, such as cognitive rigidity, make it difficult for patients to benefit from therap. Response to treatment might be improved by better understanding the neural basis of these cognitive characteristics. This study augments an existing brain imaging dataset from patients with AN while performing cognitive tasks that tap into these thinking styles. This study will contribute state-of-the-art neuroimaging analyses of brain structure and function in AN, significantly advancing our understanding of this serious disorder.