Weight History, Brain Activation to Food Cues and Eating Disorder Psychopathology

体重史、食物线索的大脑激活和饮食失调精神病理学

• 批准号: 9076365
• 负责人: Anna Rose Childress
• 金额: $ 22.88万
• 依托单位: DREXEL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-04 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9076365
• 关键词: Accounting; Address; Adverse effects; Affect; Ambulatory Care; Area; Base of the Brain; Behavior; Behavioral; Binge Eating; Body Weight; Body Weight Changes; Body Weight decreased; Brain; Brain region; Characteristics; Clinical; Cognitive Therapy; Cues; Development; Diagnosis; Diagnostic and Statistical Manual of Mental Disorders; Dimensions; Disease; Disease model; Dopamine; Eating; Eating Disorders; Energy Intake; Energy Metabolism; Etiology; Food; Frequencies; Functional Magnetic Resonance Imaging; Future; Goals; Health; Individual; Intake; Lead; Leptin; Maintenance; Measures; Mediating; Medical; Mental Health; Modeling; Nature; Negative Valence; Outcome; Overweight; Patients; Pattern; Population; Prevalence; Psychopathology; Recommendation; Recording of previous events; Research; Research Domain Criteria; Resistance; Rewards; Source; System; Testing; Translating; Underweight; Weight; Weight Gain; Weights and Measures; brain metabolism; clinically significant; disorder subtype; energy balance; follow-up; improved; interest; neuroimaging; novel; physical conditioning; prospective; purge; response; standardize measure

DESCRIPTION (provided by applicant): Eating disorders (EDs) affect approximately 5% of the population and have a variety of adverse effects on mental and physical health. The treatment of disordered eating has progressed in recent years but further progress will depend in part on improving the field's understanding of eating disorder psychopathology. The cognitive-behavioral therapy (CBT) model of EDs has garnered substantial support but this framework does not sufficiently address two domains that appear to have a major impact on disordered eating. We call the first domain Weight History, which consists of premorbid body mass, the discrepancy between highest ever and current body weight (weight suppression, WS) and current BMI (which is often at very low, unhealthy levels). We have shown that WS and BMI (and their interaction) are robust predictors of many ED characteristics and that these relationships are not sufficiently accounted for by the CBT model. The second domain involves brain reward and inhibitory responses to palatable food cues. Evidence indicates that a continuum exists, with the poles anchored by the opposing responses to food cues of restricting anorexic patients and overweight binge eaters (with the former showing reward hypo-activation and inhibitory hyper-activation and the latter showing the reverse). Yet little known about how these abnormal patterns contribute to ED psychopathology. Because the variables comprising both domains are continuous in nature, and because the current application will study ED individuals regardless of DSM diagnosis, the proposed research is consistent with RDoC recommendations. We test the hypotheses that the two domains will be cross-sectionally related to eating disorder psychopathology, will predict future weight gain, ED symptomatology and course and that brain activation in reward and inhibitory regions of interest will mediate the predictive effects of Weight History variables on weight change and ED outcomes. These hypotheses will be tested among 96 ED individuals receiving treatment in any level of outpatient care. At baseline they will be assessed using standardized measures of Weight History and ED psychopathology and will undergo structural and functional MRI using a paradigm aimed at measuring their reward and inhibitory activation to food pictures in regions of interest. The measures of weight and ED symptomatology will be repeated at 3 and 6-month follow-ups. The proposed research has substantial potential to identify new sources of ED psychopathology that can be translated into novel treatments for these treatment-resistant disorders.

描述（由申请人提供）：饮食失调（EDs）影响约5%的人口，并对心理和身体健康产生各种不利影响。饮食失调的治疗近年来取得了进展，但进一步的进展将部分取决于提高该领域对饮食失调精神病理学的理解。ed的认知行为疗法（CBT）模型已经获得了大量的支持，但这个框架并没有充分解决两个似乎对饮食失调有重大影响的领域。我们称之为第一域体重史，它包括发病前体重、最高体重和当前体重之间的差异（体重抑制，WS）和当前BMI（通常处于非常低的不健康水平）。我们已经表明，WS和BMI（以及它们之间的相互作用）是许多ED特征的可靠预测因子，而这些关系并没有被CBT模型充分解释。第二个领域涉及大脑对美味食物线索的奖励和抑制反应。有证据表明，这是一个连续统一体，限制性厌食症患者和超重暴饮暴食者对食物线索的相反反应锚定了两极（前者表现出奖励低激活和抑制性高激活，后者表现出相反的情况）。然而，对于这些异常模式如何导致ED精神病理却知之甚少。由于包含这两个领域的变量在本质上是连续的，并且由于当前的应用将研究ED个体而不考虑DSM诊断，因此拟议的研究与RDoC的建议是一致的。我们测试了以下假设：这两个区域将与饮食失调精神病理学横断面相关，将预测未来的体重增加、ED症状和病程，以及在感兴趣的奖励和抑制区域的大脑激活将介导体重史变量对体重变化和ED结果的预测作用。这些假设将在96名接受任何级别门诊治疗的ED患者中进行检验。在基线时，他们将使用体重史和ED精神病理学的标准化测量方法进行评估，并将使用旨在测量他们对感兴趣区域食物图片的奖励和抑制激活的范式进行结构和功能MRI。在3个月和6个月的随访中重复测量体重和ED症状。提出的研究有很大的潜力来确定ED精神病理的新来源，可以转化为这些治疗抵抗性疾病的新治疗方法。