A Longitudinal Multimodal MRI Study of Adolescents with Bulimia Nervosa

描述（由申请人提供）：神经性贪食症（BN）的定义是频繁出现暴食发作，并伴有严重的失控感，随后出现代偿行为以避免体重增加。我们的初步数据表明，额纹状体神经系统的解剖和功能异常与成人和青少年BN患者的暴饮暴食和其他冲动行为有关。然而，青春期是BN的发病高峰期，这表明了解这一时期额纹状体异常的发展和进展对于了解BN的生物学和设计新的治疗和预防策略是必要的。这项多模态成像研究将使用功能性MRI、解剖MRI和弥散张量成像测量来评估50名符合DSM-5 BN标准的青少年与50名13-18岁的匹配对照者在功能、解剖特征和额纹状体系统组织方面的纵向变化（超过3年）。我们将确定与症状减轻的青少年相比，症状加重的BN青少年额纹状体障碍的轨迹如何偏离正常，以及我们在基线时的脑成像测量是否可以预测随访时症状的严重程度。这将是首个针对BN青少年的纵向成像研究，首个针对饮食失调患者的多模态成像研究，以及首个针对健康青少年额纹状体系统的纵向多模态成像研究。因此，本研究的发现可能为BN的早期干预提供有用的生物标志物（额纹状体紊乱），并进一步加深我们对这些系统正常成熟的理解。

DESCRIPTION (provided by applicant): Bulimia Nervosa (BN) is defined by the frequent occurrence of binge-eating episodes that are associated with a severe sense of loss of control, followed by compensatory behaviors to avoid weight gain. Our preliminary data suggest that anatomical and functional abnormalities in frontostriatal neural systems are associated with binge- eating and other impulsive behaviors in adults and adolescents with BN. However, the peak onset of BN in adolescence suggests that understanding the development and progression of frontostriatal abnormalities during this period is necessary to understand the biology of BN and design novel treatments and prevention strategies. This multimodal imaging study will use functional MRI, anatomical MRI, and diffusion tensor imaging measures to assess longitudinal changes (over 3 years) in the function, anatomical characteristics, and organization of frontostriatal systems in 50 adolescents who meet the proposed DSM-5 criteria for BN compared with 50 matched controls, 13-18 years of age. We will determine how the trajectories of frontostriatal disturbances diverge from normal in the adolescents with BN whose symptoms worsen compared to those whose symptoms remit, and whether our brain imaging measures at baseline can predict the severity of symptoms at follow-up. This will be the first longitudinal imaging study of adolescents with BN, the first multimodal imaging study of any individuals with eating disorders, and the first longitudinal, multimodal imaging study of frontostriatal systems in the same sample of healthy adolescents. Thus, findings from this study may point to a useful biomarker (frontostriatal disturbances) for the early intervention of BN, and further our understanding of the normal maturation of these systems.