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）的定义是频繁发生暴饮暴食事件，与严重的失控感相关，随后发生补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的暴饮暴食和其他冲动行为有关。然而，BN在青春期的发病高峰表明，了解在此期间额纹状体异常的发展和进展是必要的，以了解BN的生物学和设计新的治疗和预防策略。这项多模式成像研究将使用功能MRI、解剖MRI和弥散张量成像测量，评估50名符合拟定的BN DSM-5标准的青少年与50名匹配的对照组（13-18岁）的功能、解剖特征和额纹状体系统组织的纵向变化（3年以上）。我们将确定与症状缓解的青少年相比，症状恶化的BN青少年的额纹状体紊乱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BN青少年的第一项纵向成像研究，任何饮食失调个体的第一项多模式成像研究，以及健康青少年相同样本中额纹状体系统的第一项纵向多模式成像研究。因此，这项研究的结果可能指向一个有用的生物标志物（额纹状体障碍）的BN的早期干预，并进一步了解这些系统的正常成熟。

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.