Multimodal Neuroimaging of Adolescents and Young Adults with Anorexia Nervosa

描述(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考，以及将健康和情感问题降至最低。通常，AN患者也表现出一种回避、僵化和强迫症的思维方式，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，特别是定势转移受损(缺乏灵活性)，中央连贯性较弱(夸大对细节的关注而忽视了 整体)，并对奖励和惩罚高度敏感。这些低效可能会增加特定潜在大脑异常的风险，并影响对治疗的反应。对AN核心认知效率低下的神经基础的全面调查可能会建议认知治疗的目标，以增强对治疗的反应并防止复发。关于AN认知功能的神经成像研究数量有限。这项应用提出了一种多模式神经成像分析，利用与种子资金收集的现有神经成像数据，来研究认知过程的神经关联。24名患有AN的女性，年龄在16-25岁之间，之前作为NIMH资助的治疗试验的一部分被招募。这些受试者在基线时收集了结构和功能脑图像，并与14名健康女性对照组进行了匹配。该应用程序申请资金，以收集另外8名AN患者的神经成像数据，并对这些现有数据进行全面的多模式神经成像分析。最先进的分析将包括在集转移、中央一致性和奖励处理的标准任务期间获得的功能磁共振的多变量模式分析。高分辨率的大脑解剖图像将接受整个大脑的区域体积和皮质厚度的自由浏览分析。扩散张量成像数据将用于研究整个大脑的白质完整性，并对感兴趣的纤维进行纤维束成像。这些分析将有助于在现有的AN文献中对神经心理过程的神经基础进行最全面的评估。

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.