A Longitudinal Multimodal MRI Study of Adolescents with Bulimia Nervosa

描述(由申请人提供)：神经性暴食症(BN)的定义是频繁发生暴饮暴食，与严重的失控感相关，然后是避免体重增加的代偿性行为。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的暴饮暴食和其他冲动行为有关。然而，青春期BN的发病高峰表明，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。这项多模式成像研究将使用功能MRI、解剖MRI和扩散张量成像测量方法来评估50名符合建议的DSM-5 BN标准的青少年额纹状体系统的功能、解剖特征和组织的纵向变化(超过3年)，并与50名13-18岁的匹配对照组进行比较。我们将确定在患有BN的青少年中，与症状缓解的人相比，其症状恶化的额纹状体障碍的轨迹如何偏离正常，以及我们基线的脑成像测量是否可以预测后续症状的严重性。这将是第一次对患有BN的青少年进行纵向成像研究，第一次对饮食障碍患者进行多模式成像研究，也是第一次在同一健康青少年样本中对额纹状体系统进行纵向多模式成像研究。因此，这项研究的发现可能会为BN的早期干预指出一个有用的生物标记物(额纹状体障碍)，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.