A Longitudinal Multimodal MRI Study of Adolescents with Bulimia Nervosa

描述（由申请人提供）：在01MH090062-01A1的支持下，我们正在使用多模态成像方法来确定作为自我调节能力基础的特定额纹状体回路的功能和解剖紊乱如何促进青春期神经性贪食症（BN）的发展和持续。我们目前正在评估40名13-18岁的BN青少年与40名匹配的对照组相比，这些额纹状体回路的功能、解剖特征和组织的纵向变化。这个竞争性补充的目标是使用我们新颖的虚拟现实功能磁共振成像范式来评估已经参与我们纵向研究的患有和不患有BN的青少年在第二次扫描期间调解基于奖励的学习的重叠回路的功能。我们还将评估这些重叠回路中的功能连通性，并确定功能障碍是否与BN症状严重程度相关。我们怀疑这些干扰可能从调节控制中释放了习得的和习惯性的暴饮暴食和清除BN特征的行为。因此，这一补充是一种具有成本效益的方式，可以增加父母资助中详细研究的重要性和创新，允许识别基于奖励的学习系统的功能异常，以及自我调节能力的异常，可能导致青春期持续存在BN。

DESCRIPTION (provided by applicant): Under the auspices of 01MH090062-01A1, we are using multimodal imaging measures to determine how functional and anatomical disturbances in the specific frontostriatal circuits that underlie self-regulatory capacities contribute to the development and persistence of Bulimia Nervosa (BN) over adolescence. We are currently assessing longitudinal changes in the function, anatomical characteristics, and organization of these frontostriatal circuits in 40 adolescents with BN compared with 40 matched controls, 13-18 years of age. The goal of this competitive supplement is to use our novel virtual-reality fMRI paradigm to assess the functioning of the overlapping circuits that mediate reward-based learning in the same adolescents with and without BN who are already participating in our longitudinal study, during their second scan session. We will also assess functional connectivity within these overlapping circuits and determine whether functional disturbances are associated with BN symptom severity. We suspect that these disturbances likely release from regulatory control the learned and habitual binge eating and purging behaviors that characterize BN. This supplement is therefore a cost-effective way to add to the significance and innovation of the research detailed in the parent grant, allowing to identify functional abnormalities in reward based learning systems that, together with abnormalities in self-regulatory capacities, likely contribute to the persistence of BN over adolescence. PUBLIC HEALTH RELEVANCE: This competitive supplement to our longitudinal imaging study of adolescents with Bulimia Nervosa (R01MH090062-01A1) will identify functional abnormalities in reward-based learning systems that, together with abnormalities in self-regulatory capacities, will point to a biomarker (frontostriatal circuits) that will aid in the development of early interventions and individualized treatments for this disabling illness.