Multimodal investigations of structural and functional brain alterations in anorexia and bulimia nervosa and their relationships to psychopathology.

IF 9.6 1区医学 Q1 NEUROSCIENCES Biological Psychiatry Pub Date : 2024-11-22 DOI:10.1016/j.biopsych.2024.11.008

Xinyang Yu, Lauren Robinson, Marina Bobou, Zuo Zhang, Tobias Banaschewski, Gareth J Barker, Arun L W Bokde, Herta Flor, Antoine Grigis, Hugh Garavan, Penny Gowland, Andreas Heinz, Rüdiger Brühl, Jean-Luc Martinot, Marie-Laure Paillère Martinot, Eric Artiges, Frauke Nees, Dimitri Papadopoulos Orfanos, Hervé Lemaître, Luise Poustka, Sarah Hohmann, Nathalie Holz, Christian Bäuchl, Michael N Smolka, Argyris Stringaris, Henrik Walter, Robert Whelan, Julia Sinclair, Gunter Schumann, Ulrike Schmidt, Sylvane Desrivières

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Abstract

Background: Neurobiological understanding of eating disorders (EDs) is limited. This study presents the first comparative multi-modal magnetic resonance imaging (MRI) assessments of anorexia nervosa (AN) and bulimia nervosa (BN), uncovering neurobiological differences associated with these disorders.

Methods: This female case-control study included 57 healthy controls (HC) and 130 participants with EDs (BN and AN subtypes). Structural and functional MRI assessed gray matter volume (GMV), cortical thickness (CT), and task-based activities related to reward processing, social-emotional functioning, and response inhibition. Whole-brain group differences were correlated to ED psychopathology.

Results: Significant structural differences were observed in the ED group compared to HCs, including reduced GMV in the left lateral orbitofrontal cortex and lower CT in the left rostral middle frontal gyrus and precuneus, after adjusting for BMI. Specific structural alterations were only evident in AN subgroups. GMV reductions in the orbitofrontal cortex were linked to impulsivity, while lower CT in the frontal gyrus correlated with cognitive restraint in eating, suggesting these regions may play key roles in ED psychopathology. Functional MRI also revealed notable differences. During reward anticipation, participants with EDs exhibited deactivations in the cerebellum and right superior frontal gyrus, alongside reduced activation in the left lingual gyrus. These functional changes were associated with heightened neuroticism. Mediation analyses suggested that starvation-related GMV reductions in EDs disrupt reward-related brain function, increase neuroticism, and reinforce cognitive restraint, likely contributing to the persistence of ED symptoms.

Conclusions: These findings illuminate key neurobehavioral mechanisms underlying EDs, pointing to potential brain-based targets for developing specialized treatment.

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对神经性厌食症和贪食症患者大脑结构和功能改变及其与精神病理学关系的多模式研究。

背景：人们对进食障碍（EDs）的神经生物学认识还很有限。本研究首次对神经性厌食症（AN）和神经性贪食症（BN）进行了多模态磁共振成像（MRI）对比评估，揭示了与这些疾病相关的神经生物学差异：这项女性病例对照研究包括 57 名健康对照者（HC）和 130 名 ED 患者（BN 和 AN 亚型）。结构性和功能性核磁共振成像评估了灰质体积（GMV）、皮质厚度（CT）以及与奖赏处理、社交情感功能和反应抑制相关的任务活动。全脑组间差异与 ED 精神病理学相关：结果：在对体重指数进行调整后，ED组与HC组相比存在显著的结构差异，包括左侧眶额皮层的GMV降低，左侧喙中额回和楔前叶的CT降低。特定的结构改变仅在AN亚组中明显。眶额皮质的GMV降低与冲动有关，而额叶回的CT降低与进食时的认知克制有关，这表明这些区域可能在ED精神病理学中起着关键作用。功能磁共振成像也发现了明显的差异。在奖赏预期过程中，ED 患者的小脑和右侧额上回表现出失活，而左侧舌回的活化则有所降低。这些功能变化与神经质的增强有关。中介分析表明，与饥饿相关的 ED GMV 降低会破坏与奖赏相关的大脑功能、增加神经质并强化认知约束，这可能是导致 ED 症状持续存在的原因：这些研究结果阐明了ED背后的关键神经行为机制，为开发专门的治疗方法指出了潜在的脑部目标。

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来源期刊

Biological Psychiatry 医学-精神病学

CiteScore

18.80

自引率

2.80%

发文量

1398

审稿时长

33 days

期刊介绍： Biological Psychiatry is an official journal of the Society of Biological Psychiatry and was established in 1969. It is the first journal in the Biological Psychiatry family, which also includes Biological Psychiatry: Cognitive Neuroscience and Neuroimaging and Biological Psychiatry: Global Open Science. The Society's main goal is to promote excellence in scientific research and education in the fields related to the nature, causes, mechanisms, and treatments of disorders pertaining to thought, emotion, and behavior. To fulfill this mission, Biological Psychiatry publishes peer-reviewed, rapid-publication articles that present new findings from original basic, translational, and clinical mechanistic research, ultimately advancing our understanding of psychiatric disorders and their treatment. The journal also encourages the submission of reviews and commentaries on current research and topics of interest.