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.

Public Health Relevance

We propose a longitudinal multimodal imaging study of the structure and function of frontostriatal neural systems in adolescents with Bulimia Nervosa (BN). Identification of abnormalities in these systems will foster a better understanding of the pathophysiology of BN and point to a biomarker that will aid in the development of early interventions and individualized treatments for this disabling illness.

Agency
National Institute of Health (NIH)
Type
Research Project (R01)
Project #
5R01MH090062-04
Application #
8662792
Study Section
Child Psychopathology and Developmental Disabilities Study Section (CPDD)
Program Officer
Zehr, Julia L
Project Start
Project End
Budget Start
Budget End
Support Year
4
Fiscal Year
2014
Total Cost
Indirect Cost
Name
New York State Psychiatric Institute
Department
Type
DUNS #
City
New York
State
NY
Country
United States
Zip Code
10032
Labouliere, Christa D; Terranova, Kate; Steinglass, Joanna et al. (2016) Implicit learning on a probabilistic classification task in adults and adolescents with Bulimia Nervosa. J Psychiatr Res 77:35-41
Wang, Zhishun; Jacobs, Rachel H; Marsh, Rachel et al. (2016) Sex-specific neural activity when resolving cognitive interference in individuals with or without prior internalizing disorders. Psychiatry Res 249:76-83
He, Xiaofu; Stefan, Mihaela; Terranova, Kate et al. (2016) Altered White Matter Microstructure in Adolescents and Adults with Bulimia Nervosa. Neuropsychopharmacology 41:1841-8
Cyr, Marilyn; Wang, Zhishun; Tau, Gregory Z et al. (2016) Reward-Based Spatial Learning in Teens With Bulimia Nervosa. J Am Acad Child Adolesc Psychiatry 55:962-971.e3
Marsh, Rachel; Stefan, Mihaela; Bansal, Ravi et al. (2015) Anatomical characteristics of the cerebral surface in bulimia nervosa. Biol Psychiatry 77:616-23
Berner, Laura A; Marsh, Rachel (2014) Frontostriatal circuits and the development of bulimia nervosa. Front Behav Neurosci 8:395
Wang, Zhishun; Maia, Tiago V; Marsh, Rachel et al. (2011) The neural circuits that generate tics in Tourette's syndrome. Am J Psychiatry 168:1326-37
Horga, Guillermo; Maia, Tiago V; Wang, Pengwei et al. (2011) Adaptation to conflict via context-driven anticipatory signals in the dorsomedial prefrontal cortex. J Neurosci 31:16208-16
Marsh, Rachel; Horga, Guillermo; Wang, Zhishun et al. (2011) An FMRI study of self-regulatory control and conflict resolution in adolescents with bulimia nervosa. Am J Psychiatry 168:1210-20
Marsh, Rachel; Hao, Xuejun; Xu, Dongrong et al. (2010) A virtual reality-based FMRI study of reward-based spatial learning. Neuropsychologia 48:2912-21

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