Incentive Processing and Learning in Anorexia Nervosa and Bulimia Nervosa

Study Overview
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Brief Summary
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The purpose of this study is to investigate areas of the brain responsible for 'liking', 'wanting', and learning in adults with eating disorders using brain imaging techniques, computer tasks, a test meal, and self-report questionnaires and interviews. The investigators will study changes in brain activity using a procedure called functional magnetic resonance imaging (fMRI). This study will include 252 women with an eating disorder (63 AN-restricting type (AN-R), 63 AN-binge eating/purging type (AN-BP), 63 bulimia nervosa (BN)) and 63 healthy controls (HC) aged 18-39. Aim 1: To examine neural differences in 'liking' and 'wanting' in ED relative to HC. Aim 2: To examine differences in instrumental learning for reward and punishment in ED relative to HC. Aim 3: To examine how 'liking' and 'wanting' drive instrumental learning in ED and predict clinical symptoms at baseline and 1 year later. Exploratory Aim: To explore the associations of dopamine function, as measured by neuromelanin MRI (NM-MRI), with ED diagnosis and brain response to 'liking', 'wanting', and learning.

Official Title
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Incentive Processing and Learning in Anorexia Nervosa and Bulimia Nervosa

Conditions
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Anorexia Nervosa, Bulimia Nervosa

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Eating Disorder Group: Between the ages of 18 and 39 years old Meet DSM-V criteria for AN-R, AN-BP, or BN Healthy Control Group: Between the ages of 18 and 39 years old Have maintained 85% to 120% ideal body weight since menarche Exclusion Criteria: All Groups: Psychotic illness/other mental illness requiring hospitalization Current dependence on drugs or alcohol defined by DSM IV criteria. Additionally, positive test results for drug use on the day of the scan, apart of marijuana, will result in cancelling or rescheduling the scan because acute use will impact MRI measures. Physical conditions (e.g. diabetes mellitus, pregnancy) known to influence eating or weight Neurological disorder, neurodevelopmental disorder, or history of head injury with >30 min loss of consciousness Any contraindication to undergoing an MRI Primary obsessive compulsive disorder or primary major depressive disorder Additional Exclusion Criteria for ED Group: -If taking other psychotropic medication, any change in dosage in the 2 weeks before scanning Additional Exclusion Criteria for Healthy Control Group: Meet criteria for the diagnosis of any psychiatric disorder currently Any history of binge eating or purging behaviors, including self-induced vomiting, laxative or diuretic misuse Use of any psychoactive or other medication known to affect mood or concentration in the last 3 months

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 39 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| AN-R<br>Participants that meet Diagnostic And Statistical Manual Of Mental Disorders (DSM-V) criteria for Anorexia Nervosa restricting subtype. | |
| AN-BP<br>Participants that meet DSM-V criteria for Anorexia Nervosa binging/purging subtype | |
| BN<br>Participants that meet DSM-V criteria for Bulimia Nervosa. | |
| Healthy Controls<br>Participants that do not meet DSM-V criteria for any disorder. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| BOLD response | Brain activity associated with 'liking', 'wanting', and learning | 1 Year | 
| Reward and Punishment Learning | Task reinforcement learning rate in reward and punishment trials | 1 Year | 
| Connectome-based predictive modeling (CPM) | Functional connectivity maps from task-based fMRI data and clinical data | 1 Year |