MRI Study of Eating Behavior for Bulimia
Recruiting in Palo Alto (17 mi)
Overseen byLaura A Berner, Ph.D.
Age: 18 - 65
Sex: Female
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Icahn School of Medicine at Mount Sinai
Disqualifiers: Medical instability, Shift work, Pregnancy, others
No Placebo Group
Trial Summary
What is the purpose of this trial?An impaired ability to exert control has been implicated in bulimia nervosa (BN), but this impairment may not represent a stable trait or be the most effective focus for treatment. This project aims to understand how predictions and value-based decisions about control may be abnormally influenced by eating in individuals with BN, thereby maintaining cycles of binge eating, purging, and restriction.
Do I need to stop taking my current medications to join the trial?
The trial excludes participants with ongoing medical treatment that may interfere with the study, so you might need to stop certain medications. It's best to discuss your specific medications with the trial team.
What data supports the effectiveness of the treatment Fasting state, Fed state, Magnetic Resonance Imaging, Lumakras, Vectibix for bulimia?
Research shows that brain imaging techniques like MRI can help understand the brain changes in bulimia, which might be useful in developing new treatments. However, there is no direct evidence supporting the effectiveness of Lumakras or Vectibix for bulimia, as these drugs are typically used for other conditions.
12345Is MRI safe for studying eating behavior in bulimia?
MRI is generally considered safe for studying brain activity and structure, as it is a non-invasive imaging technique that does not use radiation.
12356How does this MRI-based treatment for bulimia differ from other treatments?
This MRI-based treatment for bulimia is unique because it focuses on understanding and potentially altering brain activity related to eating behaviors, using imaging techniques to explore neural pathways involved in hunger, satiety, and reward systems. Unlike traditional treatments that may focus on behavioral therapy or medication, this approach aims to identify and address the underlying brain mechanisms contributing to bulimia.
12457Eligibility Criteria
This trial is for right-handed, English-speaking females aged 18-45 with a BMI between 18.5 and under 30 who meet the criteria for bulimia nervosa. It's not suitable for those medically unstable, on ongoing treatment, doing shift work, pregnant or lactating, allergic to meal ingredients used in the study, or unable to undergo an fMRI.Inclusion Criteria
Current BMI greater than or equal to 18.5kg/m2 but under 30kg/m2
Right-handed
I am female.
+3 more
Exclusion Criteria
Shift work
Pregnancy, planned pregnancy, or lactation during the study period
Ongoing medical treatment, medical condition, or psychiatric disorder that may interfere with study variables or participation
+3 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment
Participants undergo fMRI scans after fasting and after a standardized meal to assess neural activation related to cognitive control in bulimia nervosa
2 days
2 visits (in-person)
Follow-up
Participants are monitored for changes in binge-eating, dietary restriction, and compensatory behaviors
6 months
Participant Groups
The study examines how eating affects decision-making and self-control in women with bulimia nervosa by comparing their brain activity before and after eating using MRI scans while they are in fasting and fed states.
2Treatment groups
Experimental Treatment
Active Control
Group I: Participants with Bulimia NervosaExperimental Treatment3 Interventions
Participants are randomly assigned (in even numbers across the two groups) to scan order:
A. These participants are first scanned after 16 hours of fasting on one day, and are next scanned after a standardized meal on a second day.
B. These participants are first scanned after a standardized meal on one day, and are next scanned after 16 hours of fasting on a second day.
Group II: Participants without Bulimia NervosaActive Control3 Interventions
Participants are randomly assigned (in even numbers across the two groups) to scan order:
A. These participants are first scanned after 16 hours of fasting on one day, and are next scanned after a standardized meal on a second day.
B. These participants are first scanned after a standardized meal on one day, and are next scanned after 16 hours of fasting on a second day.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Center of Excellence in Eating and Weight Disorders at the Icahn School of Medicine at Mount SinaiNew York, NY
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Who Is Running the Clinical Trial?
Icahn School of Medicine at Mount SinaiLead Sponsor
National Institute of Mental Health (NIMH)Collaborator
References
Altered gray matter volume and functional connectivity in medial orbitofrontal cortex of bulimia nervosa patients: A combined VBM and FC study. [2022]Brain structural and functional abnormalities have been shown to be involved in the neurobiological underpinnings of bulimia nervosa (BN), while the mechanisms underlying this dysregulation are unclear. The main goal of this investigation was to explore the presence of brain structural alterations and relevant functional changes in BN. We hypothesized that BN patients had regional gray matter volume abnormalities and corresponding resting-state functional connectivity (rsFC) changes compared with healthy controls. Thirty-one BN patients and twenty-eight matched healthy controls underwent both high-resolution T1-weighted magnetic resonance imaging (MRI) and resting-state functional MRI. Structural analysis was performed by voxel-based morphometry (VBM), with subsequent rsFC analysis applied by a seed-based, whole-brain voxelwise approach using the abnormal gray matter volume (GMV) region of interest as the seed. Compared with the controls, the BN patients showed increased GMV in the left medial orbitofrontal cortex (mOFC). The BN patients also exhibited significantly increased rsFC between the left mOFC and the right superior occipital gyrus (SOG) and decreased rsFC between the left mOFC and the left precentral gyrus, postcentral gyrus, and supplementary motor area (SMA). Furthermore, the z values of rsFC between the left mOFC and right SOG was positively correlated with the Dutch Eating Behavior Questionnaire-external eating scores. Findings from this investigation further suggest that the mOFC plays a crucial role in the neural pathophysiological underpinnings of BN, which may lead to sensorimotor and visual regions reorganization and be related to representations of body image and the drive behind eating behavior. These findings have important implications for understanding neural mechanisms in BN and developing strategies for prevention.
Reward abnormalities among women with full and subthreshold bulimia nervosa: a functional magnetic resonance imaging study. [2022]To test the hypothesis that women with full and subthreshold bulimia nervosa show abnormal neural activation in response to food intake and anticipated food intake relative to healthy control women.
White matter integrity is reduced in bulimia nervosa. [2021]To investigate brain white matter (WM) functionality in bulimia nervosa (BN) in relation to anxiety.
[Cognitive function in eating disorders]. [2015]Eating disorders are characterized by uncontrolled eating behaviors. The core psychopathology is expressed in a variety of ways: body image distortion, preoccupation with food and weight, fear of weight gain, and so on. Brain-imaging techniques provide many opportunities to study neural circuits related symptoms in eating disorder. The present article focuses studies about functional magnetic resonance imaging (fMRI) of eating disorders. Studies of anorexia nervosa suggest 1) relationship between amygdala activation and fear of weight gain, 2) relationship between prefrontal cortex activity and cognitive flexibility. Studies of bulimic eating disorder (bulimia nervosa, binge eating disorder, and so on) suggest 1) relationship between brain reward system and overeating, 2) relationship between prefrontal cortex activity and impulse control.
Test-retest reliability of functional MRI food receipt, anticipated receipt, and picture tasks. [2023]Functional MRI (fMRI) tasks are increasingly being used to advance knowledge of the etiology and maintenance of obesity and eating disorders. Thus, understanding the test-retest reliability of BOLD signal contrasts from these tasks is important.
Characteristics of white matter alterations along fibres in patients with bulimia nervosa: A combined voxelwise and tractography study. [2023]Accumulating evidence supports the hypothesis that white matter (WM) abnormalities are involved in the pathophysiology of bulimia nervosa (BN); however, findings from in vivo neuroimaging studies have been inconsistent. We aimed to investigate the possible brain WM alterations, including WM volume and microstructure, in patients with BN. We recruited 43 BN patients and 31 healthy controls (HCs). All participants underwent structural and diffusion tensor imaging. Differences in WM volume and microstructure were evaluated using voxel-based morphometry, tract-based spatial statistics, and automated fibre quantification analysis. Compared with HCs, BN patients showed significantly decreased fractional anisotropy in the middle part of the corpus callosum (nodes 31-32) and increased mean diffusivity in the right cranial nerve V (CN V) (nodes 27-33 and nodes 55-88) and vertical occipital fasciculus (VOF) (nodes 58-85). Moreover, we found decreased axial diffusivity in the right inferior fronto-occipital fasciculus (node 67) and increased radial diffusivity in the CN V (nodes 22-34 and nodes 52-89) and left VOF (nodes 60-66 and nodes 81-85). Meanwhile, WM microstructural changes were correlated with patients' clinical manifestations. We did not find any significant differences in WM volume and the main WM fibre bundle properties between BN patients and HCs. Taken together, these findings provide that BN shows significant brain WM reorganization, but primarily in microstructure (part of WM fibre bundle), which is not sufficient to cause changes in WM volume. The automated fibre quantification analysis could be more sensitive to detect the subtle pathological changes in a point or segment of the WM fibre bundle.
Brain activity in hunger and satiety: an exploratory visually stimulated FMRI study. [2008]To explore neuroanatomical sites of eating behavior, we have developed a simple functional magnetic resonance imaging (fMRI) paradigm to image hunger vs. satiety using visual stimulation.