Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, New York, USA.
Curr Opin Psychiatry. 2019 Nov;32(6):491-497. doi: 10.1097/YCO.0000000000000540.
This article reviews new research in the context of existing literature to identify approaches that will advance understanding of the persistence of anorexia nervosa.
Neuroscience research in anorexia nervosa has yielded disparate findings: no definitive neural mechanism underlying illness vulnerability or persistence has been identified and no clear neural target for intervention has emerged. Recent advances using structural and functional neuroimaging research, as well as new techniques for applying and combining these approaches, have led to a refined understanding of changes in neural architecture among individuals who are acutely ill, have undergone renourishment, or are in recovery/remission. In particular, advances have come from the incorporation of computational and translational approaches, as well as efforts to link experimental paradigms with illness-relevant behavior. Recent findings converge to suggest abnormalities in systems involved in reward learning and processing among individuals with anorexia nervosa.
Anorexia nervosa is associated with neurobiological abnormalities. Aberrant learning and reward processing may contribute to the persistence of illness. To better utilize new techniques to understand the neural mechanisms of persistent anorexia nervosa, it may help to distinguish stages of illness and to link neurobiology with maladaptive behavior.
本文结合现有文献中的新研究，确定能够深入了解神经性厌食症持续性的方法。
神经性厌食症的神经科学研究得出了不同的结果：尚未确定导致疾病易感性或持续性的明确神经机制，也没有出现明确的干预神经靶点。最近，使用结构和功能神经影像学研究以及应用和结合这些方法的新技术，对急性发病、营养恢复或康复/缓解个体的神经结构变化有了更深入的了解。特别是，计算和转化方法的进步，以及将实验范式与与疾病相关的行为联系起来的努力，取得了进展。最近的研究结果表明，厌食症个体的奖励学习和处理系统存在异常。
神经性厌食症与神经生物学异常有关。异常的学习和奖励处理可能导致疾病的持续存在。为了更好地利用新技术来理解持续神经性厌食症的神经机制，区分疾病阶段并将神经生物学与适应不良行为联系起来可能会有所帮助。
