Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Peking University the Sixth Hospital (Institute of Mental Health); National Clinical Research Center for Mental Health Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China.
Int J Neuropsychopharmacol. 2020 Jun 24;23(6):356-365. doi: 10.1093/ijnp/pyaa023.
Disturbed self-regulation, taste reward, as well as somatosensory and visuospatial processes were thought to drive binge eating and purging behaviors that characterize bulimia nervosa. Although studies have implicated a central role of the striatum in these dysfunctions, there have been no direct investigations on striatal functional connectivity in bulimia nervosa from a network perspective.
We calculated the functional connectivity of striatal subregions based on the resting-state functional Magnetic Resonance Imaging data of 51 bulimia nervosa patients and 53 healthy women.
Compared with the healthy women, bulimia nervosa patients showed increased positive functional connectivity in bilateral striatal nuclei and thalamus for nearly all of the striatal subregions, and increased negative functional connectivity in bilateral primary sensorimotor cortex and occipital areas for both ventral striatum and putamen subregions. Only for the putamen subregions, we observed reduced negative functional connectivity in the prefrontal (bilateral superior and middle frontal gyri) and parietal (right inferior parietal lobe and precuneus) areas. Several striatal connectivities with occipital and primary sensorimotor cortex significantly correlated with the severity of bulimia.
The findings indicate bulimia nervosa-related alterations in striatal functional connectivity with the dorsolateral prefrontal cortex supporting self-regulation, the subcortical striatum and thalamus involved in taste reward, as well as the visual occipital and sensorimotor regions mediating body image, which contribute to our understanding of neural circuitry of bulimia nervosa and encourage future therapeutic developments for bulimia nervosa by modulating striatal pathway.
自我调节、味觉奖励以及躯体感觉和视空间过程的紊乱被认为是导致暴食和贪食行为的原因，这些行为是神经性贪食症的特征。尽管研究表明纹状体在这些功能障碍中起着核心作用，但从网络角度来看，尚未直接研究神经性贪食症患者纹状体的功能连接。
我们根据 51 名神经性贪食症患者和 53 名健康女性的静息态功能磁共振成像数据，计算了纹状体亚区的功能连接。
与健康女性相比，神经性贪食症患者双侧纹状体核和丘脑的近所有纹状体亚区的正功能连接增加，双侧初级感觉运动皮层和枕叶区的负功能连接增加，双侧腹侧纹状体和壳核亚区。仅对于壳核亚区，我们观察到额前（双侧额上和额中回）和顶叶（右侧顶下小叶和楔前叶）区域的负功能连接减少。几个纹状体与枕叶和初级感觉运动皮层的连接与贪食症的严重程度显著相关。
这些发现表明，神经性贪食症患者纹状体功能连接的改变与支持自我调节的背外侧前额叶皮层、涉及味觉奖励的皮质下纹状体和丘脑、以及介导身体形象的视觉枕叶和感觉运动区域有关，这有助于我们理解神经性贪食症的神经回路，并通过调节纹状体通路鼓励未来对神经性贪食症的治疗发展。
