Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain.
Department of Child and Adolescent Mental Health, Hospital Sant Joan de Déu, Passeig Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Spain.
Nutrients. 2023 Jun 30;15(13):2994. doi: 10.3390/nu15132994.
Binge-eating disorder (BED) is a highly prevalent disorder. Subthreshold BED conditions (sBED) are even more frequent in youth, but their significance regarding BED etiology and long-term prognosis is unclear. A better understanding of brain findings associated with BED and sBED, in the context of critical periods for neurodevelopment, is relevant to answer such questions. The present narrative review starts from the knowledge of the development of emotional self-regulation in youth, and the brain circuits supporting emotion-regulation and eating behaviour. Next, neuroimaging studies with sBED and BED samples will be reviewed, and their brain-circuitry overlap will be examined. Deficits in inhibition control systems are observed to precede, and hyperactivity of reward regions to characterize, sBED, with overlapping findings in BED. The imbalance between reward/inhibition systems, and the implication of interoception/homeostatic processing brain systems should be further examined. Recent knowledge of the potential impact that the high consumption of ultra-processed foods in paediatric samples may have on these sBED/BED-associated brain systems is then discussed. There is a need to identify, early on, those sBED individuals at risk of developing BED at neurodevelopmental stages when there is a great possibility of prevention. However, more neuroimaging studies with sBED/BED pediatric samples are needed.
暴食障碍(BED)是一种高发疾病。阈下暴食障碍(sBED)在青少年中更为常见,但它们在暴食障碍病因学和长期预后方面的意义尚不清楚。更好地了解与 BED 和 sBED 相关的大脑发现,以及神经发育的关键时期,对于回答这些问题至关重要。本综述从青少年情绪自我调节的发展知识开始,以及支持情绪调节和饮食行为的大脑回路。接下来,将回顾 sBED 和 BED 样本的神经影像学研究,并检查它们的大脑回路重叠情况。抑制控制系统的缺陷被观察到先于 sBED 发生,而奖励区域的过度活跃则是其特征,在 BED 中也有重叠的发现。需要进一步研究奖励/抑制系统之间的不平衡,以及内脏感知/内稳态处理大脑系统的影响。然后讨论了在儿童样本中大量食用超加工食品可能对这些 sBED/BED 相关大脑系统产生的潜在影响。需要在神经发育阶段尽早识别那些处于风险中的 sBED 个体,因为此时有很大的预防可能性。然而,还需要更多的 sBED/BED 儿科样本的神经影像学研究。