Wang Yiling, Wang Xinghao, Wang Jiani, Li Weihua, Chen Qian, Li Zhanjiang, Tang Lirong, Grzegorzek Marcin, Liu Wenjuan, Wang Zhenchang, Zhang Peng
Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
Institute for Medical Informatics, University of Luebeck, 23562, Luebeck, Germany.
Eat Weight Disord. 2025 May 19;30(1):41. doi: 10.1007/s40519-025-01754-z.
Observational studies suggest white matter (WM) microstructural anomalies are linked to bulimia nervosa (BN), but a direct causal relationship remains unestablished. This study aimed to investigate the causal impact of BN on WM microstructure.
We analyzed genome-wide association study (GWAS) summary data from 2442 individuals to identify genetically predicted BN. Diffusion MRI were obtained from the UK Biobank. After assessing instrumental variable validity, we conducted Mendelian randomization (MR) using inverse variance weighting (IVW) as the primary method, followed by pleiotropy and heterogeneity tests.
The MR analysis from BN to brain imaging-derived phenotypes showed that BN had significant causal effects on a union set of nine tracts (including a total of 18 image-derived phenotypes) (IVW, P < 0.05): brainstem tracts (pontine crossing tract, bilateral medial lemniscus, left superior cerebellar peduncle, and middle cerebellar peduncle), sensory-related tracts (right retrolenticular part of the internal capsule and left inferior longitudinal fasciculus), and emotion-related tracts (left anterior corona radiata and right cingulum hippocampus).
This study revealed that BN has a causal effect on WM microstructure, which extends the reports of association to causation for WM and BN. These causal effects may explain the deficits in feeding, taste, vision, and emotion regulation that are often observed in patients with BN. Level of evidence III well-designed cohort analytic study.
观察性研究表明，白质（WM）微观结构异常与神经性贪食症（BN）有关，但直接的因果关系尚未确立。本研究旨在调查BN对WM微观结构的因果影响。
我们分析了2442名个体的全基因组关联研究（GWAS）汇总数据，以确定基因预测的BN。扩散磁共振成像数据来自英国生物银行。在评估工具变量有效性后，我们使用逆方差加权（IVW）作为主要方法进行孟德尔随机化（MR），随后进行多效性和异质性检验。
从BN到脑成像衍生表型的MR分析表明，BN对九条束的联合集（包括总共18个图像衍生表型）有显著的因果效应（IVW，P < 0.05）：脑干束（脑桥交叉束、双侧内侧丘系、左侧上小脑脚和小脑中脚）、感觉相关束（右侧内囊后肢和左侧下纵束）和情绪相关束（左侧放射冠前部和右侧扣带回海马）。
本研究表明BN对WM微观结构有因果效应，这将WM与BN之间的关联报告扩展到了因果关系。这些因果效应可能解释了BN患者中经常观察到的进食、味觉、视觉和情绪调节方面的缺陷。证据水平III：精心设计的队列分析研究。
