An fMRI Study of Self-regulation in Adolescents With Bulimia Nervosa

• Wechsler Abbreviated Scale of Intelligence (WASI) [ Time Frame: Measured at a single visit ] [ Designated as safety issue: No ]
• Continuous Performance Task [ Time Frame: Measured at a single visit ] [ Designated as safety issue: No ]
• Stroop Word-Color Interference [ Time Frame: Measured at a single visit ] [ Designated as safety issue: No ]
• Weather Prediction Task [ Time Frame: Measured at a single visit ] [ Designated as safety issue: No ]
• Silverman [ Time Frame: Measured at a single visit ] [ Designated as safety issue: No ]

The aim of this project is to use both functional MRI (fMRI) and behavioral measures to investigate how disturbances in frontostriatal neural systems contribute to the impulsive and habitual binge-eating behaviors in patients with Bulimia Nervosa (BN). Findings from this study will have wide-ranging importance for our understanding of the development and treatment of BN.

Patients with Bulimia Nervosa (BN) have difficulty regulating impulsive behaviors as suggested by their binge-eating and purging, as well as the high incidence of drug abuse and shoplifting in this population. Understanding dysfunction in the frontostriatal circuitry that mediates self-regulatory control processes will aid development of new therapeutics for the impulsivity associated with BN. Thus we aim to use fMRI and neuropsychological measures to investigate the functioning of frontostriatal systems and self-regulatory control processes in adolescents with BN.

Participation in this study includes 4 sections: Neuropsychological Tests, Diagnostic interviews, Pregnancy Test, and MRI scan. All efforts are made to coordinate procedures into one day, and they require between 4 and 5 hours of the participant's time. The option of splitting participation into two study days is also offered for participants who find it more convenient. Participants are compensated with $100 in the form of a check, which is mailed to their home address.

Adolescents (ages 12-21 years) with bulimia nervosa and age, gender, and weight-matched controls

• Other: fMRI
  Functional Magnetic Resonance Imaging scans
  Other Names:

  • GE 3T scanner
  • Anatomical Images, DTI, and MRS
• Behavioral: Neuropsychological Testing
  Neuropsychological tests
  Other Names:

  • Wechsler Abbreviated Scale of Intelligence (WASI)
  • Continuous Performance Task
  • Rotary Pursuit
  • Mirror Tracing
  • Stroop Word-Color Interference
  • Weather Prediction Task

• 1
  Adolescents with Bulimia Nervosa or subclinical Bulimia Nervosa
  Interventions:

  • Other: fMRI
  • Behavioral: Neuropsychological Testing
• 2
  Healthy control adolescents
  Interventions:

  • Other: fMRI
  • Behavioral: Neuropsychological Testing

Inclusion Criteria:

• Current or prior DSM IV diagnosis of Bulimia Nervosa or Sub-threshold Bulimia Nervosa (those who meet all DSM-IV criteria for BN, but engage in subjective binge-eating episodes and binge/purge at a frequency of at least once per week for 3 months, whereas meeting full DSM-IV criteria for BN requires binge eating and purging twice per week for 3 months)
• Major Depression
• For control adolescents, no current or past history of an eating disorder

Exclusion Criteria:

• Ferromagnetic implants (e.g., pacemaker)
• Metal braces or retainers
• IQ less than 80
• Any other current major Axis I disorder, other than major depressive disorder (MDD)
• History of concussion, seizure disorder, or other neurological illness
• Claustrophobia
• Pregnant