Self-Control in Bulimia Nervosa
- Conditions
- Bulimia Nervosa
- Interventions
- Other: fasting stateOther: fed stateOther: magnetic resonance imaging
- Registration Number
- NCT04409457
- Lead Sponsor
- Icahn School of Medicine at Mount Sinai
- Brief Summary
This study examines the influence of acute fasting and eating on self-control in adult females with and without bulimia nervosa (BN). Specifically, the study team is investigating whether differences in behavior and brain activation in response to computer tasks after fasting and after eating a meal could help to explain the symptoms of bulimia nervosa. Data will be collected using questionnaires and a technology called magnetic resonance imaging (MRI).
- Detailed Description
Treatment-resistant binge eating and purging may be perpetuated by self-control deficits linked to reduced activation in frontostriatal circuits. To date, however, neurocognitive studies of BN have not assessed the dynamic computational processes underlying inhibition or considered the fact that individuals with BN oscillate between two extremes-under-controlled and over-controlled intake. The proposed study combines neuroimaging with computational modeling to investigate the influences of acute fasting and eating (i.e., metabolic states) on how the brains of women with bulimia nervosa (BN) adaptively prepare for and exert inhibitory control. More specifically, the study has the following main objectives: 1) To determine whether eating and fasting affect adaptive inhibitory control and related frontostriatal activation abnormally in BN; 2) To identify associations of BN severity with state-specific frontostriatal activation and behavior.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Female
- Target Recruitment
- 60
- Female
- Aged 18 to 35 years
- Currently between 85 and 130% of the expected weight for height
- Right-handed
- English-speaking
Additional Inclusion Criteria for Women with Bulimia Nervosa:
° Meet DSM-5 criteria for bulimia nervosa
- Medical instability
- Ongoing medical treatment, medical condition, or psychiatric disorder that may interfere with study variables or participation
- Shift work
- Pregnancy, planned pregnancy, or lactation during the study period
- Allergy to any of the ingredients in or unwillingness to consume the standardized meal or unwillingness to drink water during the fasting period
- Any contraindication for fMRI
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- CROSSOVER
- Arm && Interventions
Group Intervention Description Participants with Bulimia Nervosa magnetic resonance imaging Participants are randomly assigned (in even numbers across the two groups) to scan order: A. These participants are first scanned after 16 hours of fasting on one day, and are next scanned after a standardized meal on a second day. B. These participants are first scanned after a standardized meal on one day, and are next scanned after 16 hours of fasting on a second day. Participants without Bulimia Nervosa fed state Participants are randomly assigned (in even numbers across the two groups) to scan order: A. These participants are first scanned after 16 hours of fasting on one day, and are next scanned after a standardized meal on a second day. B. These participants are first scanned after a standardized meal on one day, and are next scanned after 16 hours of fasting on a second day. Participants without Bulimia Nervosa magnetic resonance imaging Participants are randomly assigned (in even numbers across the two groups) to scan order: A. These participants are first scanned after 16 hours of fasting on one day, and are next scanned after a standardized meal on a second day. B. These participants are first scanned after a standardized meal on one day, and are next scanned after 16 hours of fasting on a second day. Participants with Bulimia Nervosa fasting state Participants are randomly assigned (in even numbers across the two groups) to scan order: A. These participants are first scanned after 16 hours of fasting on one day, and are next scanned after a standardized meal on a second day. B. These participants are first scanned after a standardized meal on one day, and are next scanned after 16 hours of fasting on a second day. Participants with Bulimia Nervosa fed state Participants are randomly assigned (in even numbers across the two groups) to scan order: A. These participants are first scanned after 16 hours of fasting on one day, and are next scanned after a standardized meal on a second day. B. These participants are first scanned after a standardized meal on one day, and are next scanned after 16 hours of fasting on a second day. Participants without Bulimia Nervosa fasting state Participants are randomly assigned (in even numbers across the two groups) to scan order: A. These participants are first scanned after 16 hours of fasting on one day, and are next scanned after a standardized meal on a second day. B. These participants are first scanned after a standardized meal on one day, and are next scanned after 16 hours of fasting on a second day.
- Primary Outcome Measures
Name Time Method Successful inhibition at fasting state at 16 hours after fast Frontostriatal activation associated with successful inhibition
P(stop) at fed state at 30 minutes after a standardized meal Frontostriatal activation associated with the predicted likelihood that upcoming inhibition is needed (P(stop))
Prediction errors at fed state at 30 minutes after a standardized meal Frontostriatal activation associated with inhibitory control prediction errors (signed and unsigned)
Prediction errors at fasting state at 16 hours after fast Frontostriatal activation associated with: inhibitory control prediction errors (signed and unsigned)
P(stop) at fasting state at 16 hours after fast Frontostriatal activation associated with the predicted likelihood that upcoming inhibition is needed (P(stop))
Successful inhibition at fed state at 30 minutes after a standardized meal Frontostriatal activation associated with successful inhibition
- Secondary Outcome Measures
Name Time Method Stop Signal Task Performance at fasting state at 16 hours after fast Percent correct responses to stop trial on Stop Signal Task Performance
Stop Signal Task Performance at fed state at 30 minutes after a standardized meal Percent correct responses to stop trial on Stop Signal Task Performance
Stop Signal Reaction Time (SSRT) at fed state at 30 minutes after a standardized meal Behavioral performance on the stop signal task, as measured by stop signal reaction time
Stop Signal Reaction Time (SSRT) at fasting state at 16 hours after fast Behavioral performance on the stop signal task, as measured by stop signal reaction time
Frequency of Eating Disorder Symptom Episodes Baseline (At study screening) The frequency of binge eating episodes, self-induced vomiting episodes, and fasting episodes as assessed by the Eating Disorder Examination (EDE). Frequency of episodes assessed with no minimum or maximum limit.
Trial Locations
- Locations (1)
Center of Excellence in Eating and Weight Disorders at the Icahn School of Medicine at Mount Sinai
🇺🇸New York, New York, United States