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Zheng L, Wang Y, Ma J, Wang M, Liu Y, Li J, Li T, Zhang L. Machine learning research based on diffusion tensor images to distinguish between anorexia nervosa and bulimia nervosa. Front Psychiatry 2024; 14:1326271. [PMID: 38274433 PMCID: PMC10808644 DOI: 10.3389/fpsyt.2023.1326271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/27/2023] [Indexed: 01/27/2024] Open
Abstract
Background Anorexia nervosa (AN) and bulimia nervosa (BN), two subtypes of eating disorders, often present diagnostic challenges due to their overlapping symptoms. Machine learning has proven its capacity to improve group classification without requiring researchers to specify variables. The study aimed to distinguish between AN and BN using machine learning models based on diffusion tensor images (DTI). Methods This is a cross-sectional study, drug-naive females diagnosed with anorexia nervosa (AN) and bulimia nervosa (BN) were included. Demographic data and DTI were collected for all patients. Features for machine learning included Fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD). Support vector machine was constructed by LIBSVM, MATLAB2013b, and FSL5.0.9 software. Results A total of 58 female patients (24 AN, 34 BN) were included in this study. Statistical analysis revealed no significant differences in age, years of education, or course of illness between the two groups. AN patients had significantly lower BMI than BN patients. The AD model exhibited an area under the curve was 0.793 (accuracy: 75.86%, sensitivity: 66.67%, specificity: 88.23%), highlighting the left middle temporal gyrus (MTG_L) and the left superior temporal gyrus (STG_L) as differentiating brain regions. AN patients exhibited lower AD features in the STG_L and MTG_L than BN. Machine learning analysis indicated no significant differences in FA, MD, and RD values between AN and BN groups (p > 0.001). Conclusion Machine learning based on DTI could effectively distinguish between AN and BN, with MTG_L and STG_L potentially serving as neuroimaging biomarkers.
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Affiliation(s)
- Linli Zheng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yu Wang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Ma
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Meiou Wang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yang Liu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jin Li
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Li
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- Affiliated Mental Health Centre and Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lan Zhang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
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Li WH, Tang LR, Wang M, Wang JN, Guo T, He Q, He YY, Lv ZL, Chen Q, Wang Z, Li XH, Zhang P, Li ZJ, Wang ZC. Altered gray matter volume and functional connectivity in medial orbitofrontal cortex of bulimia nervosa patients: A combined VBM and FC study. Front Psychiatry 2022; 13:963092. [PMID: 36061303 PMCID: PMC9437330 DOI: 10.3389/fpsyt.2022.963092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Brain structural and functional abnormalities have been shown to be involved in the neurobiological underpinnings of bulimia nervosa (BN), while the mechanisms underlying this dysregulation are unclear. The main goal of this investigation was to explore the presence of brain structural alterations and relevant functional changes in BN. We hypothesized that BN patients had regional gray matter volume abnormalities and corresponding resting-state functional connectivity (rsFC) changes compared with healthy controls. Thirty-one BN patients and twenty-eight matched healthy controls underwent both high-resolution T1-weighted magnetic resonance imaging (MRI) and resting-state functional MRI. Structural analysis was performed by voxel-based morphometry (VBM), with subsequent rsFC analysis applied by a seed-based, whole-brain voxelwise approach using the abnormal gray matter volume (GMV) region of interest as the seed. Compared with the controls, the BN patients showed increased GMV in the left medial orbitofrontal cortex (mOFC). The BN patients also exhibited significantly increased rsFC between the left mOFC and the right superior occipital gyrus (SOG) and decreased rsFC between the left mOFC and the left precentral gyrus, postcentral gyrus, and supplementary motor area (SMA). Furthermore, the z values of rsFC between the left mOFC and right SOG was positively correlated with the Dutch Eating Behavior Questionnaire-external eating scores. Findings from this investigation further suggest that the mOFC plays a crucial role in the neural pathophysiological underpinnings of BN, which may lead to sensorimotor and visual regions reorganization and be related to representations of body image and the drive behind eating behavior. These findings have important implications for understanding neural mechanisms in BN and developing strategies for prevention.
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Affiliation(s)
- Wei-Hua Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Li-Rong Tang
- Beijing Anding Hospital, Capital Medical University, Beijing, China.,The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Miao Wang
- Chinese Institute for Brain Research, Beijing, China
| | - Jia-Ni Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ting Guo
- Beijing Anding Hospital, Capital Medical University, Beijing, China.,The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Qiong He
- Beijing Anding Hospital, Capital Medical University, Beijing, China.,The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Yu-Yang He
- Beijing Anding Hospital, Capital Medical University, Beijing, China.,The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Zi-Ling Lv
- Beijing Anding Hospital, Capital Medical University, Beijing, China.,The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zheng Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiao-Hong Li
- Beijing Anding Hospital, Capital Medical University, Beijing, China.,The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Peng Zhang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhan-Jiang Li
- Beijing Anding Hospital, Capital Medical University, Beijing, China.,The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Zhen-Chang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Vidal L, Ortega MA, Alvarez-Mon MA, Álvarez-Mon M, Lahera G. Volumetric Alterations of the Cerebral Cortex in Eating Disorders. J Clin Med 2021; 10:jcm10235480. [PMID: 34884181 PMCID: PMC8658332 DOI: 10.3390/jcm10235480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/10/2021] [Accepted: 11/18/2021] [Indexed: 11/16/2022] Open
Abstract
Eating disorders are relatively frequent psychiatric disorders that can produce serious consequences at the brain level. In an effort to clarify the neurobiological mechanisms of their pathogenesis, some studies have suggested the existence of modifications of the cortical architecture in eating disorders, but it is unknown whether the alterations described are a cause or consequence of eating disorders. The main objective of this systematic review is to collect the evidence available about the volumetric alterations of the cerebral cortex in eating disorders in adults and their apparent relationship with the pathogenesis of the disease. Initially, 91 articles were found by a search that included the terms anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder, gray matter, cortical thickness (CT), and brain volume. To pare down the articles, the following inclusion criteria were applied: (1) cortical thickness and/or gray matter volume (GMV) in patients with anorexia, bulimia nervosa, or binge-eating disorder was the main measure of the study; and (2) the sample was adult patients aged 18–65. The exclusion criteria were as follows: (1) articles that did not analyze cortical thickness or gray matter volume; (2) studies with patients with comorbidities; and (3) studies in patients who did not meet the DSM-IV/DSM-V criteria. In the first phase of selection, we proceeded to read the titles and abstracts as a first screen, thereby excluding 62 studies, followed by a complete critical reading of the 29 remaining articles. In this last phase, nine studies were excluded because they did not specify the eating disorder subtype, they included adolescents, or they did not measure GMV or CT. Finally, after the above systematic selection process, 20 articles were included in this review. Despite the methodological heterogeneity of the studies, there was some agreement between them. They showed an overall reduction in GMV in eating disorders, as well as alterations in certain regions of the cerebral cortex. Some of the most often mentioned cortical areas were the frontal, cingulate, and right orbitofrontal cortices, the precuneus, the right insula, and some temporoparietal gyri in cases of AN, with greater cortical involvement in frontotemporal and medial orbitofrontal regions in BN and binge eating disorder. Likewise, certain cortical regions, such as the left inferior frontal gyrus, the precuneus, the right superior motor area, the cingulate cortex, the insula, and the medial orbitofrontal sulcus, often remained altered after recovery from AN, making them potential cortical areas involved in the etiopathogenesis of AN. A reduction in GMV in specific areas of the CNS can inform us about the neurobiological mechanisms that underlie eating disorders as well as give us a better understanding of their possible consequences at the brain level.
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Affiliation(s)
- Laura Vidal
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcalá de Henares, Spain; (L.V.); (M.A.A.-M.); (M.Á.-M.); (G.L.)
| | - Miguel A Ortega
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcalá de Henares, Spain; (L.V.); (M.A.A.-M.); (M.Á.-M.); (G.L.)
- Ramón y Cajal Institute of Sanitary Researcsh, 28034 Madrid, Spain
- Cancer Registry and Pathology Department, Hospital Universitario Principe de Asturias, 28806 Alcalá de Henares, Spain
- Correspondence:
| | - Miguel Angel Alvarez-Mon
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcalá de Henares, Spain; (L.V.); (M.A.A.-M.); (M.Á.-M.); (G.L.)
- Ramón y Cajal Institute of Sanitary Researcsh, 28034 Madrid, Spain
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
| | - Melchor Álvarez-Mon
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcalá de Henares, Spain; (L.V.); (M.A.A.-M.); (M.Á.-M.); (G.L.)
- Ramón y Cajal Institute of Sanitary Researcsh, 28034 Madrid, Spain
- Immune System Diseases-Rheumatology, Oncology Service an Internal Medicine, University Hospital Príncipe de Asturias, 28806 Alcalá de Henares, Spain
| | - Guillermo Lahera
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcalá de Henares, Spain; (L.V.); (M.A.A.-M.); (M.Á.-M.); (G.L.)
- Ramón y Cajal Institute of Sanitary Researcsh, 28034 Madrid, Spain
- Psychiatry Service, Center for Biomedical Research in the Mental Health Network, University Hospital Príncipe de Asturias, 28806 Alcalá de Henares, Spain
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You B, Jackson T. Gray Matter Volume Differences Between More Versus Less Resilient Adults with Chronic Musculoskeletal Pain: A Voxel-based Morphology Study. Neuroscience 2021; 457:155-164. [PMID: 33484820 DOI: 10.1016/j.neuroscience.2021.01.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 12/21/2020] [Accepted: 01/12/2021] [Indexed: 12/15/2022]
Abstract
Resilience, a personality construct that reflects capacities to persevere, maintain a positive outlook and/or thrive despite ongoing stressors, has emerged as an important focus of research on chronic pain (CP). Although behavior studies have found more resilient persons with CP experience less pain-related dysfunction than less resilient cohorts do, the presence and nature of associated brain structure differences has received scant attention. To address this gap, we examined gray matter volume (GMV) differences between more versus less resilient adults with chronic musculoskeletal pain. Participants (75 women, 43 men) were community-dwellers who reported ongoing musculoskeletal pain for at least three months. More (n = 57) and less (n = 61) resilient subgroups, respectively, were identified on the basis of scoring above and below median scores on two validated resilience questionnaires. Voxel-based morphology (VBM) undertaken to examine resilience subgroup differences in GMV indicated more resilient participants displayed significantly larger GMV in the (1) bilateral precuneus, (2) left superior and inferior parietal lobules, (3) orbital right middle frontal gyrus and medial right superior frontal gyrus, and (4) bilateral median cingulate and paracingulate gyri, even after controlling for subgroup differences on demographics and measures of pain-related distress. Together, results underscored the presence and nature of specific GMV differences underlying subjective reports of more versus less resilient responses to ongoing musculoskeletal pain.
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Affiliation(s)
- Beibei You
- Key Laboratory of Cognition and Personality, China Education Ministry, Southwest University, Chongqing 400715, China; Qiannan Preschool Education College, Guizhou 551300, China
| | - Todd Jackson
- Department of Psychology, University of Macau, Taipa 999078, Macau, SAR, China; Key Laboratory of Cognition and Personality, China Education Ministry, Southwest University, Chongqing 400715, China.
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