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Hamamoto Y, Oba K, Ishibashi R, Ding Y, Nouchi R, Sugiura M. Reduced body-image disturbance by body-image interventions is associated with neural-response changes in visual and social processing regions: a preliminary study. Front Psychiatry 2024; 15:1337776. [PMID: 38510808 PMCID: PMC10951070 DOI: 10.3389/fpsyt.2024.1337776] [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: 11/13/2023] [Accepted: 02/15/2024] [Indexed: 03/22/2024] Open
Abstract
Introduction Body-image disturbance is a major factor in the development of eating disorders, especially among young women. There are two main components: perceptual disturbance, characterized by a discrepancy between perceived and actual body size, and affective disturbance, characterized by a discrepancy between perceived and ideal body size. Interventions targeting body-image disturbance ask individuals to describe their own body without using negative expressions when either viewing it in a mirror or imagining it. Despite the importance of reducing body-image disturbance, its neural mechanisms remain unclear. Here we investigated the changes in neural responses before and after an intervention. We hypothesized that neural responses correlated with the degree of body-image disturbance would also be related to its reduction, i.e., a reduction in perceptual and affective disturbances would be related to changes in attentional and socio-cognitive processing, respectively. Methods Twenty-eight young adult women without known psychiatric disorders underwent a single 40-min intervention. Participants completed tasks before and after the intervention, in which they estimated their perceived and ideal body sizes using distorted silhouette images to measure body-image disturbance. We analyzed the behavioral and neural responses of participants during the tasks. Results The intervention did not significantly reduce body-image disturbance. Analysis of individual differences showed distinct changes in neural responses for each type of disturbance. A decrease in perceptual disturbance was associated with bodily visuospatial processing: increased activation in the left superior parietal lobule, bilateral occipital gyri, and right cuneus. Reduced affective disturbance was associated with socio-cognitive processing; decreased activation in the right temporoparietal junction, and increased functional connectivity between the left extrastriate body area and the right precuneus. Discussion We identified distinct neural mechanisms (bodily visuospatial and socio-cognitive processing) associated with the reduction in each component of body-image disturbance. Our results imply that different neural mechanisms are related to reduced perceptual disturbance and the expression thereof, whereas similar neural mechanisms are related to the reduction and expression of affective disturbance. Considering the small sample size of this study, our results should be regarded as preliminary.
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Affiliation(s)
- Yumi Hamamoto
- Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
- Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Kentaro Oba
- Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Ryo Ishibashi
- Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Yi Ding
- Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
- School of Medicine, Tohoku University, Sendai, Japan
| | - Rui Nouchi
- Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Motoaki Sugiura
- Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
- International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
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2
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Collantoni E, Alberti F, Dahmen B, von Polier G, Konrad K, Herpertz-Dahlmann B, Favaro A, Seitz J. Intra-individual cortical networks in Anorexia Nervosa: Evidence from a longitudinal dataset. EUROPEAN EATING DISORDERS REVIEW 2024; 32:298-309. [PMID: 37876109 DOI: 10.1002/erv.3043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 10/14/2023] [Accepted: 10/16/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVE This work investigates cortical thickness (CT) and gyrification patterns in Anorexia Nervosa (AN) before and after short-term weight restoration using graph theory tools. METHODS 38 female adolescents with AN underwent structural magnetic resonance imaging scans at baseline and after - on average - 3.5 months following short-term weight restoration while 53 age-matched healthy controls (HCs) were scanned once. Graph measures were compared between groups and longitudinally within the AN group. Associations with clinical measures such as age of onset, duration of illness, BMI standard deviation score (BMI-SDS), and longitudinal weight changes were tested via stepwise regression. RESULTS Cortical thickness graphs of patients with acute AN displayed lower modularity and small-world index (SWI) than HCs. Modularity recovered after weight gain. Reduced global efficiency and SWI were observed in patients at baseline compared to HCs based on gyrification networks. Significant associations between local clustering of CT at admission and BMI-SDS, and clustering/global efficiency of gyrification and duration of illness emerged. CONCLUSIONS Our results indicate a shift towards less organised CT networks in patients with acute AN. After weight recovery, the disarrangement seems to be partially reduced. However, longer-term follow-ups are needed to determine whether cortical organizational patterns fully return to normal.
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Affiliation(s)
- Enrico Collantoni
- Department of Neurosciences, University of Padua, Padova, Italy
- Padua Neuroscience Center, University of Padua, Padova, Italy
| | | | - Brigitte Dahmen
- Child and Adolescent Psychiatry, University Hospital, RWTH Aachen, Aachen, Germany
| | - Georg von Polier
- Child and Adolescent Psychiatry, University Hospital, RWTH Aachen, Aachen, Germany
- Child and Adolescent Psychiatry, University Hospital, Frankfurt, Germany
| | - Kerstin Konrad
- Child and Adolescent Psychiatry, University Hospital, RWTH Aachen, Aachen, Germany
- Section Neuropsychology, Child and Adolescent Psychiatry, University Hospital, RWTH Aachen, Aachen, Germany
| | | | - Angela Favaro
- Department of Neurosciences, University of Padua, Padova, Italy
- Padua Neuroscience Center, University of Padua, Padova, Italy
| | - Jochen Seitz
- Child and Adolescent Psychiatry, University Hospital, RWTH Aachen, Aachen, Germany
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Lloyd EC, Foerde KE, Muratore AF, Aw N, Semanek D, Steinglass JE, Posner J. Large-Scale Exploration of Whole-Brain Structural Connectivity in Anorexia Nervosa: Alterations in the Connectivity of Frontal and Subcortical Networks. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:864-873. [PMID: 35714857 PMCID: PMC11060509 DOI: 10.1016/j.bpsc.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 05/27/2022] [Accepted: 06/01/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Anorexia nervosa (AN) is characterized by disturbances in cognition and behavior surrounding eating and weight. The severity of AN combined with the absence of localized brain abnormalities suggests distributed, systemic underpinnings that may be identified using diffusion-weighted magnetic resonance imaging and tractography to reconstruct white matter pathways. METHODS Diffusion-weighted magnetic resonance imaging data acquired from female patients with AN (n= 147) and female healthy control (HC) participants (n = 119), ages 12 to 40 years, were combined across 5 studies. Probabilistic tractography was completed, and full-cortex connectomes describing streamline counts between 84 brain regions were generated and harmonized. Graph theory methods were used to describe alterations in network organization in AN. The network-based statistic tested between-group differences in brain subnetwork connectivity. The metrics strength and efficiency indexed the connectivity of brain regions (network nodes) and were compared between groups using multiple linear regression. RESULTS Individuals with AN, relative to HC peers, had reduced connectivity in a network comprising subcortical regions and greater connectivity between frontal cortical regions (p < .05, familywise error corrected). Node-based analyses indicated reduced connectivity of the left hippocampus in patients relative to HC peers (p < .05, permutation corrected). Severity of illness, assessed by body mass index, was associated with subcortical connectivity (p < .05, uncorrected). CONCLUSIONS Analyses identified reduced structural connectivity of subcortical networks and regions, and stronger cortical network connectivity, among individuals with AN relative to HC peers. These findings are consistent with alterations in feeding, emotion, and executive control circuits in AN, and may direct hypothesis-driven research into mechanisms of persistent restrictive eating behavior.
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Affiliation(s)
- E Caitlin Lloyd
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York; New York State Psychiatric Institute, New York, New York.
| | - Karin E Foerde
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York; New York State Psychiatric Institute, New York, New York; Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Alexandra F Muratore
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York; New York State Psychiatric Institute, New York, New York
| | - Natalie Aw
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York; New York State Psychiatric Institute, New York, New York
| | - David Semanek
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York; New York State Psychiatric Institute, New York, New York
| | - Joanna E Steinglass
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York; New York State Psychiatric Institute, New York, New York
| | - Jonathan Posner
- Department of Psychiatry, Duke University, Durham, North Carolina
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4
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Kaufmann LK, Hänggi J, Jäncke L, Baur V, Piccirelli M, Kollias S, Schnyder U, Martin-Soelch C, Milos G. Disrupted longitudinal restoration of brain connectivity during weight normalization in severe anorexia nervosa. Transl Psychiatry 2023; 13:136. [PMID: 37117179 PMCID: PMC10147636 DOI: 10.1038/s41398-023-02428-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/03/2023] [Accepted: 04/06/2023] [Indexed: 04/30/2023] Open
Abstract
Altered intrinsic brain connectivity of patients with anorexia nervosa has been observed in the acute phase of the disorder, but it remains unclear to what extent these alterations recover during weight normalization. In this study, we used functional imaging data from three time points to probe longitudinal changes in intrinsic connectivity patterns in patients with severe anorexia nervosa (BMI ≤ 15.5 kg/m2) over the course of weight normalization. At three distinct stages of inpatient treatment, we examined resting-state functional connectivity in 27 women with severe anorexia nervosa and 40 closely matched healthy controls. Using network-based statistics and graph-theoretic measures, we examined differences in global network strength, subnetworks with altered intrinsic connectivity, and global network topology. Patients with severe anorexia nervosa showed weakened intrinsic connectivity and altered network topology which did not recover during treatment. The persistent disruption of brain networks suggests sustained alterations of information processing in weight-recovered severe anorexia nervosa.
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Affiliation(s)
- Lisa-Katrin Kaufmann
- Department of Consultation-Liaison Psychiatry and Psychosomatics, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland.
| | - Jürgen Hänggi
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Lutz Jäncke
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program (URPP) "Dynamic of Healthy Aging", University of Zurich, Zurich, Switzerland
| | - Volker Baur
- Department of Consultation-Liaison Psychiatry and Psychosomatics, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Marco Piccirelli
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Spyros Kollias
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | | | - Chantal Martin-Soelch
- Unit of Clinical and Health Psychology, Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Gabriella Milos
- Department of Consultation-Liaison Psychiatry and Psychosomatics, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Cassioli E, Rossi E, Martelli M, Arganini F, Giuranno G, Siviglia S, Tarchi L, Faldi M, Castellini G, Ricca V. Longitudinal Coupling between Eating Disorder Psychopathology and Depression in Patients with Anorexia Nervosa and Bulimia Nervosa Treated with Enhanced Cognitive Behavior Therapy: A One-Year Follow-Up Study. Brain Sci 2023; 13:brainsci13040535. [PMID: 37190499 DOI: 10.3390/brainsci13040535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/13/2023] [Accepted: 03/19/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND The relationship between eating disorder (ED) specific psychopathology and depressive symptomatology in EDs is often debated. The aim of this study was to provide an explicative model regarding the mechanisms by which enhanced cognitive-behavior therapy (CBT-E) might determine an amelioration of depressive symptoms in patients with anorexia nervosa (AN) or bulimia nervosa (BN). METHODS A total of 157 women with AN or BN and no history of childhood trauma or bipolar disorder were evaluated before treatment and after 12 months of CBT-E. Self-administered questionnaires were used to measure ED psychopathology and depressive symptoms. RESULTS All psychopathological measures improved after treatment, with no significant additional improvement with the concomitant use of antidepressants. Structural equation modeling using the bivariate latent change score approach showed that higher levels of depressive symptoms at baseline were associated with a worse longitudinal trend of ED psychopathology, and vice versa. Finally, the amelioration of ED psychopathology predicted the improvement in depressive symptoms at follow-up, whereas data did not support the inverse path. CONCLUSION This study elucidated the complex longitudinal interplay between ED psychopathology and depression during CBT-E, underlining the importance of addressing ED symptoms as a primary target in the case of comorbidity between AN or BN and depressive symptoms.
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Affiliation(s)
- Emanuele Cassioli
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla 3, 50100 Florence, Italy
| | - Eleonora Rossi
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla 3, 50100 Florence, Italy
| | - Michela Martelli
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla 3, 50100 Florence, Italy
| | - Francesca Arganini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla 3, 50100 Florence, Italy
| | - Gabriele Giuranno
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla 3, 50100 Florence, Italy
| | - Serena Siviglia
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla 3, 50100 Florence, Italy
| | - Livio Tarchi
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla 3, 50100 Florence, Italy
| | - Marco Faldi
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla 3, 50100 Florence, Italy
| | - Giovanni Castellini
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla 3, 50100 Florence, Italy
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence, Largo Brambilla 3, 50100 Florence, Italy
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6
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Meregalli V, Tenconi E, Madan CR, Somà E, Meneguzzo P, Ceccato E, Zuanon S, Sala A, Favaro A, Collantoni E. Beyond body image: what body schema and motor imagery can tell us about the way patients with anorexia nervosa experience their body. Psychiatry Clin Neurosci 2023; 77:94-101. [PMID: 36330847 DOI: 10.1111/pcn.13501] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/04/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Abstract
AIM Recent evidence suggests that the body image disturbance often observed in patients with anorexia nervosa also extends to the body schema. According to the embodiment approach, the body schema is not only involved in motor execution, but also in tasks that only require a mental simulation of a movement such as motor imagery, mental rotation of bodies, and visuospatial perspective-taking. The aim of the present study was to assess the ability of patients with anorexia to mentally simulate movements. METHODS The sample included 52 patients with acute anorexia and 62 healthy controls. All participants completed three tests of explicit motor imagery, a mental rotation test and a test of visuospatial perspective-taking. RESULTS Patients with anorexia nervosa, with respect to controls, reported greater difficulties in imagining movements according to a first-person perspective, lower accuracy in motor imagery, selective impairment in the mental rotation of human figures, and reduced ability in assuming a different egocentric visuospatial perspective. CONCLUSION These results are indicative of a specific alteration in motor imagery in patients with anorexia nervosa. Interestingly, patients' difficulties appear to be limited to those tasks which specifically rely on the body schema, while patients and controls performed similarly in the 3D objects mental rotation task.
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Affiliation(s)
- Valentina Meregalli
- Department of Neurosciences, University of Padua, Padova, Italy.,Padua Neuroscience Center, University of Padua, Padova, Italy
| | - Elena Tenconi
- Department of Neurosciences, University of Padua, Padova, Italy.,Padua Neuroscience Center, University of Padua, Padova, Italy
| | | | - Enrica Somà
- Department of Neurosciences, University of Padua, Padova, Italy
| | - Paolo Meneguzzo
- Department of Neurosciences, University of Padua, Padova, Italy.,Padua Neuroscience Center, University of Padua, Padova, Italy
| | - Enrico Ceccato
- Eating Disorders Unit, Ospedale San Bortolo, Vicenza, Italy
| | - Sophia Zuanon
- Eating Disorders Unit, Ospedale San Bortolo, Vicenza, Italy
| | | | - Angela Favaro
- Department of Neurosciences, University of Padua, Padova, Italy.,Padua Neuroscience Center, University of Padua, Padova, Italy
| | - Enrico Collantoni
- Department of Neurosciences, University of Padua, Padova, Italy.,Padua Neuroscience Center, University of Padua, Padova, Italy
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7
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Gupta A, Bhatt RR, Rivera-Cancel A, Makkar R, Kragel PA, Rodriguez T, Graner JL, Alaverdyan A, Hamadani K, Vora P, Naliboff B, Labus JS, LaBar KS, Mayer EA, Zucker N. Complex functional brain network properties in anorexia nervosa. J Eat Disord 2022; 10:13. [PMID: 35123579 PMCID: PMC8817538 DOI: 10.1186/s40337-022-00534-9] [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: 10/08/2021] [Accepted: 01/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anorexia nervosa (AN) is a disorder characterized by an incapacitating fear of weight gain and by a disturbance in the way the body is experienced, facets that motivate dangerous weight loss behaviors. Multimodal neuroimaging studies highlight atypical neural activity in brain networks involved in interoceptive awareness and reward processing. METHODS The current study used resting-state neuroimaging to model the architecture of large-scale functional brain networks and characterize network properties of individual brain regions to clinical measures. Resting-state neuroimaging was conducted in 62 adolescents, 22 (21 female) with a history of AN and 40 (39 female) healthy controls (HCs). Sensorimotor and basal ganglia regions, as part of a 165-region whole-brain network, were investigated. Subject-specific functional brain networks were computed to index centrality. A contrast analysis within the general linear model covarying for age was performed. Correlations between network properties and behavioral measures were conducted (significance q < .05). RESULTS Compared to HCs, AN had lower connectivity from sensorimotor regions, and greater connectivity from the left caudate nucleus to the right postcentral gyrus. AN demonstrated lower sensorimotor centrality, but higher basal ganglia centrality. Sensorimotor connectivity dyads and centrality exhibited negative correlations with body dissatisfaction and drive for thinness, two essential features of AN. CONCLUSIONS These findings suggest that AN is associated with greater communication from the basal ganglia, and lower information propagation in sensorimotor cortices. This is consistent with the clinical presentation of AN, where individuals exhibit patterns of rigid habitual behavior that is not responsive to bodily needs, and seem "disconnected" from their bodies.
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Affiliation(s)
- Arpana Gupta
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA. .,David Geffen School of Medicine, UCLA, Los Angeles, CA, 90095, USA. .,Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA, Los Angeles, CA, 90095, USA.
| | - Ravi R Bhatt
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA.,Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine at USC, University of Southern California, Los Angeles, USA
| | | | - Rishi Makkar
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA
| | | | - Thomas Rodriguez
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA
| | - John L Graner
- Department of Psychology and Neuroscience, Duke University, Durham, USA
| | - Anita Alaverdyan
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA
| | - Kareem Hamadani
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA
| | - Priten Vora
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA
| | - Bruce Naliboff
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA.,David Geffen School of Medicine, UCLA, Los Angeles, CA, 90095, USA.,Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA, Los Angeles, CA, 90095, USA
| | - Jennifer S Labus
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA.,David Geffen School of Medicine, UCLA, Los Angeles, CA, 90095, USA.,Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA, Los Angeles, CA, 90095, USA
| | - Kevin S LaBar
- Department of Psychology and Neuroscience, Duke University, Durham, USA
| | - Emeran A Mayer
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA.,David Geffen School of Medicine, UCLA, Los Angeles, CA, 90095, USA.,Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA, Los Angeles, CA, 90095, USA.,Ahmanson-Lovelace Brain Mapping Center, UCLA, Los Angeles, CA, 90095, USA
| | - Nancy Zucker
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, USA.,Department of Psychology and Neuroscience, Duke University, Durham, USA
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