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Arold D, Bernardoni F, Geisler D, Doose A, Uen V, Boehm I, Roessner V, King JA, Ehrlich S. Predicting long-term outcome in anorexia nervosa: a machine learning analysis of brain structure at different stages of weight recovery. Psychol Med 2023; 53:7827-7836. [PMID: 37554008 PMCID: PMC10758339 DOI: 10.1017/s0033291723001861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 03/31/2023] [Accepted: 06/15/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Anorexia nervosa (AN) is characterized by sizable, widespread gray matter (GM) reductions in the acutely underweight state. However, evidence for persistent alterations after weight-restoration has been surprisingly scarce despite high relapse rates, frequent transitions to other psychiatric disorders, and generally unfavorable outcome. While most studies investigated brain regions separately (univariate analysis), psychiatric disorders can be conceptualized as brain network disorders characterized by multivariate alterations with only subtle local effects. We tested for persistent multivariate structural brain alterations in weight-restored individuals with a history of AN, investigated their putative biological substrate and relation with 1-year treatment outcome. METHODS We trained machine learning models on regional GM measures to classify healthy controls (HC) (N = 289) from individuals at three stages of AN: underweight patients starting intensive treatment (N = 165, used as baseline), patients after partial weight-restoration (N = 115), and former patients after stable and full weight-restoration (N = 89). Alterations after weight-restoration were related to treatment outcome and characterized both anatomically and functionally. RESULTS Patients could be classified from HC when underweight (ROC-AUC = 0.90) but also after partial weight-restoration (ROC-AUC = 0.64). Alterations after partial weight-restoration were more pronounced in patients with worse outcome and were not detected in long-term weight-recovered individuals, i.e. those with favorable outcome. These alterations were more pronounced in regions with greater functional connectivity, not merely explained by body mass index, and even increases in cortical thickness were observed (insula, lateral orbitofrontal, temporal pole). CONCLUSIONS Analyzing persistent multivariate brain structural alterations after weight-restoration might help to develop personalized interventions after discharge from inpatient treatment.
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Affiliation(s)
- Dominic Arold
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Fabio Bernardoni
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Daniel Geisler
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Arne Doose
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Volkan Uen
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Ilka Boehm
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Veit Roessner
- Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Joseph A. King
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Stefan Ehrlich
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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Bernardoni F, King JA, Hellerhoff I, Schoemann M, Seidel M, Geisler D, Boehm I, Pauligk S, Doose A, Steding J, Gramatke K, Roessner V, Scherbaum S, Ehrlich S. Mouse-cursor trajectories reveal reduced contextual influence on decision conflict during delay discounting in anorexia nervosa. Int J Eat Disord 2023; 56:1898-1908. [PMID: 37415568 DOI: 10.1002/eat.24019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 06/05/2023] [Accepted: 06/26/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVE The capacity of individuals with anorexia nervosa (AN) to forgo immediate food rewards in their long-term pursuit of thinness is thought to reflect elevated self-control and/or abnormal reward sensitivity. Prior research attempted to capture an increased tendency to delay gratification in AN using delay-discounting tasks that assess how rapidly the subjective value of rewards decreases as a function of time until receipt. However, significant effects were mostly subtle or absent. Here, we tested whether the process leading to such decisions might be altered in AN. METHOD We recorded mouse-cursor movement trajectories leading to the final choice in a computerized delay-discounting task (238 trials) in 55 acutely underweight females with AN and pairwise age-matched female healthy controls (HC). We tested for group differences in deviations from a direct choice path, a measure of conflict strength in decision making, and whether group moderated the effect of several predictors of conflict strength (e.g., choice difficulty, consistency). We also explored reaction times and changes in trajectory directions (X-flips). RESULTS No group differences in delay-discounting parameters or movement trajectories were detected. However, the effect of the aforementioned predictors on deviations (and to a lesser extent reaction times) was reduced in AN. DISCUSSION These findings suggest that while delay discounting and conflict strength in decision making are generally unaltered in AN, conflict strength was more stable across different decisions in the disorder. This might enable individuals with AN to pursue (maladaptive) long-term body-weight goals, because particularly conflicting choices may not be experienced as such. PUBLIC SIGNIFICANCE The deviations from a direct path of mouse-cursor movements during a computerized delay-discounting task varied less in people with anorexia nervosa. Assuming such deviations measure decision conflict, we speculate that this increased stability might help people with anorexia nervosa achieve their long-term weight goals, as for them the struggle with the decision to eat high-calorie meals when hungry will be milder, so they would be more likely to skip them.
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Affiliation(s)
- Fabio Bernardoni
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Joseph A King
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Inger Hellerhoff
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
- Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Martin Schoemann
- Department of Psychology, Faculty of Natural sciences, TU Dresden, Dresden, Germany
| | - Maria Seidel
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Daniel Geisler
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Ilka Boehm
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Sophie Pauligk
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Arne Doose
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Julius Steding
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Katrin Gramatke
- Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden, Dresden, Germany
| | - Stefan Scherbaum
- Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Stefan Ehrlich
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
- Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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Doose A, Tam FI, Hellerhoff I, King JA, Boehm I, Gottloeber K, Wahl H, Werner A, Raschke F, Bartnik-Olson B, Lin AP, Akgün K, Roessner V, Linn J, Ehrlich S. Triangulating brain alterations in anorexia nervosa: a multimodal investigation of magnetic resonance spectroscopy, morphometry and blood-based biomarkers. Transl Psychiatry 2023; 13:277. [PMID: 37573444 PMCID: PMC10423271 DOI: 10.1038/s41398-023-02580-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/14/2023] Open
Abstract
The acute state of anorexia nervosa (AN) is associated with widespread reductions in cortical gray matter (GM) thickness and white matter (WM) volume, suspected changes in myelin content and elevated levels of the neuronal damage marker neurofilament light (NF-L), but the underlying mechanisms remain largely unclear. To gain a deeper understanding of brain changes in AN, we applied a multimodal approach combining advanced neuroimaging methods with analysis of blood-derived biomarkers. In addition to standard measures of cortical GM thickness and WM volume, we analyzed tissue-specific profiles of brain metabolites using multivoxel proton magnetic resonance spectroscopy, T1 relaxation time as a proxy of myelin content leveraging advanced quantitative MRI methods and serum NF-L concentrations in a sample of 30 female, predominately adolescent patients with AN and 30 age-matched female healthy control participants. In patients with AN, we found a reduction in GM cortical thickness and GM total N-acetyl aspartate. The latter predicted higher NF-L levels, which were elevated in AN. Furthermore, GM total choline was elevated. In WM, there were no group differences in either imaging markers, choline levels or N-acetyl aspartate levels. The current study provides evidence for neuronal damage processes as well as for increased membrane lipid catabolism and turnover in GM in acute AN but no evidence for WM pathology. Our results illustrate the potential of multimodal research including tissue-specific proton magnetic resonance spectroscopy analyses to shed light on brain changes in psychiatric and neurological conditions, which may ultimately lead to better treatments.
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Affiliation(s)
- Arne Doose
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Friederike I Tam
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Inger Hellerhoff
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Joseph A King
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Ilka Boehm
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Kim Gottloeber
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Hannes Wahl
- Department of Neuroradiology, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Annett Werner
- Department of Neuroradiology, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Felix Raschke
- OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden - Rossendorf, Dresden, Germany
| | - Brenda Bartnik-Olson
- Department of Radiology, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Alexander P Lin
- Center for Clinical Spectroscopy, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Katja Akgün
- Center of Clinical Neuroscience, Neurological Clinic, University Hospital Carl Gustav Carus, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Jennifer Linn
- Department of Neuroradiology, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Stefan Ehrlich
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
- Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
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Steding J, Ritschel F, Boehm I, Geisler D, King JA, Roessner V, Smolka MN, Zepf FD, Ehrlich S. The effects of acute tryptophan depletion on instrumental reward learning in anorexia nervosa - an fMRI study. Psychol Med 2023; 53:3426-3436. [PMID: 35343412 PMCID: PMC10277771 DOI: 10.1017/s0033291721005493] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 10/15/2021] [Accepted: 12/20/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND The serotonin (5-HT) hypothesis of anorexia nervosa (AN) posits that individuals predisposed toward or recovered from AN (recAN) have a central nervous hyperserotonergic state and therefore restrict food intake as a means to reduce 5-HT availability (via diminished tryptophan-derived precursor supply) and alleviate associated negative mood states. Importantly, the 5-HT system has also been generally implicated in reward processing, which has also been shown to be altered in AN. METHODS In this double-blind crossover study, 22 individuals recAN and 25 healthy control participants (HC) underwent functional magnetic resonance imaging (fMRI) while performing an established instrumental reward learning paradigm during acute tryptophan depletion (ATD; a dietary intervention that lowers central nervous 5-HT availability) as well as a sham depletion. RESULTS On a behavioral level, the main effects of reward and ATD were evident, but no group differences were found. fMRI analyses revealed a group × ATD × reward level interaction in the ventral anterior insula during reward anticipation as well as in the medial orbitofrontal cortex during reward consumption. DISCUSSION The precise pattern of results is suggestive of a 'normalization' of reward-related neural responses during ATD in recAN compared to HC. Our results lend further evidence to the 5-HT hypothesis of AN. Decreasing central nervous 5-HT synthesis and availability during ATD and possibly also by dieting may be a means to normalize 5-HT availability and associated brain processes.
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Affiliation(s)
- Julius Steding
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Franziska Ritschel
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Ilka Boehm
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Daniel Geisler
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Joseph A. King
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden, Dresden, Germany
| | - Michael N. Smolka
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Florian Daniel Zepf
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Stefan Ehrlich
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
- Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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5
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Boehm I, Hennig J, Ritschel F, Geisler D, King JA, Lesch I, Roessner V, Zepf FD, Ehrlich S. Acute tryptophan depletion balances altered resting-state functional connectivity of the salience network in female patients recovered from anorexia nervosa. J Psychiatry Neurosci 2022; 47:E351-E358. [PMID: 36195339 PMCID: PMC9533767 DOI: 10.1503/jpn.210161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 01/03/2022] [Accepted: 04/17/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND It has been suggested that individuals predisposed to or recovered from anorexia nervosa experience a hyperserotonergic state associated with anxiety that might be mitigated by restricted food intake, because diminished levels of the tryptophan precursor lower the central availability of serotonin (5-HT). At the neural level, the salience network is a system of functionally connected brain regions; it has been closely associated with 5-HT functioning and mental disorders (including anorexia nervosa). The aim of the present study was to investigate the effect on the salience network of a temporary dietary manipulation of 5-HT synthesis in patients with anorexia nervosa. METHODS In this double-blind crossover study, we obtained data on resting-state functional connectivity from 22 weight-recovered female patients with a history of anorexia nervosa, and 22 age-matched female healthy controls. The study procedure included acute tryptophan depletion (a dietary intervention that lowers the central 5-HT synthesis rate) and a sham condition. RESULTS We identified an interaction of group and experimental condition in resting-state functional connectivity between the salience network and the orbitofrontal cortex extending to the frontal pole (F 1,42 = 12.52; p FWE = 0.026). Further analysis revealed increased resting-state functional connectivity during acute tryptophan depletion in patients recovered from anorexia nervosa, resembling that of healthy controls during the sham condition (T 42 = -0.66; p = 0.51). LIMITATIONS The effect of acute tryptophan depletion on the central availability of 5-HT can be judged only indirectly using plasma ratios of tryptophan to large neutral amino acids. Moreover, the definition of anorexia nervosa recovery varies widely across studies, limiting comparability. CONCLUSION Taken together, our findings support the notion of 5-HT dysregulation in anorexia nervosa and indicate that reduced 5-HT synthesis and availability during acute tryptophan depletion (and possibly with food restriction) may balance hyperserotonergic functioning and the associated resting-state functional connectivity of the salience network.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Stefan Ehrlich
- From the Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Boehm, Hennig, Ritschel, Geisler, King, Lesch, Ehrlich); the Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden, Dresden, Germany (Roessner); the Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Friedrich Schiller University, Jena, Germany (Zepf); the Eating Disorder Treatment and Research Centre, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Ehrlich)
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6
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Watson HJ, Thornton LM, Yilmaz Z, Baker JH, Coleman JR, Adan RA, Alfredsson L, Andreassen OA, Ask H, Berrettini WH, Boehnke M, Boehm I, Boni C, Buehren K, Bulant J, Burghardt R, Chang X, Cichon S, Cone RD, Courtet P, Crow S, Crowley JJ, Danner UN, de Zwaan M, Dedoussis G, DeSocio JE, Dick DM, Dikeos D, Dina C, Djurovic S, Dmitrzak-Weglarz M, Docampo-Martinez E, Duriez P, Egberts K, Ehrlich S, Eriksson JG, Escaramís G, Esko T, Estivill X, Farmer A, Fernández-Aranda F, Fichter MM, Föcker M, Foretova L, Forstner AJ, Frei O, Gallinger S, Giegling I, Giuranna J, Gonidakis F, Gorwood P, Gratacòs M, Guillaume S, Guo Y, Hakonarson H, Hauser J, Havdahl A, Hebebrand J, Helder SG, Herms S, Herpertz-Dahlmann B, Herzog W, Hinney A, Hübel C, Hudson JI, Imgart H, Jamain S, Janout V, Jiménez-Murcia S, Jones IR, Julià A, Kalsi G, Kaminská D, Kaprio J, Karhunen L, Kas MJ, Keel PK, Kennedy JL, Keski-Rahkonen A, Kiezebrink K, Klareskog L, Klump KL, Knudsen GPS, La Via MC, Le Hellard S, Leboyer M, Li D, Lilenfeld L, Lin B, Lissowska J, Luykx J, Magistretti P, Maj M, Marsal S, Marshall CR, Mattingsdal M, Meulenbelt I, Micali N, Mitchell KS, Monteleone AM, Monteleone P, Myers R, Navratilova M, Ntalla I, O’Toole JK, Ophoff RA, Padyukov L, Pantel J, Papežová H, Pinto D, Raevuori A, Ramoz N, Reichborn-Kjennerud T, Ricca V, Ripatti S, Ripke S, Ritschel F, Roberts M, Rotondo A, Rujescu D, Rybakowski F, Scherag A, Scherer SW, Schmidt U, Scott LJ, Seitz J, Silén Y, Šlachtová L, Slagboom PE, Slof-Op ‘t Landt MC, Slopien A, Sorbi S, Świątkowska B, Tortorella A, Tozzi F, Treasure J, Tsitsika A, Tyszkiewicz-Nwafor M, Tziouvas K, van Elburg AA, van Furth EF, Walton E, Widen E, Zerwas S, Zipfel S, Bergen AW, Boden JM, Brandt H, Crawford S, Halmi KA, Horwood LJ, Johnson C, Kaplan AS, Kaye WH, Mitchell JE, Olsen CM, Pearson JF, Pedersen NL, Strober M, Werge T, Whiteman DC, Woodside DB, Gordon S, Maguire S, Larsen JT, Parker R, Petersen LV, Jordan J, Kennedy M, Wade TD, Birgegård A, Lichtenstein P, Landén M, Martin NG, Mortensen PB, Breen G, Bulik CM. Common Genetic Variation and Age of Onset of Anorexia Nervosa. Biol Psychiatry Glob Open Sci 2022; 2:368-378. [PMID: 36324647 PMCID: PMC9616394 DOI: 10.1016/j.bpsgos.2021.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/08/2021] [Accepted: 09/10/2021] [Indexed: 11/08/2022] Open
Abstract
Background Genetics and biology may influence the age of onset of anorexia nervosa (AN). The aims of this study were to determine whether common genetic variation contributes to age of onset of AN and to investigate the genetic associations between age of onset of AN and age at menarche. Methods A secondary analysis of the Psychiatric Genomics Consortium genome-wide association study (GWAS) of AN was performed, which included 9335 cases and 31,981 screened controls, all from European ancestries. We conducted GWASs of age of onset, early-onset AN (<13 years), and typical-onset AN, and genetic correlation, genetic risk score, and Mendelian randomization analyses. Results Two loci were genome-wide significant in the typical-onset AN GWAS. Heritability estimates (single nucleotide polymorphism-h 2) were 0.01-0.04 for age of onset, 0.16-0.25 for early-onset AN, and 0.17-0.25 for typical-onset AN. Early- and typical-onset AN showed distinct genetic correlation patterns with putative risk factors for AN. Specifically, early-onset AN was significantly genetically correlated with younger age at menarche, and typical-onset AN was significantly negatively genetically correlated with anthropometric traits. Genetic risk scores for age of onset and early-onset AN estimated from independent GWASs significantly predicted age of onset. Mendelian randomization analysis suggested a causal link between younger age at menarche and early-onset AN. Conclusions Our results provide evidence consistent with a common variant genetic basis for age of onset and implicate biological pathways regulating menarche and reproduction.
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Affiliation(s)
- Hunna J. Watson
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- School of Psychology, Curtin University, Perth, Western Australia, Australia
- Division of Paediatrics, School of Medicine, The University of Western Australia, Perth, Western Australia, Australia
| | - Laura M. Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Zeynep Yilmaz
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jessica H. Baker
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jonathan R.I. Coleman
- Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry Centre, King’s College London, London, United Kingdom
- National Institute for Health Research Biomedical Research Centre, King’s College London and South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - Roger A.H. Adan
- Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, the Netherlands
- Altrecht Eating Disorders Rintveld, Zeist, the Netherlands
| | - Lars Alfredsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ole A. Andreassen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Helga Ask
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Wade H. Berrettini
- Department of Psychiatry, Center for Neurobiology and Behavior, Philadelphia, Pennsylvania
| | - Michael Boehnke
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan
| | - Ilka Boehm
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Claudette Boni
- INSERM 1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
| | - Katharina Buehren
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany
| | - Josef Bulant
- Department of Pediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Roland Burghardt
- Department of Child and Adolescent Psychiatry, Klinikum Frankfurt/Oder, Frankfurt, Germany
| | - Xiao Chang
- Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Sven Cichon
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
- The Center for Eating Disorders at Sheppard Pratt, Baltimore, Maryland
- Institute of Neuroscience and Medicine, Research Center Jülich, Jülich, Germany
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Roger D. Cone
- Life Sciences Institute and Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, Michigan
| | - Philippe Courtet
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, University of Montpellier, Montpellier, France
| | - Scott Crow
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
- The Center for Eating Disorders at Sheppard Pratt, Baltimore, Maryland
- Institute of Neuroscience and Medicine, Research Center Jülich, Jülich, Germany
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - James J. Crowley
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Unna N. Danner
- Department of Clinical Psychology, Faculty of Social Sciences, University Utrecht, Utrecht, the Netherlands
- Altrecht Eating Disorders Rintveld, Zeist, the Netherlands
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - George Dedoussis
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | - Danielle M. Dick
- Department of Psychology, Commonwealth University, Richmond, Virginia
- College Behavioral and Emotional Health Institute, Commonwealth University, Richmond, Virginia
- Department of Human and Molecular Genetics, Commonwealth University, Richmond, Virginia
| | - Dimitris Dikeos
- First Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - Christian Dina
- L’institut du thorax, INSERM, CNRS, UNIV Nantes, Nantes, France
| | - Srdjan Djurovic
- NORMENT Centre, Department of Clinical Science, University of Oslo, Oslo, Norway
- Department of Medical Genetics, University of Bergen, Bergen, Norway
| | | | - Elisa Docampo-Martinez
- Barcelona Institute of Science and Technology, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Barcelona, Spain
| | - Philibert Duriez
- INSERM 1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- GHU Paris Psychiatrie et Neurosciences, CMME, Paris, France
| | - Karin Egberts
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Centre for Mental Health, Würzburg, Germany
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Johan G. Eriksson
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Geòrgia Escaramís
- Barcelona Institute of Science and Technology, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Barcelona, Spain
| | - Tõnu Esko
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Xavier Estivill
- Barcelona Institute of Science and Technology, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Barcelona, Spain
- Genomics and Disease, Bioinformatics and Genomics Programme, Centre for Genomic Regulation, Barcelona, Spain
| | - Anne Farmer
- Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry Centre, King’s College London, London, United Kingdom
| | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital Bellvitge-IDIBELL and CIBEROBN, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Manfred M. Fichter
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
- Schön Klinik Roseneck Affiliated With the Medical Faculty of the University of Munich, Prien, Germany
| | - Manuel Föcker
- Department of Child and Adolescent Psychiatry, University Hospital Münster, Münster, Germany
| | - Lenka Foretova
- Institute of Neuroscience and Medicine, Research Center Jülich, Jülich, Germany
| | - Andreas J. Forstner
- Institute of Neuroscience and Medicine, Research Center Jülich, Jülich, Germany
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Centre for Human Genetics, University of Marburg, Marburg, Germany
| | - Oleksandr Frei
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Steven Gallinger
- QIMR Berghofer Medical Research Institute, University of Queensland, Brisbane, Queensland, Australia
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, University of Montpellier, Montpellier, France
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Ina Giegling
- Department of Psychiatry, Psychotherapy and Psychosomatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Johanna Giuranna
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Fragiskos Gonidakis
- First Department of Psychiatry, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - Philip Gorwood
- INSERM 1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- CMME (GHU Paris Psychiatrie et Neurosciences), Hôpital Sainte Anne, Paris, France
| | - Mònica Gratacòs
- Barcelona Institute of Science and Technology, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Barcelona, Spain
| | - Sébastien Guillaume
- QIMR Berghofer Medical Research Institute, University of Queensland, Brisbane, Queensland, Australia
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, University of Montpellier, Montpellier, France
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Yiran Guo
- Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Hakon Hakonarson
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
- Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Joanna Hauser
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Alexandra Havdahl
- Nic Waals Institute, Lovisenberg Diaconal Hospitaland, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Sietske G. Helder
- Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry Centre, King’s College London, London, United Kingdom
- Zorg op Orde, Delft, the Netherlands
| | - Stefan Herms
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Beate Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany
| | - Wolfgang Herzog
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Anke Hinney
- Nic Waals Institute, Lovisenberg Diaconal Hospitaland, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Christopher Hübel
- National Institute for Health Research Biomedical Research Centre, King’s College London and South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - James I. Hudson
- Biological Psychiatry Laboratory, McLean Hospital/Harvard Medical School, Boston, Massachusetts
| | - Hartmut Imgart
- Eating Disorders Unit, Parklandklinik, Bad Wildungen, Germany
| | - Stephanie Jamain
- Inserm U955, Institut Mondor de recherches Biomédicales, Laboratoire, Neuro-Psychiatrie Translationnelle, and Fédération Hospitalo-Universitaire de Précision Médecine en Addictologie et Psychiatrie, University Paris-Est-Créteil, Créteil, France
| | - Vladimir Janout
- Faculty of Health Sciences, Palacky University, Olomouc, Czech Republic
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital Bellvitge-IDIBELL and CIBEROBN, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Ian R. Jones
- National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom
| | - Antonio Julià
- Rheumatology Research Group, Vall d’Hebron Research Institute, Barcelona, Spain
| | - Gursharan Kalsi
- Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry Centre, King’s College London, London, United Kingdom
| | - Deborah Kaminská
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Leila Karhunen
- Division of Rheumatology, Department of Medicine, Karolinska Institutet, Karolinska Institutet and Karolinska University Hospital, Solna, Sweden
- Institute of Public Health and Clinical Nutrition, Department of Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Martien J.H. Kas
- Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, the Netherlands
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, the Netherlands
| | - Pamela K. Keel
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - James L. Kennedy
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Anna Keski-Rahkonen
- Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Kirsty Kiezebrink
- Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom
| | - Lars Klareskog
- Division of Rheumatology, Department of Medicine, Karolinska Institutet, Karolinska Institutet and Karolinska University Hospital, Solna, Sweden
- Institute of Public Health and Clinical Nutrition, Department of Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Kelly L. Klump
- Department of Psychology, Michigan State University, Lansing, Michigan
| | - Gun Peggy S. Knudsen
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Maria C. La Via
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Stephanie Le Hellard
- Department of Clinical Science, K.G. Jebsen Centre for Psychosis Research, Norwegian Centre for Mental Disorders Research, University of Bergen, Bergen, Norway
- Dr. Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, Laboratory Building, Haukeland University Hospital, Bergen, Norway
| | - Marion Leboyer
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Institute of Neuroscience and Physiology, Gothenburg University, Gothenburg, Sweden
- Inserm U955, Institut Mondor de recherches Biomédicales, Laboratoire, Neuro-Psychiatrie Translationnelle, and Fédération Hospitalo-Universitaire de Précision Médecine en Addictologie et Psychiatrie, University Paris-Est-Créteil, Créteil, France
| | - Dong Li
- Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Lisa Lilenfeld
- Department of Clinical Psychology, the Chicago School of Professional Psychology, Washington, DC
| | - Bochao Lin
- Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, the Netherlands
| | - Jolanta Lissowska
- Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, the Netherlands
- Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Jurjen Luykx
- Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, the Netherlands
- Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Pierre Magistretti
- Department of Psychiatry, University of Lausanne-University Hospital of Lausanne, Lausanne, Switzerland
- BESE Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Salerno, Italy
| | - Mario Maj
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychiatry, University of Campania “Luigi Vanvitelli,” Naples, Italy
| | - Sara Marsal
- InsideOut Institute for Eating Disorders, The Charles Perkins Centre, the University of Sydney, Sydney, New South Wales, Australia
- Sydney Local Health District, NSW Health, St. Leonards, New South Wales, Australia
- Rheumatology Research Group, Vall d’Hebron Research Institute, Barcelona, Spain
| | - Christian R. Marshall
- Department of Paediatric Laboratory Medicine, the Hospital for Sick Children, Toronto, Ontario, Canada
| | - Morten Mattingsdal
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychiatry, University of Campania “Luigi Vanvitelli,” Naples, Italy
| | - Ingrid Meulenbelt
- Department of Biomedical Data Science, Leiden University Medical Centre, Leiden, the Netherlands
| | - Nadia Micali
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Pediatrics Gynaecology and Obstetrics, University of Geneva, Geneva, Switzerland
| | - Karen S. Mitchell
- Women’s Health Sciences Division, National Center for PTSD, Boston, Massachusetts
- Department of Psychiatry, Boston University, Boston, Massachusetts
| | | | - Palmiero Monteleone
- Department of Psychiatry, University of Lausanne-University Hospital of Lausanne, Lausanne, Switzerland
- BESE Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Salerno, Italy
| | - Richard Myers
- HudsonAlpha Institute for Biotechnology, Huntsville, Alabama
| | - Marie Navratilova
- Department of Cancer, Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Ionna Ntalla
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | - Roel A. Ophoff
- Center for Neurobehavioral Genetics, University of California at Los Angeles, Los Angeles, California
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Leonid Padyukov
- Division of Rheumatology, Department of Medicine, Karolinska Institutet, Karolinska Institutet and Karolinska University Hospital, Solna, Sweden
| | | | - Hana Papežová
- Eating Disorders Unit, Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Dalila Pinto
- Division of Psychiatric Genomics, Department of Psychiatry, and Genetics and Genomics Sciences, Icahn School of Medicine at Mount Sinai, New York
| | - Anu Raevuori
- Department of Adolescent Psychiatry, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland
- Department of Adolescent Psychiatry, University of Helsinki, Helsinki, Finland
- Department of Psychiatry, Neurobiology, Pharmacology, and Biotechnologies, University of Pisa, Pisa, Italy
| | - Nicolas Ramoz
- INSERM 1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
| | - Ted Reichborn-Kjennerud
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Valdo Ricca
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
- Department of Health Science, University of Florence, Florence, Italy
| | - Samuli Ripatti
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts
- Department of Psychiatry and Psychotherapy, Charité – Universitätsmedizin, Berlin, Germany
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Department of Biometry, University of Helsinki, Helsinki, Finland
| | - Stephan Ripke
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts
- Department of Psychiatry and Psychotherapy, Charité – Universitätsmedizin, Berlin, Germany
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Department of Biometry, University of Helsinki, Helsinki, Finland
| | - Franziska Ritschel
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Eating Disorders Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Marion Roberts
- Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry Centre, King’s College London, London, United Kingdom
| | - Alessandro Rotondo
- Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland
- Department of Adolescent Psychiatry, University of Helsinki, Helsinki, Finland
- Department of Psychiatry, Neurobiology, Pharmacology, and Biotechnologies, University of Pisa, Pisa, Italy
| | - Dan Rujescu
- Department of Psychiatry, Psychotherapy and Psychosomatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Filip Rybakowski
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Eating Disorders Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - André Scherag
- Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital – Friedrich Schiller University Jena, Jena, Germany
- Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Stephen W. Scherer
- McLaughlin Centre, University of Toronto, Toronto, Ontario, Canada
- Department of Genetics and Genome Biology and the Center for Applied Genomics, the Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ulrike Schmidt
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry Centre, King’s College London, London, United Kingdom
- National Institute for Health Research Biomedical Research Centre, King’s College London and South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - Laura J. Scott
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan
| | - Jochen Seitz
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany
| | - Yasmina Silén
- Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Lenka Šlachtová
- Department of Biochemistry and Molecular Biology, Institute of Organic Chemistry and Biochemistry, Prague, Czech Republic
| | - P. Eline Slagboom
- Department of Biomedical Data Science, Leiden University Medical Centre, Leiden, the Netherlands
| | - Margarita C.T. Slof-Op ‘t Landt
- Department of Psychiatry, Leiden University Medical Centre, Leiden, the Netherlands
- Rivierduinen Eating Disorders Ursula, Leiden, the Netherlands
| | - Agnieszka Slopien
- Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital – Friedrich Schiller University Jena, Jena, Germany
- Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
- IRCSS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Beata Świątkowska
- Department of Environmental Epidemiology, the Reference Center for Asbestos Exposure and Health Risk Assessment, Lódź, Poland
| | - Alfonso Tortorella
- Adolescent Health Unit, Second Department of Pediatrics, Athens, Greece
- Department of Psychiatry, University of Perugia, Perugia, Italy
| | - Federica Tozzi
- Brain Sciences Department, Stremble Ventures, Limassol, Cyprus
| | - Janet Treasure
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry Centre, King’s College London, London, United Kingdom
- National Institute for Health Research Biomedical Research Centre, King’s College London and South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - Artemis Tsitsika
- Adolescent Health Unit, Second Department of Pediatrics, Athens, Greece
- Department of Psychiatry, University of Perugia, Perugia, Italy
| | - Marta Tyszkiewicz-Nwafor
- Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Konstantinos Tziouvas
- Pediatric Intensive Care Unit, “P. & A. Kyriakou” Children's Hospital, University of Athens, Athens, Greece
| | - Annemarie A. van Elburg
- Department of Clinical Psychology, Faculty of Social Sciences, University Utrecht, Utrecht, the Netherlands
- Altrecht Eating Disorders Rintveld, Zeist, the Netherlands
| | - Eric F. van Furth
- Department of Psychiatry, Leiden University Medical Centre, Leiden, the Netherlands
- Rivierduinen Eating Disorders Ursula, Leiden, the Netherlands
| | - Esther Walton
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, Helsinki, Finland
| | - Elisabeth Widen
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, Helsinki, Finland
| | - Stephanie Zerwas
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tuebingen, Tuebingen, Germany
- Centre of Excellence for Eating Disorders, University Tuebingen, Tuebingen, Germany
| | - Stephan Zipfel
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tuebingen, Tuebingen, Germany
- Centre of Excellence for Eating Disorders, University Tuebingen, Tuebingen, Germany
| | - Andrew W. Bergen
- Oregon Research Institute, Eugene, Oregon
- Biorealm Research, Walnut, California
| | - Joseph M. Boden
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Harry Brandt
- The Center for Eating Disorders at Sheppard Pratt, Baltimore, Maryland
| | - Steven Crawford
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
- The Center for Eating Disorders at Sheppard Pratt, Baltimore, Maryland
- Institute of Neuroscience and Medicine, Research Center Jülich, Jülich, Germany
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Katherine A. Halmi
- New York Presbyterian Hospital-Westchester Division, Weill Cornell Medical College of Cornell University, White Plains, New York
| | - L. John Horwood
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | | | - Allan S. Kaplan
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Walter H. Kaye
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - James E. Mitchell
- Department of Psychiatry and Behavioral Science, School of Medicine and Health Sciences, University of North Dakota, Fargo, North Dakota
| | - Catherine M. Olsen
- Cancer Control Group, University of Queensland, Brisbane, Queensland, Australia
| | - John F. Pearson
- Biostatistics and Computational Biology Unit, University of Otago, Christchurch, New Zealand
| | - Nancy L. Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Michael Strober
- Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California
- David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California
| | - Thomas Werge
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - David C. Whiteman
- QIMR Berghofer Medical Research Institute, University of Queensland, Brisbane, Queensland, Australia
| | - D. Blake Woodside
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Mental Health, University Health Network, Toronto, Ontario, Canada
- Program for Eating Disorders, University Health Network, Toronto, Ontario, Canada
| | - Scott Gordon
- QIMR Berghofer Medical Research Institute, University of Queensland, Brisbane, Queensland, Australia
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, University of Montpellier, Montpellier, France
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Sarah Maguire
- InsideOut Institute for Eating Disorders, The Charles Perkins Centre, the University of Sydney, Sydney, New South Wales, Australia
- Sydney Local Health District, NSW Health, St. Leonards, New South Wales, Australia
- Rheumatology Research Group, Vall d’Hebron Research Institute, Barcelona, Spain
| | - Janne T. Larsen
- National Centre for Register-based Research, Aarhus BSS, Aarhus, Denmark
- Centre for Integrated Register-Based Research, Aarhus University, Aarhus, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Richard Parker
- QIMR Berghofer Medical Research Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Liselotte V. Petersen
- National Centre for Register-based Research, Aarhus BSS, Aarhus, Denmark
- Centre for Integrated Register-Based Research, Aarhus University, Aarhus, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Jennifer Jordan
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
- Clinical Research Unit, Canterbury District Health Board, Christchurch, New Zealand
| | - Martin Kennedy
- Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - Tracey D. Wade
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia
| | - Andreas Birgegård
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Landén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Institute of Neuroscience and Physiology, Gothenburg University, Gothenburg, Sweden
- Inserm U955, Institut Mondor de recherches Biomédicales, Laboratoire, Neuro-Psychiatrie Translationnelle, and Fédération Hospitalo-Universitaire de Précision Médecine en Addictologie et Psychiatrie, University Paris-Est-Créteil, Créteil, France
| | - Nicholas G. Martin
- QIMR Berghofer Medical Research Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Preben Bo Mortensen
- National Centre for Register-based Research, Aarhus BSS, Aarhus, Denmark
- Centre for Integrated Register-Based Research, Aarhus University, Aarhus, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Gerome Breen
- Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry Centre, King’s College London, London, United Kingdom
- National Institute for Health Research Biomedical Research Centre, King’s College London and South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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7
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Seidel M, King JA, Fürtjes S, Labitzke N, Wronski ML, Boehm I, Hennig J, Gramatke K, Roessner V, Ehrlich S. Increased Habit Frequency in the Daily Lives of Patients with Acute Anorexia Nervosa. Nutrients 2022; 14:nu14193905. [PMID: 36235556 PMCID: PMC9573582 DOI: 10.3390/nu14193905] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/10/2022] [Accepted: 09/16/2022] [Indexed: 11/16/2022] Open
Abstract
Strict eating routines and frequent rigid behavior patterns are commonly observed in patients with anorexia nervosa (AN). A recent theory proposes that while these behaviors may have been reinforced initially, they later become habitual. To date, however, research has been overly focused on eating-disorder (ED)-related habits. Over the course of seven days, we applied an ecological momentary assessment (EMA) to investigate the habit frequency and strength of ED-specific (food intake) and ED-unspecific (hygiene) habits in the daily lives of a sample of n = 57 AN and n = 57 healthy controls (HC). The results of the hierarchical models revealed that habits were significantly more likely in patients compared with HC for both categories, independently. Furthermore, a lower body mass index (BMI) was associated with increased habit frequency in AN. Our study strengthens the habit theory of AN by showing the relevance of habits beyond ED-specific behavioral domains. This also supports the development of innovative therapeutic interventions targeting habitual behavior in EDs.
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Affiliation(s)
- Maria Seidel
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany
- Correspondence: ; Tel.: +49-(0)351-458-2244
| | - Joseph A. King
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany
| | - Sophia Fürtjes
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany
| | - Natalie Labitzke
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany
| | - Marie-Louis Wronski
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany
| | - Ilka Boehm
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany
| | - Julius Hennig
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany
| | - Katrin Gramatke
- Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital Dresden, 01307 Dresden, Germany
| | - Stefan Ehrlich
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany
- Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany
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8
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Munn‐Chernoff MA, Johnson EC, Chou Y, Coleman JR, Thornton LM, Walters RK, Yilmaz Z, Baker JH, Hübel C, Gordon S, Medland SE, Watson HJ, Gaspar HA, Bryois J, Hinney A, Leppä VM, Mattheisen M, Ripke S, Yao S, Giusti‐Rodríguez P, Hanscombe KB, Adan RA, Alfredsson L, Ando T, Andreassen OA, Berrettini WH, Boehm I, Boni C, Boraska Perica V, Buehren K, Burghardt R, Cassina M, Cichon S, Clementi M, Cone RD, Courtet P, Crow S, Crowley JJ, Danner UN, Davis OS, Zwaan M, Dedoussis G, Degortes D, DeSocio JE, Dick DM, Dikeos D, Dina C, Dmitrzak‐Weglarz M, Docampo E, Duncan LE, Egberts K, Ehrlich S, Escaramís G, Esko T, Estivill X, Farmer A, Favaro A, Fernández‐Aranda F, Fichter MM, Fischer K, Föcker M, Foretova L, Forstner AJ, Forzan M, Franklin CS, Gallinger S, Giegling I, Giuranna J, Gonidakis F, Gorwood P, Gratacos Mayora M, Guillaume S, Guo Y, Hakonarson H, Hatzikotoulas K, Hauser J, Hebebrand J, Helder SG, Herms S, Herpertz‐Dahlmann B, Herzog W, Huckins LM, Hudson JI, Imgart H, Inoko H, Janout V, Jiménez‐Murcia S, Julià A, Kalsi G, Kaminská D, Karhunen L, Karwautz A, Kas MJ, Kennedy JL, Keski‐Rahkonen A, Kiezebrink K, Kim Y, Klump KL, Knudsen GPS, La Via MC, Le Hellard S, Levitan RD, Li D, Lilenfeld L, Lin BD, Lissowska J, Luykx J, Magistretti PJ, Maj M, Mannik K, Marsal S, Marshall CR, Mattingsdal M, McDevitt S, McGuffin P, Metspalu A, Meulenbelt I, Micali N, Mitchell K, Monteleone AM, Monteleone P, Nacmias B, Navratilova M, Ntalla I, O'Toole JK, Ophoff RA, Padyukov L, Palotie A, Pantel J, Papezova H, Pinto D, Rabionet R, Raevuori A, Ramoz N, Reichborn‐Kjennerud T, Ricca V, Ripatti S, Ritschel F, Roberts M, Rotondo A, Rujescu D, Rybakowski F, Santonastaso P, Scherag A, Scherer SW, Schmidt U, Schork NJ, Schosser A, Seitz J, Slachtova L, Slagboom PE, Slof‐Op't Landt MC, Slopien A, Sorbi S, Świątkowska B, Szatkiewicz JP, Tachmazidou I, Tenconi E, Tortorella A, Tozzi F, Treasure J, Tsitsika A, Tyszkiewicz‐Nwafor M, Tziouvas K, Elburg AA, Furth EF, Wagner G, Walton E, Widen E, Zeggini E, Zerwas S, Zipfel S, Bergen AW, Boden JM, Brandt H, Crawford S, Halmi KA, Horwood LJ, Johnson C, Kaplan AS, Kaye WH, Mitchell J, Olsen CM, Pearson JF, Pedersen NL, Strober M, Werge T, Whiteman DC, Woodside DB, Grove J, Henders AK, Larsen JT, Parker R, Petersen LV, Jordan J, Kennedy MA, Birgegård A, Lichtenstein P, Norring C, Landén M, Mortensen PB, Polimanti R, McClintick JN, Adkins AE, Aliev F, Bacanu S, Batzler A, Bertelsen S, Biernacka JM, Bigdeli TB, Chen L, Clarke T, Degenhardt F, Docherty AR, Edwards AC, Foo JC, Fox L, Frank J, Hack LM, Hartmann AM, Hartz SM, Heilmann‐Heimbach S, Hodgkinson C, Hoffmann P, Hottenga J, Konte B, Lahti J, Lahti‐Pulkkinen M, Lai D, Ligthart L, Loukola A, Maher BS, Mbarek H, McIntosh AM, McQueen MB, Meyers JL, Milaneschi Y, Palviainen T, Peterson RE, Ryu E, Saccone NL, Salvatore JE, Sanchez‐Roige S, Schwandt M, Sherva R, Streit F, Strohmaier J, Thomas N, Wang J, Webb BT, Wedow R, Wetherill L, Wills AG, Zhou H, Boardman JD, Chen D, Choi D, Copeland WE, Culverhouse RC, Dahmen N, Degenhardt L, Domingue BW, Frye MA, Gäebel W, Hayward C, Ising M, Keyes M, Kiefer F, Koller G, Kramer J, Kuperman S, Lucae S, Lynskey MT, Maier W, Mann K, Männistö S, Müller‐Myhsok B, Murray AD, Nurnberger JI, Preuss U, Räikkönen K, Reynolds MD, Ridinger M, Scherbaum N, Schuckit MA, Soyka M, Treutlein J, Witt SH, Wodarz N, Zill P, Adkins DE, Boomsma DI, Bierut LJ, Brown SA, Bucholz KK, Costello EJ, Wit H, Diazgranados N, Eriksson JG, Farrer LA, Foroud TM, Gillespie NA, Goate AM, Goldman D, Grucza RA, Hancock DB, Harris KM, Hesselbrock V, Hewitt JK, Hopfer CJ, Iacono WG, Johnson EO, Karpyak VM, Kendler KS, Kranzler HR, Krauter K, Lind PA, McGue M, MacKillop J, Madden PA, Maes HH, Magnusson PK, Nelson EC, Nöthen MM, Palmer AA, Penninx BW, Porjesz B, Rice JP, Rietschel M, Riley BP, Rose RJ, Shen P, Silberg J, Stallings MC, Tarter RE, Vanyukov MM, Vrieze S, Wall TL, Whitfield JB, Zhao H, Neale BM, Wade TD, Heath AC, Montgomery GW, Martin NG, Sullivan PF, Kaprio J, Breen G, Gelernter J, Edenberg HJ, Bulik CM, Agrawal A. Shared genetic risk between eating disorder‐ and substance‐use‐related phenotypes: Evidence from genome‐wide association studies. Addict Biol 2021; 26:e12880. [DOI: 10.1111/adb.12880] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/09/2019] [Accepted: 01/13/2020] [Indexed: 02/01/2023]
Affiliation(s)
- Melissa A. Munn‐Chernoff
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Emma C. Johnson
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
| | - Yi‐Ling Chou
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
| | - Jonathan R.I. Coleman
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
- National Institute for Health Research Biomedical Research Centre King's College London and South London and Maudsley National Health Service Trust London UK
| | - Laura M. Thornton
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Raymond K. Walters
- Analytic and Translational Genetics Unit, Department of Medicine Massachusetts General Hospital and Harvard Medical School Boston Massachusetts USA
- Stanley Center for Psychiatric Research Broad Institute of MIT and Harvard Cambridge Massachusetts USA
| | - Zeynep Yilmaz
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
- Department of Genetics University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Jessica H. Baker
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Christopher Hübel
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
- National Institute for Health Research Biomedical Research Centre King's College London and South London and Maudsley National Health Service Trust London UK
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
| | - Scott Gordon
- QIMR Berghofer Medical Research Institute Brisbane Queensland Australia
| | - Sarah E. Medland
- QIMR Berghofer Medical Research Institute Brisbane Queensland Australia
| | - Hunna J. Watson
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
- School of Psychology Curtin University Perth Western Australia Australia
- School of Paediatrics and Child Health University of Western Australia Perth Western Australia Australia
| | - Héléna A. Gaspar
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
- National Institute for Health Research Biomedical Research Centre King's College London and South London and Maudsley National Health Service Trust London UK
| | - Julien Bryois
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
| | - Anke Hinney
- Department of Child and Adolescent Psychiatry University Hospital Essen, University of Duisburg‐Essen Essen Germany
| | - Virpi M. Leppä
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
| | - Manuel Mattheisen
- Department of Biomedicine Aarhus University Aarhus Denmark
- Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden
- Center for Psychiatry Research, Stockholm Health Care Services Stockholm County Council Stockholm Sweden
- Department of Psychiatry, Psychosomatics and Psychotherapy University of Würzburg Germany
| | - Stephan Ripke
- Analytic and Translational Genetics Unit, Department of Medicine Massachusetts General Hospital and Harvard Medical School Boston Massachusetts USA
- Stanley Center for Psychiatric Research Broad Institute of MIT and Harvard Cambridge Massachusetts USA
- Department of Psychiatry and Psychotherapy Charité ‐ Universitätsmedizin Berlin Germany
| | - Shuyang Yao
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
| | - Paola Giusti‐Rodríguez
- Department of Genetics University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Ken B. Hanscombe
- Department of Medical and Molecular Genetics King's College London, Guy's Hospital London UK
| | - Roger A.H. Adan
- Department of Translational Neuroscience, Brain Center Rudolf Magnus University Medical Center Utrecht Utrecht The Netherlands
- Center for Eating Disorders Rintveld Altrecht Mental Health Institute Zeist The Netherlands
- Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Lars Alfredsson
- Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
| | - Tetsuya Ando
- Department of Behavioral Medicine, National Institute of Mental Health National Center of Neurology and Psychiatry Kodaira Tokyo Japan
| | - Ole A. Andreassen
- NORMENT Centre, Division of Mental Health and Addiction, NORMENT Centre University of Oslo, Oslo University Hospital Oslo Norway
| | - Wade H. Berrettini
- Department of Psychiatry, Center for Neurobiology and Behavior University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
| | - Ilka Boehm
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine Technische Universität Dresden Dresden Germany
| | - Claudette Boni
- Centre of Psychiatry and Neuroscience INSERM U894 Paris France
| | - Vesna Boraska Perica
- Wellcome Sanger Institute, Wellcome Genome Campus Hinxton Cambridge UK
- Department of Medical Biology, School of Medicine University of Split Split Croatia
| | - Katharina Buehren
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy RWTH Aachen University Aachen Germany
| | | | - Matteo Cassina
- Clinical Genetics Unit, Department of Woman and Child Health University of Padova Italy
| | - Sven Cichon
- Institute of Medical Genetics and Pathology University Hospital Basel Basel Switzerland
- Department of Biomedicine University of Basel Basel Switzerland
- Institute of Neuroscience and Medicine (INM‐1) Research Center Juelich Germany
| | - Maurizio Clementi
- Clinical Genetics Unit, Department of Woman and Child Health University of Padova Italy
| | - Roger D. Cone
- Department of Molecular and Integrative Physiology, Life Sciences Institute University of Michigan Ann Arbor Michigan USA
| | - Philippe Courtet
- Department of Emergency Psychiatry and Post‐Acute Care, CHRU Montpellier University of Montpellier Montpellier France
| | - Scott Crow
- Department of Psychiatry University of Minnesota Minneapolis Minnesota USA
| | - James J. Crowley
- Department of Genetics University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
- Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden
| | - Unna N. Danner
- Altrecht Eating Disorders Rintveld Altrecht Mental Health Institute Zeist The Netherlands
| | - Oliver S.P. Davis
- MRC Integrative Epidemiology Unit University of Bristol Bristol UK
- School of Social and Community Medicine University of Bristol Bristol UK
| | - Martina Zwaan
- Department of Psychosomatic Medicine and Psychotherapy Hannover Medical School Hannover Germany
| | - George Dedoussis
- Department of Nutrition and Dietetics Harokopio University Athens Greece
| | | | | | - Danielle M. Dick
- Department of Psychology Virginia Commonwealth University Richmond Virginia USA
- College Behavioral and Emotional Health Institute Virginia Commonwealth University Richmond Virginia USA
- Department of Human & Molecular Genetics Virginia Commonwealth University Richmond Virginia USA
| | - Dimitris Dikeos
- Department of Psychiatry, Athens University Medical School Athens University Athens Greece
| | - Christian Dina
- l'institut du thorax INSERM, CNRS, Univ Nantes Nantes France
| | | | - Elisa Docampo
- Barcelona Institute of Science and Technology Barcelona Spain
- Universitat Pompeu Fabra Barcelona Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP) Barcelona Spain
| | - Laramie E. Duncan
- Department of Psychiatry and Behavioral Sciences Stanford University Stanford California USA
| | - Karin Egberts
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Centre for Mental Health University Hospital of Würzburg Würzburg Germany
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine Technische Universität Dresden Dresden Germany
| | - Geòrgia Escaramís
- Barcelona Institute of Science and Technology Barcelona Spain
- Universitat Pompeu Fabra Barcelona Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP) Barcelona Spain
| | - Tõnu Esko
- Estonian Genome Center University of Tartu Tartu Estonia
- Program in Medical and Population Genetics Broad Institute of MIT and Harvard Cambridge Massachusetts USA
| | - Xavier Estivill
- Barcelona Institute of Science and Technology Barcelona Spain
- Universitat Pompeu Fabra Barcelona Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP) Barcelona Spain
- Genomics and Disease, Bioinformatics and Genomics Programme Centre for Genomic Regulation Barcelona Spain
| | - Anne Farmer
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - Angela Favaro
- Department of Neurosciences University of Padova Padova Italy
| | - Fernando Fernández‐Aranda
- Department of Psychiatry University Hospital of Bellvitge –IDIBELL and CIBERobn Barcelona Spain
- Department of Clinical Sciences, School of Medicine University of Barcelona Barcelona Spain
| | - Manfred M. Fichter
- Department of Psychiatry and Psychotherapy Ludwig‐Maximilians‐University Munich Germany
- Schön Klinik Roseneck affiliated with the Medical Faculty of the University of Munich Munich Germany
| | - Krista Fischer
- Estonian Genome Center University of Tartu Tartu Estonia
| | - Manuel Föcker
- Department of Child and Adolescent Psychiatry University of Münster Münster Germany
| | - Lenka Foretova
- Department of Cancer, Epidemiology and Genetics Masaryk Memorial Cancer Institute Brno Czech Republic
| | - Andreas J. Forstner
- Department of Biomedicine University of Basel Basel Switzerland
- Centre for Human Genetics University of Marburg Marburg Germany
- Institute of Human Genetics School of Medicine & University Hospital Bonn, University of Bonn Bonn Germany
- Department of Psychiatry (UPK) University of Basel Basel Switzerland
| | - Monica Forzan
- Clinical Genetics Unit, Department of Woman and Child Health University of Padova Italy
| | | | - Steven Gallinger
- Department of Surgery, Faculty of Medicine University of Toronto Toronto Ontario Canada
| | - Ina Giegling
- Department of Psychiatry, Psychotherapy and Psychosomatics Martin‐Luther‐University Halle‐Wittenberg Halle (Saale) Germany
| | - Johanna Giuranna
- Department of Child and Adolescent Psychiatry University Hospital Essen, University of Duisburg‐Essen Essen Germany
| | - Fragiskos Gonidakis
- 1st Psychiatric Department National and Kapodistrian University of Athens, Medical School, Eginition Hospital Athens Greece
| | - Philip Gorwood
- Institute of Psychiatry and Neuroscience of Paris INSERM U1266 Paris France
- CMME (GHU Paris Psychiatrie et Neurosciences), Paris Descartes University Paris France
| | - Monica Gratacos Mayora
- Barcelona Institute of Science and Technology Barcelona Spain
- Universitat Pompeu Fabra Barcelona Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP) Barcelona Spain
| | - Sébastien Guillaume
- Department of Emergency Psychiatry and Post‐Acute Care, CHRU Montpellier University of Montpellier Montpellier France
| | - Yiran Guo
- Center for Applied Genomics Children's Hospital of Philadelphia Philadelphia Pennsylvania USA
| | - Hakon Hakonarson
- Center for Applied Genomics Children's Hospital of Philadelphia Philadelphia Pennsylvania USA
- Department of Pediatrics University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
| | - Konstantinos Hatzikotoulas
- Wellcome Sanger Institute, Wellcome Genome Campus Hinxton Cambridge UK
- Institute of Translational Genomics, Helmholtz Zentrum München ‐ German Research Centre for Environmental Health Neuherberg Germany
| | - Joanna Hauser
- Department of Adult Psychiatry Poznan University of Medical Sciences Poznan Poland
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry University Hospital Essen, University of Duisburg‐Essen Essen Germany
| | - Sietske G. Helder
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
- Zorg op Orde Delft The Netherlands
| | - Stefan Herms
- Institute of Medical Genetics and Pathology University Hospital Basel Basel Switzerland
- Department of Biomedicine University of Basel Basel Switzerland
| | - Beate Herpertz‐Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy RWTH Aachen University Aachen Germany
| | - Wolfgang Herzog
- Department of General Internal Medicine and Psychosomatics Heidelberg University Hospital, Heidelberg University Heidelberg Germany
| | - Laura M. Huckins
- Wellcome Sanger Institute, Wellcome Genome Campus Hinxton Cambridge UK
- Department of Psychiatry, and Genetics and Genomics Sciences, Division of Psychiatric Genomics Icahn School of Medicine at Mount Sinai New York New York USA
| | - James I. Hudson
- Biological Psychiatry Laboratory McLean Hospital/Harvard Medical School Boston Massachusetts USA
| | - Hartmut Imgart
- Eating Disorders Unit Parklandklinik Bad Wildungen Germany
| | - Hidetoshi Inoko
- Department of Molecular Life Science, Division of Basic Medical Science and Molecular Medicine, School of Medicine Tokai University Isehara Japan
| | - Vladimir Janout
- Faculty of Health Sciences Palacky University Olomouc Czech Republic
| | - Susana Jiménez‐Murcia
- Department of Psychiatry University Hospital of Bellvitge –IDIBELL and CIBERobn Barcelona Spain
- Department of Clinical Sciences, School of Medicine University of Barcelona Barcelona Spain
| | - Antonio Julià
- Rheumatology Research Group Vall d'Hebron Research Institute Barcelona Spain
| | - Gursharan Kalsi
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - Deborah Kaminská
- Department of Psychiatry, First Faculty of Medicine Charles University Prague Czech Republic
| | - Leila Karhunen
- Department of Clinical Nutrition, Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
| | - Andreas Karwautz
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry Medical University of Vienna Vienna Austria
| | - Martien J.H. Kas
- Department of Translational Neuroscience, Brain Center Rudolf Magnus University Medical Center Utrecht Utrecht The Netherlands
- Groningen Institute for Evolutionary Life Sciences University of Groningen Groningen The Netherlands
| | - James L. Kennedy
- Centre for Addiction and Mental Health Toronto Ontario Canada
- Institute of Medical Science University of Toronto Toronto Ontario Canada
- Department of Psychiatry University of Toronto Toronto Ontario Canada
| | | | - Kirsty Kiezebrink
- Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition University of Aberdeen Aberdeen UK
| | - Youl‐Ri Kim
- Department of Psychiatry Seoul Paik Hospital, Inje University Seoul Korea
| | - Kelly L. Klump
- Department of Psychology Michigan State University East Lansing Michigan USA
| | | | - Maria C. La Via
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Stephanie Le Hellard
- Department of Clinical Science, Norwegian Centre for Mental Disorders Research (NORMENT) University of Bergen Bergen Norway
- Dr. Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine Haukeland University Hospital Bergen Norway
- Department of Clinical Medicine, Laboratory Building Haukeland University Hospital Bergen Norway
| | - Robert D. Levitan
- Centre for Addiction and Mental Health Toronto Ontario Canada
- Institute of Medical Science University of Toronto Toronto Ontario Canada
- Department of Psychiatry University of Toronto Toronto Ontario Canada
| | - Dong Li
- Center for Applied Genomics Children's Hospital of Philadelphia Philadelphia Pennsylvania USA
| | - Lisa Lilenfeld
- The Chicago School of Professional Psychology, Washington DC Campus Washington District of Columbia USA
| | - Bochao Danae Lin
- Department of Translational Neuroscience, Brain Center Rudolf Magnus University Medical Center Utrecht Utrecht The Netherlands
| | - Jolanta Lissowska
- Department of Cancer Epidemiology and Prevention M Skłodowska‐Curie Cancer Center ‐ Oncology Center Warsaw Poland
| | - Jurjen Luykx
- Department of Translational Neuroscience, Brain Center Rudolf Magnus University Medical Center Utrecht Utrecht The Netherlands
| | - Pierre J. Magistretti
- BESE Division King Abdullah University of Science and Technology Thuwal Saudi Arabia
- Department of Psychiatry University of Lausanne‐University Hospital of Lausanne (UNIL‐CHUV) Lausanne Switzerland
| | - Mario Maj
- Department of Psychiatry University of Campania "Luigi Vanvitelli" Naples Italy
| | - Katrin Mannik
- Estonian Genome Center University of Tartu Tartu Estonia
- Center for Integrative Genomics University of Lausanne Lausanne Switzerland
| | - Sara Marsal
- Rheumatology Research Group Vall d'Hebron Research Institute Barcelona Spain
| | - Christian R. Marshall
- Department of Paediatric Laboratory Medicine, Division of Genome Diagnostics The Hospital for Sick Children Toronto Ontario Canada
| | - Morten Mattingsdal
- NORMENT KG Jebsen Centre, Division of Mental Health and Addiction University of Oslo, Oslo University Hospital Oslo Norway
| | - Sara McDevitt
- Department of Psychiatry University College Cork Cork Ireland
- Eist Linn Adolescent Unit, Bessborough Health Service Executive South Cork Ireland
| | - Peter McGuffin
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - Andres Metspalu
- Estonian Genome Center University of Tartu Tartu Estonia
- Institute of Molecular and Cell Biology University of Tartu Tartu Estonia
| | - Ingrid Meulenbelt
- Molecular Epidemiology Section (Department of Biomedical Datasciences) Leiden University Medical Centre Leiden The Netherlands
| | - Nadia Micali
- Department of Psychiatry, Faculty of Medicine University of Geneva Geneva Switzerland
- Division of Child and Adolescent Psychiatry Geneva University Hospital Geneva Switzerland
| | - Karen Mitchell
- National Center for PTSD VA Boston Healthcare System Boston Massachusetts USA
- Department of Psychiatry Boston University School of Medicine Boston Massachusetts USA
| | | | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" University of Salerno Salerno Italy
| | - Benedetta Nacmias
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA) University of Florence Florence Italy
| | - Marie Navratilova
- Department of Cancer, Epidemiology and Genetics Masaryk Memorial Cancer Institute Brno Czech Republic
| | - Ioanna Ntalla
- Department of Nutrition and Dietetics Harokopio University Athens Greece
| | | | - Roel A. Ophoff
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior University of California Los Angeles Los Angeles California USA
- Department of Psychiatry, Erasmus MC University Medical Center Rotterdam Rotterdam The Netherlands
| | - Leonid Padyukov
- Department of Medicine, Center for Molecular Medicine, Division of Rheumatology Karolinska Institutet and Karolinska University Hospital Stockholm Sweden
| | - Aarno Palotie
- Program in Medical and Population Genetics Broad Institute of MIT and Harvard Cambridge Massachusetts USA
- Institute for Molecular Medicine FIMM, HiLIFE University of Helsinki Helsinki Finland
- Center for Human Genome Research Massachusetts General Hospital Boston Massachusetts USA
| | - Jacques Pantel
- Centre of Psychiatry and Neuroscience INSERM U894 Paris France
| | - Hana Papezova
- Department of Psychiatry, First Faculty of Medicine Charles University Prague Czech Republic
| | - Dalila Pinto
- Department of Psychiatry, and Genetics and Genomics Sciences, Division of Psychiatric Genomics Icahn School of Medicine at Mount Sinai New York New York USA
| | - Raquel Rabionet
- Saint Joan de Déu Research Institute Saint Joan de Déu Barcelona Children's Hospital Barcelona Spain
- Institute of Biomedicine (IBUB) University of Barcelona Barcelona Spain
- Department of Genetics, Microbiology and Statistics University of Barcelona Barcelona Spain
| | - Anu Raevuori
- Department of Public Health University of Helsinki Helsinki Finland
| | - Nicolas Ramoz
- Institute of Psychiatry and Neuroscience of Paris INSERM U1266 Paris France
| | - Ted Reichborn‐Kjennerud
- Department of Mental Disorders Norwegian Institute of Public Health Oslo Norway
- Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Valdo Ricca
- Department of Health Science University of Florence Florence Italy
| | - Samuli Ripatti
- Department of Biometry University of Helsinki Helsinki Finland
| | - Franziska Ritschel
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine Technische Universität Dresden Dresden Germany
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Eating Disorders Research and Treatment Center Technische Universität Dresden Dresden Germany
| | - Marion Roberts
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - Alessandro Rotondo
- Department of Psychiatry, Neurobiology, Pharmacology, and Biotechnologies University of Pisa Pisa Italy
| | - Dan Rujescu
- Department of Psychiatry, Psychotherapy and Psychosomatics Martin‐Luther‐University Halle‐Wittenberg Halle (Saale) Germany
| | - Filip Rybakowski
- Department of Psychiatry Poznan University of Medical Sciences Poznan Poland
| | - Paolo Santonastaso
- Department of Neurosciences, Padua Neuroscience Center University of Padova Padova Italy
| | - André Scherag
- Institute of Medical Statistics, Computer and Data Sciences Jena University Hospital Jena Germany
| | - Stephen W. Scherer
- Department of Genetics and Genomic Biology The Hospital for Sick Children Toronto Ontario Canada
- McLaughlin Centre University of Toronto Toronto Ontario Canada
| | - Ulrike Schmidt
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | | | - Alexandra Schosser
- Department of Psychiatry and Psychotherapy Medical University of Vienna Vienna Austria
| | - Jochen Seitz
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy RWTH Aachen University Aachen Germany
| | - Lenka Slachtova
- Department of Pediatrics and Center of Applied Genomics, First Faculty of Medicine Charles University Prague Czech Republic
| | - P. Eline Slagboom
- Molecular Epidemiology Section (Department of Medical Statistics) Leiden University Medical Centre Leiden The Netherlands
| | - Margarita C.T. Slof‐Op't Landt
- Center for Eating Disorders Ursula Rivierduinen Leiden The Netherlands
- Department of Psychiatry Leiden University Medical Centre Leiden The Netherlands
| | - Agnieszka Slopien
- Department of Child and Adolescent Psychiatry Poznan University of Medical Sciences Poznan Poland
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA) University of Florence Florence Italy
- IRCCS Fondazione Don Carlo Gnocchi Florence Italy
| | - Beata Świątkowska
- Department of Environmental Epidemiology Nofer Institute of Occupational Medicine Lodz Poland
| | - Jin P. Szatkiewicz
- Department of Genetics University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | | | - Elena Tenconi
- Department of Neurosciences University of Padova Padova Italy
| | - Alfonso Tortorella
- Department of Psychiatry University of Naples SUN Naples Italy
- Department of Psychiatry University of Perugia Perugia Italy
| | - Federica Tozzi
- Brain Sciences Department Stremble Ventures Limassol Cyprus
| | - Janet Treasure
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - Artemis Tsitsika
- Adolescent Health Unit, Second Department of Pediatrics "P. & A. Kyriakou" Children's Hospital, University of Athens Athens Greece
| | - Marta Tyszkiewicz‐Nwafor
- Department of Child and Adolescent Psychiatry Poznan University of Medical Sciences Poznan Poland
| | - Konstantinos Tziouvas
- Pediatric Intensive Care Unit "P. & A. Kyriakou" Children's Hospital, University of Athens Athens Greece
| | - Annemarie A. Elburg
- Center for Eating Disorders Rintveld Altrecht Mental Health Institute Zeist The Netherlands
- Faculty of Social and Behavioral Sciences Utrecht University Utrecht The Netherlands
| | - Eric F. Furth
- Center for Eating Disorders Ursula Rivierduinen Leiden The Netherlands
- Department of Psychiatry Leiden University Medical Centre Leiden The Netherlands
| | - Gudrun Wagner
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry Medical University of Vienna Vienna Austria
| | - Esther Walton
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine Technische Universität Dresden Dresden Germany
| | - Elisabeth Widen
- Institute for Molecular Medicine FIMM, HiLIFE University of Helsinki Helsinki Finland
| | - Eleftheria Zeggini
- Wellcome Sanger Institute, Wellcome Genome Campus Hinxton Cambridge UK
- Institute of Translational Genomics, Helmholtz Zentrum München ‐ German Research Centre for Environmental Health Neuherberg Germany
| | - Stephanie Zerwas
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Stephan Zipfel
- Department of Internal Medicine VI, Psychosomatic Medicine and Psychotherapy University Medical Hospital Tuebingen Tuebingen Germany
| | - Andrew W. Bergen
- BioRealm, LLC Walnut California USA
- Oregon Research Institute Eugene Oregon USA
| | - Joseph M. Boden
- Christchurch Health and Development Study University of Otago Christchurch New Zealand
| | - Harry Brandt
- The Center for Eating Disorders at Sheppard Pratt Baltimore Maryland USA
| | - Steven Crawford
- The Center for Eating Disorders at Sheppard Pratt Baltimore Maryland USA
| | - Katherine A. Halmi
- Department of Psychiatry Weill Cornell Medical College New York New York USA
| | - L. John Horwood
- Christchurch Health and Development Study University of Otago Christchurch New Zealand
| | | | - Allan S. Kaplan
- Centre for Addiction and Mental Health Toronto Ontario Canada
- Institute of Medical Science University of Toronto Toronto Ontario Canada
- Department of Psychiatry University of Toronto Toronto Ontario Canada
| | - Walter H. Kaye
- Department of Psychiatry University of California San Diego La Jolla California USA
| | - James Mitchell
- Department of Psychiatry and Behavioral Science University of North Dakota School of Medicine and Health Sciences Fargo North Dakota USA
| | - Catherine M. Olsen
- Population Health Department QIMR Berghofer Medical Research Institute Brisbane Queensland Australia
| | - John F. Pearson
- Biostatistics and Computational Biology Unit University of Otago Christchurch New Zealand
| | - Nancy L. Pedersen
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
| | - Michael Strober
- Department of Psychiatry and Biobehavioral Science, Semel Institute for Neuroscience and Human Behavior University of California Los Angeles Los Angeles California USA
- David Geffen School of Medicine University of California Los Angeles Los Angeles California USA
| | - Thomas Werge
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - David C. Whiteman
- Population Health Department QIMR Berghofer Medical Research Institute Brisbane Queensland Australia
| | - D. Blake Woodside
- Institute of Medical Science University of Toronto Toronto Ontario Canada
- Department of Psychiatry University of Toronto Toronto Ontario Canada
- Centre for Mental Health University Health Network Toronto Ontario Canada
- Program for Eating Disorders University Health Network Toronto Ontario Canada
| | - Jakob Grove
- Department of Biomedicine Aarhus University Aarhus Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH) Aarhus Denmark
- Centre for Integrative Sequencing, iSEQ Aarhus University Aarhus Denmark
- Bioinformatics Research Centre Aarhus University Aarhus Denmark
| | - Anjali K. Henders
- Institute for Molecular Bioscience University of Queensland Brisbane Queensland Australia
| | - Janne T. Larsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH) Aarhus Denmark
- National Centre for Register‐Based Research, Aarhus BSS Aarhus University Aarhus Denmark
- Centre for Integrated Register‐based Research (CIRRAU) Aarhus University Aarhus Denmark
| | - Richard Parker
- QIMR Berghofer Medical Research Institute Brisbane Queensland Australia
| | - Liselotte V. Petersen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH) Aarhus Denmark
- National Centre for Register‐Based Research, Aarhus BSS Aarhus University Aarhus Denmark
- Centre for Integrated Register‐based Research (CIRRAU) Aarhus University Aarhus Denmark
| | - Jennifer Jordan
- Department of Psychological Medicine University of Otago Christchurch New Zealand
- Canterbury District Health Board Christchurch New Zealand
| | - Martin A. Kennedy
- Department of Pathology and Biomedical Science University of Otago Christchurch New Zealand
| | - Andreas Birgegård
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
- Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden
- Center for Psychiatry Research, Stockholm Health Care Services Stockholm County Council Stockholm Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
| | - Claes Norring
- Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden
- Center for Psychiatry Research, Stockholm Health Care Services Stockholm County Council Stockholm Sweden
| | - Mikael Landén
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology The Sahlgrenska Academy at the University of Gothenburg Gothenburg Sweden
| | - Preben Bo Mortensen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH) Aarhus Denmark
- National Centre for Register‐Based Research, Aarhus BSS Aarhus University Aarhus Denmark
- Centre for Integrated Register‐based Research (CIRRAU) Aarhus University Aarhus Denmark
| | - Renato Polimanti
- Department of Psychiatry, Division of Human Genetics Yale School of Medicine New Haven Connecticut USA
- Veterans Affairs Connecticut Healthcare System West Haven Connecticut USA
| | - Jeanette N. McClintick
- Department of Biochemistry and Molecular Biology Indiana University School of Medicine Indianapolis Indiana USA
| | - Amy E. Adkins
- Department of Psychology Virginia Commonwealth University Richmond Virginia USA
- College Behavioral and Emotional Health Institute Virginia Commonwealth University Richmond Virginia USA
| | - Fazil Aliev
- Department of Psychology Virginia Commonwealth University Richmond Virginia USA
- Faculty of Business Karabuk University Karabuk Turkey
| | - Silviu‐Alin Bacanu
- Virginia Commonwealth University Alcohol Research Center Virginia Commonwealth University Richmond Virginia USA
- Virginia Institute for Psychiatric and Behavioral Genetics Virginia Commonwealth University Richmond Virginia USA
- Department of Psychiatry Virginia Commonwealth University Richmond Virginia USA
| | - Anthony Batzler
- Psychiatric Genomics and Pharmacogenomics Program Mayo Clinic Rochester Minnesota USA
| | - Sarah Bertelsen
- Department of Neuroscience Icahn School of Medicine at Mount Sinai New York New York USA
| | - Joanna M. Biernacka
- Department of Health Sciences Research Mayo Clinic Rochester Minnesota USA
- Department of Psychiatry and Psychology Mayo Clinic Rochester Minnesota USA
| | - Tim B. Bigdeli
- Department of Psychiatry and Behavioral Sciences State University of New York Downstate Medical Center Brooklyn New York USA
| | - Li‐Shiun Chen
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
| | | | - Franziska Degenhardt
- Institute of Human Genetics University of Bonn School of Medicine & University Hospital Bonn Bonn Germany
| | - Anna R. Docherty
- Department of Psychiatry University of Utah Salt Lake City Utah USA
| | - Alexis C. Edwards
- Virginia Institute for Psychiatric and Behavioral Genetics Virginia Commonwealth University Richmond Virginia USA
- Department of Psychiatry Virginia Commonwealth University Richmond Virginia USA
| | - Jerome C. Foo
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim Heidelberg University Mannheim Germany
| | - Louis Fox
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
| | - Josef Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim Heidelberg University Mannheim Germany
| | - Laura M. Hack
- Department of Psychiatry and Behavioral Sciences Stanford University Stanford California USA
| | - Annette M. Hartmann
- Department of Psychiatry, Psychotherapy and Psychosomatics Martin‐Luther‐University Halle‐Wittenberg Halle (Saale) Germany
| | - Sarah M. Hartz
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
| | - Stefanie Heilmann‐Heimbach
- Institute of Human Genetics University of Bonn School of Medicine & University Hospital Bonn Bonn Germany
| | | | - Per Hoffmann
- Institute of Medical Genetics and Pathology University Hospital Basel Basel Switzerland
- Institute of Human Genetics School of Medicine & University Hospital Bonn, University of Bonn Bonn Germany
- Human Genomics Research Group, Department of Biomedicine University of Basel Basel Switzerland
| | - Jouke‐Jan Hottenga
- Department of Biological Psychology, Amsterdam Public Health Research Institute Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Bettina Konte
- Department of Psychiatry, Psychotherapy and Psychosomatics Martin‐Luther‐University Halle‐Wittenberg Halle (Saale) Germany
| | - Jari Lahti
- Turku Institute for Advanced Studies University of Turku Turku Finland
| | | | - Dongbing Lai
- Department of Medical and Molecular Genetics Indiana University School of Medicine Indianapolis Indiana USA
| | - Lannie Ligthart
- Department of Biological Psychology, Amsterdam Public Health Research Institute Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Anu Loukola
- Institute for Molecular Medicine FIMM, HiLIFE University of Helsinki Helsinki Finland
| | - Brion S. Maher
- Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA
| | - Hamdi Mbarek
- Department of Biological Psychology, Amsterdam Public Health Research Institute Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Andrew M. McIntosh
- Division of Psychiatry, Centre for Cognitive Ageing and Cognitive Epidemiology University of Edinburgh Edinburgh UK
| | - Matthew B. McQueen
- Department of Integrative Physiology University of Colorado Boulder Boulder Colorado USA
| | - Jacquelyn L. Meyers
- Department of Psychiatry and Behavioral Sciences, Henri Begleiter Neurodynamics Laboratory SUNY Downstate Medical Center Brooklyn New York USA
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam Public Health Research Institute VU University Medical Center/GGz inGeest Amsterdam The Netherlands
| | - Teemu Palviainen
- Institute for Molecular Medicine FIMM, HiLIFE University of Helsinki Helsinki Finland
| | - Roseann E. Peterson
- Virginia Institute for Psychiatric and Behavioral Genetics Virginia Commonwealth University Richmond Virginia USA
- Department of Psychiatry Virginia Commonwealth University Richmond Virginia USA
| | - Euijung Ryu
- Department of Health Sciences Research Mayo Clinic Rochester Minnesota USA
| | - Nancy L. Saccone
- Department of Genetics Washington University School of Medicine Saint Louis Missouri USA
| | - Jessica E. Salvatore
- Department of Psychology Virginia Commonwealth University Richmond Virginia USA
- Virginia Institute for Psychiatric and Behavioral Genetics Virginia Commonwealth University Richmond Virginia USA
- Department of Psychiatry Virginia Commonwealth University Richmond Virginia USA
| | - Sandra Sanchez‐Roige
- Department of Psychiatry University of California San Diego La Jolla California USA
| | | | - Richard Sherva
- Department of Medicine (Biomedical Genetics) Boston University School of Medicine Boston Massachusetts USA
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim Heidelberg University Mannheim Germany
| | - Jana Strohmaier
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim Heidelberg University Mannheim Germany
| | - Nathaniel Thomas
- Department of Psychology Virginia Commonwealth University Richmond Virginia USA
- College Behavioral and Emotional Health Institute Virginia Commonwealth University Richmond Virginia USA
| | - Jen‐Chyong Wang
- Department of Neuroscience Icahn School of Medicine at Mount Sinai New York New York USA
| | - Bradley T. Webb
- Virginia Commonwealth University Alcohol Research Center Virginia Commonwealth University Richmond Virginia USA
- Virginia Institute for Psychiatric and Behavioral Genetics Virginia Commonwealth University Richmond Virginia USA
- Department of Psychiatry Virginia Commonwealth University Richmond Virginia USA
| | - Robbee Wedow
- Analytic and Translational Genetics Unit, Department of Medicine Massachusetts General Hospital and Harvard Medical School Boston Massachusetts USA
- Stanley Center for Psychiatric Research Broad Institute of MIT and Harvard Cambridge Massachusetts USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health Harvard University Cambridge Massachusetts USA
- Department of Sociology Harvard University Cambridge Massachusetts USA
| | - Leah Wetherill
- Department of Medical and Molecular Genetics Indiana University School of Medicine Indianapolis Indiana USA
| | - Amanda G. Wills
- Department of Pharmacology University of Colorado School of Medicine Aurora Colorado USA
| | - Hang Zhou
- Department of Psychiatry, Division of Human Genetics Yale School of Medicine New Haven Connecticut USA
- Veterans Affairs Connecticut Healthcare System West Haven Connecticut USA
| | - Jason D. Boardman
- Institute of Behavioral Science University of Colorado Boulder Colorado USA
- Department of Sociology University of Colorado Boulder Colorado USA
| | - Danfeng Chen
- Stanley Center for Psychiatric Research Broad Institute of MIT and Harvard Cambridge Massachusetts USA
| | - Doo‐Sup Choi
- Department of Molecular Pharmacology and Experimental Therapeutics Mayo Clinic Rochester Minnesota USA
| | - William E. Copeland
- Department of Psychiatry University of Vermont Medical Center Burlington Vermont USA
| | - Robert C. Culverhouse
- Department of Medicine, Division of Biostatistics Washington University School of Medicine Saint Louis Missouri USA
| | - Norbert Dahmen
- Department of Psychiatry University of Mainz Mainz Germany
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre University of New South Wales Sydney New South Wales Australia
| | - Benjamin W. Domingue
- Stanford University Graduate School of Education Stanford University Stanford California USA
| | - Mark A. Frye
- Department of Psychiatry and Psychology Mayo Clinic Rochester Minnesota USA
| | - Wolfgang Gäebel
- Department of Psychiatry and Psychotherapy University of Düsseldorf Duesseldorf Germany
| | - Caroline Hayward
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine University of Edinburgh Edinburgh UK
| | - Marcus Ising
- Max‐Planck‐Institute of Psychiatry Munich Germany
| | - Margaret Keyes
- Department of Psychology University of Minnesota Minneapolis Minnesota USA
| | - Falk Kiefer
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim Heidelberg University Mannheim Germany
| | - Gabriele Koller
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
| | - John Kramer
- Department of Psychiatry University of Iowa Roy J and Lucille A Carver College of Medicine Iowa City Iowa USA
| | - Samuel Kuperman
- Department of Psychiatry University of Iowa Roy J and Lucille A Carver College of Medicine Iowa City Iowa USA
| | | | - Michael T. Lynskey
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience King's College London London UK
| | - Wolfgang Maier
- Department of Psychiatry University of Bonn Bonn Germany
| | - Karl Mann
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim Heidelberg University Mannheim Germany
| | - Satu Männistö
- Department of Public Health Solutions National Institute for Health and Welfare Helsinki Finland
| | - Bertram Müller‐Myhsok
- Department of Statistical Genetics Max‐Planck‐Institute of Psychiatry München Germany
| | - Alison D. Murray
- Aberdeen Biomedical Imaging Centre, School of Medicine, Medical Sciences & Nutrition University of Aberdeen Foresterhill Aberdeen UK
| | - John I. Nurnberger
- Department of Medical and Molecular Genetics Indiana University School of Medicine Indianapolis Indiana USA
- Department of Psychiatry Indiana University School of Medicine Indianapolis Indiana USA
| | - Ulrich Preuss
- Department of Psychiatry, Psychotherapy and Psychosomatics Martin‐Luther‐University Halle‐Wittenberg Herborn Germany
- Department of Psychiatry and Psychotherapy Vitos Hospital Herborn Herborn Germany
| | - Katri Räikkönen
- Department of Psychology and Logopedics University of Helsinki Helsinki Finland
| | | | - Monika Ridinger
- Department of Psychiatry and Psychotherapy University of Regensburg Psychiatric Health Care Aargau Regensburg Germany
| | - Norbert Scherbaum
- Department of Psychiatry and Psychotherapy and Department of Addictive Behaviour and Addiction Medicine, Medical Faculty LVR‐Hospital Essen, University of Duisburg‐Essen Essen Germany
| | - Marc A. Schuckit
- Department of Psychiatry University of California San Diego La Jolla California USA
| | - Michael Soyka
- Medical Park Chiemseeblick in Bernau‐Felden Ludwig‐Maximilians‐University Bernau am Chiemsee Germany
- Psychiatric Hospital, Ludwig‐Maximilians‐University Bernau am Chiemsee Germany
| | - Jens Treutlein
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim Heidelberg University Mannheim Germany
| | - Stephanie H. Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim Heidelberg University Mannheim Germany
| | - Norbert Wodarz
- Department of Psychiatry and Psychotherapy University of Regensburg Regensburg Germany
| | - Peter Zill
- Department of Psychiatry Psychiatric Hospital, Ludwig‐Maximilians‐University Munich Germany
| | - Daniel E. Adkins
- Department of Psychiatry University of Utah Salt Lake City Utah USA
- Department of Sociology University of Utah Salt Lake City Utah USA
| | - Dorret I. Boomsma
- Department of Biological Psychology, Amsterdam Public Health Research Institute Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Laura J. Bierut
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
| | - Sandra A. Brown
- Department of Psychiatry University of California San Diego La Jolla California USA
- Department of Psychology University of California San Diego La Jolla California USA
| | - Kathleen K. Bucholz
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
| | - E. Jane Costello
- Department of Psychiatry and Behavioral Sciences Duke University Medical Center Durham North Carolina USA
| | - Harriet Wit
- Department of Psychiatry and Behavioral Neuroscience University of Chicago Chicago Illinois USA
| | | | - Johan G. Eriksson
- Department of General Practice and Primary Health Care University of Helsinki Helsinki Finland
- National Institute for Health and Welfare Helsinki Finland
| | - Lindsay A. Farrer
- Department of Medicine (Biomedical Genetics) Boston University School of Medicine Boston Massachusetts USA
- Department of Neurology Boston University School of Medicine Boston Massachusetts USA
- Department of Ophthalmology Boston University School of Medicine Boston Massachusetts USA
- Department of Epidemiology, School of Public Health Boston University Boston Massachusetts USA
- Department of Biostatistics, School of Public Health Boston University Boston Massachusetts USA
| | - Tatiana M. Foroud
- Department of Medical and Molecular Genetics Indiana University School of Medicine Indianapolis Indiana USA
| | - Nathan A. Gillespie
- Virginia Institute for Psychiatric and Behavioral Genetics Virginia Commonwealth University Richmond Virginia USA
| | - Alison M. Goate
- Department of Neuroscience Icahn School of Medicine at Mount Sinai New York New York USA
| | - David Goldman
- Laboratory of Neurogenetics NIH/NIAAA Bethesda Maryland USA
- Office of the Clinical Director NIH/NIAAA Besthesda Maryland USA
| | - Richard A. Grucza
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
| | - Dana B. Hancock
- Center for Omics Discovery and Epidemiology, Behavioral Health Research Division RTI International Research Triangle Park North Carolina USA
| | - Kathleen Mullan Harris
- Department of Sociology University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
- Carolina Population Center University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Victor Hesselbrock
- Department of Psychiatry University of Connecticut School of Medicine Farmington Connecticut USA
| | - John K. Hewitt
- Institute for Behavioral Genetics University of Colorado Boulder Boulder Colorado USA
| | | | - William G. Iacono
- Department of Psychology University of Minnesota Minneapolis Minnesota USA
| | - Eric O. Johnson
- Center for Omics Discovery and Epidemiology, Behavioral Health Research Division RTI International Research Triangle Park North Carolina USA
- Fellow Program RTI International Research Triangle Park North Carolina USA
| | - Victor M. Karpyak
- Department of Psychiatry and Psychology Mayo Clinic Rochester Minnesota USA
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics Virginia Commonwealth University Richmond Virginia USA
- Department of Psychiatry Virginia Commonwealth University Richmond Virginia USA
| | - Henry R. Kranzler
- Center for Studies of Addiction University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
- VISN 4 MIRECC Crescenz VAMC Philadelphia Pennsylvania USA
| | - Kenneth Krauter
- Department of Molecular, Cellular, and Developmental Biology University of Colorado Boulder Boulder Colorado USA
| | - Penelope A. Lind
- QIMR Berghofer Medical Research Institute Brisbane Queensland Australia
| | - Matt McGue
- Department of Psychology University of Minnesota Minneapolis Minnesota USA
| | - James MacKillop
- Peter Boris Centre for Addictions Research McMaster University/St. Joseph's Healthcare Hamilton Hamilton Ontario Canada
- Michael G. DeGroote Centre for Medicinal Cannabis Research McMaster University/St. Joseph's Healthcare Hamilton Hamilton Ontario Canada
| | - Pamela A.F. Madden
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
| | - Hermine H. Maes
- Virginia Institute for Psychiatric and Behavioral Genetics Virginia Commonwealth University Richmond Virginia USA
| | - Patrik K.E. Magnusson
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
| | - Elliot C. Nelson
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
| | - Markus M. Nöthen
- Institute of Human Genetics University of Bonn School of Medicine & University Hospital Bonn Bonn Germany
| | - Abraham A. Palmer
- Department of Psychiatry University of California San Diego La Jolla California USA
- Institute for Genomic Medicine University of California San Diego La Jolla California USA
| | - Brenda W.J.H. Penninx
- Department of Psychiatry, Amsterdam UMC VU University and GGZinGeest Amsterdam The Netherlands
| | - Bernice Porjesz
- Department of Psychiatry and Behavioral Sciences, Henri Begleiter Neurodynamics Laboratory SUNY Downstate Medical Center Brooklyn New York USA
| | - John P. Rice
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim Heidelberg University Mannheim Germany
| | - Brien P. Riley
- Virginia Commonwealth University Alcohol Research Center Virginia Commonwealth University Richmond Virginia USA
- Virginia Institute for Psychiatric and Behavioral Genetics Virginia Commonwealth University Richmond Virginia USA
- Department of Psychiatry Virginia Commonwealth University Richmond Virginia USA
| | - Richard J. Rose
- Department of Psychological & Brain Sciences Indiana University Bloomington Bloomington Indiana USA
| | - Pei‐Hong Shen
- Laboratory of Neurogenetics NIH/NIAAA Bethesda Maryland USA
| | - Judy Silberg
- Virginia Institute for Psychiatric and Behavioral Genetics Virginia Commonwealth University Richmond Virginia USA
- Department of Psychiatry Virginia Commonwealth University Richmond Virginia USA
| | - Michael C. Stallings
- Institute for Behavioral Genetics University of Colorado Boulder Boulder Colorado USA
| | - Ralph E. Tarter
- School of Pharmacy University of Pittsburgh Pittsburgh Pennsylvania USA
| | | | - Scott Vrieze
- Department of Psychology University of Minnesota Minneapolis Minnesota USA
| | - Tamara L. Wall
- Department of Psychiatry University of California San Diego La Jolla California USA
| | - John B. Whitfield
- QIMR Berghofer Medical Research Institute Brisbane Queensland Australia
| | - Hongyu Zhao
- Department of Biostatistics, Yale School of Public Health Yale University New Haven Connecticut USA
| | - Benjamin M. Neale
- Analytic and Translational Genetics Unit, Department of Medicine Massachusetts General Hospital and Harvard Medical School Boston Massachusetts USA
- Stanley Center for Psychiatric Research Broad Institute of MIT and Harvard Cambridge Massachusetts USA
| | - Tracey D. Wade
- School of Psychology Flinders University Adelaide South Australia Australia
| | - Andrew C. Heath
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
| | - Grant W. Montgomery
- QIMR Berghofer Medical Research Institute Brisbane Queensland Australia
- Institute for Molecular Bioscience University of Queensland Brisbane Queensland Australia
- Queensland Brain Institute University of Queensland Brisbane Queensland Australia
| | | | - Patrick F. Sullivan
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
- Department of Genetics University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
| | - Jaakko Kaprio
- Department of Public Health University of Helsinki Helsinki Finland
- Institute for Molecular Medicine FIMM, HiLIFE University of Helsinki Helsinki Finland
| | - Gerome Breen
- Social, Genetic and Developmental Psychiatry (SGDP) Centre, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
- National Institute for Health Research Biomedical Research Centre King's College London and South London and Maudsley National Health Service Trust London UK
| | - Joel Gelernter
- Department of Psychiatry, Division of Human Genetics Yale School of Medicine New Haven Connecticut USA
- Veterans Affairs Connecticut Healthcare System West Haven Connecticut USA
- Department of Genetics Yale School of Medicine New Haven Connecticut USA
- Department of Neuroscience Yale School of Medicine New Haven Connecticut USA
| | - Howard J. Edenberg
- Department of Biochemistry and Molecular Biology Indiana University School of Medicine Indianapolis Indiana USA
- Department of Medical and Molecular Genetics Indiana University School of Medicine Indianapolis Indiana USA
| | - Cynthia M. Bulik
- Department of Psychiatry University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
- Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden
- Department of Nutrition University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Arpana Agrawal
- Department of Psychiatry Washington University School of Medicine Saint Louis Missouri USA
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Seidel M, Ehrlich S, Breithaupt L, Welch E, Wiklund C, Hübel C, Thornton LM, Savva A, Fundin BT, Pege J, Billger A, Abbaspour A, Schaefer M, Boehm I, Zvrskovec J, Rosager EV, Hasselbalch KC, Leppä V, Sjögren M, Nergårdh R, Feusner JD, Ghaderi A, Bulik CM. Study protocol of comprehensive risk evaluation for anorexia nervosa in twins (CREAT): a study of discordant monozygotic twins with anorexia nervosa. BMC Psychiatry 2020; 20:507. [PMID: 33054774 PMCID: PMC7557028 DOI: 10.1186/s12888-020-02903-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 09/29/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Anorexia nervosa (AN) is a severe disorder, for which genetic evidence suggests psychiatric as well as metabolic origins. AN has high somatic and psychiatric comorbidities, broad impact on quality of life, and elevated mortality. Risk factor studies of AN have focused on differences between acutely ill and recovered individuals. Such comparisons often yield ambiguous conclusions, as alterations could reflect different effects depending on the comparison. Whereas differences found in acutely ill patients could reflect state effects that are due to acute starvation or acute disease-specific factors, they could also reflect underlying traits. Observations in recovered individuals could reflect either an underlying trait or a "scar" due to lasting effects of sustained undernutrition and illness. The co-twin control design (i.e., monozygotic [MZ] twins who are discordant for AN and MZ concordant control twin pairs) affords at least partial disambiguation of these effects. METHODS Comprehensive Risk Evaluation for Anorexia nervosa in Twins (CREAT) will be the largest and most comprehensive investigation of twins who are discordant for AN to date. CREAT utilizes a co-twin control design that includes endocrinological, neurocognitive, neuroimaging, genomic, and multi-omic approaches coupled with an experimental component that explores the impact of an overnight fast on most measured parameters. DISCUSSION The multimodal longitudinal twin assessment of the CREAT study will help to disambiguate state, trait, and "scar" effects, and thereby enable a deeper understanding of the contribution of genetics, epigenetics, cognitive functions, brain structure and function, metabolism, endocrinology, microbiology, and immunology to the etiology and maintenance of AN.
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Affiliation(s)
- Maria Seidel
- grid.4488.00000 0001 2111 7257Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany ,Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
| | - Lauren Breithaupt
- grid.38142.3c000000041936754XDepartment of Psychiatry, Harvard Medical School, Boston, MA USA ,grid.32224.350000 0004 0386 9924Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA USA
| | - Elisabeth Welch
- grid.4714.60000 0004 1937 0626Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden ,grid.467087.a0000 0004 0442 1056Stockholm Health Care Services, Region Stockholm, Stockholm Centre for Eating Disorders, Stockholm, Sweden
| | - Camilla Wiklund
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden
| | - Christopher Hübel
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden ,grid.13097.3c0000 0001 2322 6764Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,grid.37640.360000 0000 9439 0839UK National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), South London and Maudsley NHS Foundation Trust, London, UK ,grid.7048.b0000 0001 1956 2722National Centre for Register-based Research, Aarhus Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Laura M. Thornton
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Androula Savva
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden
| | - Bengt T. Fundin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden
| | - Jessica Pege
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden
| | - Annelie Billger
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden
| | - Afrouz Abbaspour
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden
| | - Martin Schaefer
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Ilka Boehm
- grid.4488.00000 0001 2111 7257Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
| | - Johan Zvrskovec
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden ,grid.13097.3c0000 0001 2322 6764Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Emilie Vangsgaard Rosager
- grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Virpi Leppä
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden
| | - Magnus Sjögren
- grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark ,Eating Disorder Research Unit, Mental Health Center Ballerup, Ballerup, Denmark
| | - Ricard Nergårdh
- grid.4714.60000 0004 1937 0626Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Jamie D. Feusner
- grid.19006.3e0000 0000 9632 6718Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA USA
| | - Ata Ghaderi
- grid.13097.3c0000 0001 2322 6764Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Cynthia M. Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutetet, Nobels väg 12A, 17165 Stockholm, Solna Sweden ,grid.10698.360000000122483208Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC USA ,grid.10698.360000000122483208Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC USA
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10
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Bernardoni F, Bernhardt N, Pooseh S, King JA, Geisler D, Ritschel F, Boehm I, Seidel M, Roessner V, Smolka MN, Ehrlich S. Metabolic state and value-based decision-making in acute and recovered female patients with anorexia nervosa. J Psychiatry Neurosci 2020; 45:253-261. [PMID: 32129584 PMCID: PMC7828930 DOI: 10.1503/jpn.190031] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Patients with anorexia nervosa forgo eating despite emaciation and severe health consequences. Such dysfunctional decision-making might be explained by an excessive level of self-control, alterations in homeostatic and hedonic regulation, or an interplay between these processes. We aimed to understand value-based decision-making in anorexia nervosa and its association with the gut hormone ghrelin. Besides its homeostatic function, ghrelin has been implicated in the hedonic regulation of appetite and reward via the modulation of phasic dopamine signalling. METHODS In a cross-sectional design, we studied acutely underweight (n = 94) and recovered (n = 37) patients with anorexia nervosa of the restrictive subtype, as well as healthy control participants (n = 119). We assessed plasma concentrations of desacyl ghrelin and parameters of delay discounting, probability discounting for gains and losses, and loss aversion. RESULTS Recovered patients displayed higher risk aversion for gains, but we observed no group differences for the remaining decision-making parameters. Desacyl ghrelin was higher in acutely underweight and recovered participants with anorexia nervosa relative to healthy controls. Moreover, we found a significant group × desacyl ghrelin interaction in delay discounting, indicating that in contrast to healthy controls, acutely underweight patients with anorexia nervosa who had high desacyl ghrelin concentrations preferably chose the delayed reward option. LIMITATIONS We probed decision-making using monetary rewards, but patients with anorexia nervosa may react differently to disorder-relevant stimuli. Furthermore, in contrast to acyl ghrelin, the functions of desacyl ghrelin are unclear. Therefore, the interpretation of the results is preliminary. CONCLUSION The propensity for risk aversion as found in recovered patients with anorexia nervosa could help them successfully complete therapy, or it could reflect sequelae of the disorder. Conversely, ghrelin findings might be related to a mechanism contributing to disease maintenance; that is, in acutely underweight anorexia nervosa, a hungry state may facilitate the ability to forgo an immediate reward to achieve a (dysfunctional) long-term goal.
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Affiliation(s)
- Fabio Bernardoni
- From the Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Bernardoni, King, Geisler, Ritschel, Boehm, Seidel, Ehrlich); the Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany (Bernhardt, Pooseh, Smolka); the Freiburg Center for Data Analysis and Modeling, Albert-Ludwigs-Universität Freiburg, Germany (Pooseh); and the Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Roessner, Ehrlich)
| | - Nadine Bernhardt
- From the Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Bernardoni, King, Geisler, Ritschel, Boehm, Seidel, Ehrlich); the Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany (Bernhardt, Pooseh, Smolka); the Freiburg Center for Data Analysis and Modeling, Albert-Ludwigs-Universität Freiburg, Germany (Pooseh); and the Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Roessner, Ehrlich)
| | - Shakoor Pooseh
- From the Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Bernardoni, King, Geisler, Ritschel, Boehm, Seidel, Ehrlich); the Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany (Bernhardt, Pooseh, Smolka); the Freiburg Center for Data Analysis and Modeling, Albert-Ludwigs-Universität Freiburg, Germany (Pooseh); and the Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Roessner, Ehrlich)
| | - Joseph A. King
- From the Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Bernardoni, King, Geisler, Ritschel, Boehm, Seidel, Ehrlich); the Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany (Bernhardt, Pooseh, Smolka); the Freiburg Center for Data Analysis and Modeling, Albert-Ludwigs-Universität Freiburg, Germany (Pooseh); and the Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Roessner, Ehrlich)
| | - Daniel Geisler
- From the Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Bernardoni, King, Geisler, Ritschel, Boehm, Seidel, Ehrlich); the Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany (Bernhardt, Pooseh, Smolka); the Freiburg Center for Data Analysis and Modeling, Albert-Ludwigs-Universität Freiburg, Germany (Pooseh); and the Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Roessner, Ehrlich)
| | - Franziska Ritschel
- From the Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Bernardoni, King, Geisler, Ritschel, Boehm, Seidel, Ehrlich); the Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany (Bernhardt, Pooseh, Smolka); the Freiburg Center for Data Analysis and Modeling, Albert-Ludwigs-Universität Freiburg, Germany (Pooseh); and the Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Roessner, Ehrlich)
| | - Ilka Boehm
- From the Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Bernardoni, King, Geisler, Ritschel, Boehm, Seidel, Ehrlich); the Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany (Bernhardt, Pooseh, Smolka); the Freiburg Center for Data Analysis and Modeling, Albert-Ludwigs-Universität Freiburg, Germany (Pooseh); and the Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Roessner, Ehrlich)
| | - Maria Seidel
- From the Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Bernardoni, King, Geisler, Ritschel, Boehm, Seidel, Ehrlich); the Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany (Bernhardt, Pooseh, Smolka); the Freiburg Center for Data Analysis and Modeling, Albert-Ludwigs-Universität Freiburg, Germany (Pooseh); and the Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Roessner, Ehrlich)
| | - Veit Roessner
- From the Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Bernardoni, King, Geisler, Ritschel, Boehm, Seidel, Ehrlich); the Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany (Bernhardt, Pooseh, Smolka); the Freiburg Center for Data Analysis and Modeling, Albert-Ludwigs-Universität Freiburg, Germany (Pooseh); and the Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Roessner, Ehrlich)
| | - Michael N. Smolka
- From the Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Bernardoni, King, Geisler, Ritschel, Boehm, Seidel, Ehrlich); the Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany (Bernhardt, Pooseh, Smolka); the Freiburg Center for Data Analysis and Modeling, Albert-Ludwigs-Universität Freiburg, Germany (Pooseh); and the Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Roessner, Ehrlich)
| | - Stefan Ehrlich
- From the Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Bernardoni, King, Geisler, Ritschel, Boehm, Seidel, Ehrlich); the Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany (Bernhardt, Pooseh, Smolka); the Freiburg Center for Data Analysis and Modeling, Albert-Ludwigs-Universität Freiburg, Germany (Pooseh); and the Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Roessner, Ehrlich)
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Boehm I, Walton E, Alexander N, Batury VL, Seidel M, Geisler D, King JA, Weidner K, Roessner V, Ehrlich S. Peripheral serotonin transporter DNA methylation is linked to increased salience network connectivity in females with anorexia nervosa. J Psychiatry Neurosci 2020; 45:206-213. [PMID: 31823595 PMCID: PMC7828979 DOI: 10.1503/jpn.190016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Epigenetic variation in the serotonin transporter gene (SLC6A4) has been shown to modulate the functioning of brain circuitry associated with the salience network and may heighten the risk for mental illness. This study is, to our knowledge, the first to test this epigenome–brain–behaviour pathway in patients with anorexia nervosa. METHODS We obtained resting-state functional connectivity (rsFC) data and blood samples from 55 acutely underweight female patients with anorexia nervosa and 55 age-matched female healthy controls. We decomposed imaging data using independent component analysis. We used bisulfite pyrosequencing to analyze blood DNA methylation within the promoter region of SLC6A4. We then explored salience network rsFC patterns in the group × methylation interaction. RESULTS We identified a positive relationship between SLC6A4 methylation levels and rsFC between the dorsolateral prefrontal cortex and the salience network in patients with anorexia nervosa compared to healthy controls. Increased rsFC in the salience network mediated the link between SLC6A4 methylation and eating disorder symptoms in patients with anorexia nervosa. We confirmed findings of rsFC alterations for CpG-specific methylation at a locus with evidence of methylation correspondence between brain and blood tissue. LIMITATIONS This study was cross-sectional in nature, the sample size was modest for the method and methylation levels were measured peripherally, so findings cannot be fully generalized to brain tissue. CONCLUSION This study sheds light on the neurobiological process of how epigenetic variation in the SLC6A4 gene may relate to rsFC in the salience network that is linked to psychopathology in anorexia nervosa.
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Affiliation(s)
- Ilka Boehm
- From the Division of Psychological and Social Medicine and Developmental Neurosciences, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Boehm, Walton, Batury, Seidel, Geisler, King, Ehrlich); the Department of Psychology, University of Bath, Bath, UK (Walton); the Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany (Alexander); the Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Weidner); the Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Roessner); and the Eating Disorders Research and Treatment Center at the Department of Child and Adolescent Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Ehrlich)
| | - Esther Walton
- From the Division of Psychological and Social Medicine and Developmental Neurosciences, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Boehm, Walton, Batury, Seidel, Geisler, King, Ehrlich); the Department of Psychology, University of Bath, Bath, UK (Walton); the Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany (Alexander); the Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Weidner); the Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Roessner); and the Eating Disorders Research and Treatment Center at the Department of Child and Adolescent Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Ehrlich)
| | - Nina Alexander
- From the Division of Psychological and Social Medicine and Developmental Neurosciences, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Boehm, Walton, Batury, Seidel, Geisler, King, Ehrlich); the Department of Psychology, University of Bath, Bath, UK (Walton); the Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany (Alexander); the Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Weidner); the Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Roessner); and the Eating Disorders Research and Treatment Center at the Department of Child and Adolescent Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Ehrlich)
| | - Victoria-Luise Batury
- From the Division of Psychological and Social Medicine and Developmental Neurosciences, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Boehm, Walton, Batury, Seidel, Geisler, King, Ehrlich); the Department of Psychology, University of Bath, Bath, UK (Walton); the Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany (Alexander); the Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Weidner); the Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Roessner); and the Eating Disorders Research and Treatment Center at the Department of Child and Adolescent Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Ehrlich)
| | - Maria Seidel
- From the Division of Psychological and Social Medicine and Developmental Neurosciences, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Boehm, Walton, Batury, Seidel, Geisler, King, Ehrlich); the Department of Psychology, University of Bath, Bath, UK (Walton); the Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany (Alexander); the Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Weidner); the Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Roessner); and the Eating Disorders Research and Treatment Center at the Department of Child and Adolescent Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Ehrlich)
| | - Daniel Geisler
- From the Division of Psychological and Social Medicine and Developmental Neurosciences, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Boehm, Walton, Batury, Seidel, Geisler, King, Ehrlich); the Department of Psychology, University of Bath, Bath, UK (Walton); the Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany (Alexander); the Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Weidner); the Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Roessner); and the Eating Disorders Research and Treatment Center at the Department of Child and Adolescent Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Ehrlich)
| | - Joseph A. King
- From the Division of Psychological and Social Medicine and Developmental Neurosciences, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Boehm, Walton, Batury, Seidel, Geisler, King, Ehrlich); the Department of Psychology, University of Bath, Bath, UK (Walton); the Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany (Alexander); the Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Weidner); the Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Roessner); and the Eating Disorders Research and Treatment Center at the Department of Child and Adolescent Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Ehrlich)
| | - Kerstin Weidner
- From the Division of Psychological and Social Medicine and Developmental Neurosciences, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Boehm, Walton, Batury, Seidel, Geisler, King, Ehrlich); the Department of Psychology, University of Bath, Bath, UK (Walton); the Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany (Alexander); the Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Weidner); the Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Roessner); and the Eating Disorders Research and Treatment Center at the Department of Child and Adolescent Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Ehrlich)
| | - Veit Roessner
- From the Division of Psychological and Social Medicine and Developmental Neurosciences, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Boehm, Walton, Batury, Seidel, Geisler, King, Ehrlich); the Department of Psychology, University of Bath, Bath, UK (Walton); the Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany (Alexander); the Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Weidner); the Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Roessner); and the Eating Disorders Research and Treatment Center at the Department of Child and Adolescent Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Ehrlich)
| | - Stefan Ehrlich
- From the Division of Psychological and Social Medicine and Developmental Neurosciences, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Boehm, Walton, Batury, Seidel, Geisler, King, Ehrlich); the Department of Psychology, University of Bath, Bath, UK (Walton); the Department of Psychology, Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany (Alexander); the Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Weidner); the Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Roessner); and the Eating Disorders Research and Treatment Center at the Department of Child and Adolescent Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (Ehrlich)
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Fürtjes S, Seidel M, King JA, Boehm I, Jaite C, Roessner V, Ehrlich S. A naturalistic investigation of cognitive-affective dysfunction in anorexia nervosa: The role of inefficiency. Int J Eat Disord 2020; 53:239-247. [PMID: 31633224 DOI: 10.1002/eat.23189] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 09/21/2019] [Accepted: 09/22/2019] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Research has shown that rumination and negative affect are elevated in patients with anorexia nervosa (AN), but the underlying origins remain unclear. Drawing from the theoretical framework of the Goal Progress Theory of rumination, we propose that heightened feelings of "inefficiency" (i.e., low self-efficacy) in AN might play an important role in these dysfunctional cognitive-affective processes. METHOD Thirty-two weight-recovered participants with a history of AN and 32 healthy control participants filled out questionnaires regarding rumination and affect six times a day over a period of 2 weeks via ecological momentary assessment in real-life. RESULTS Analyses via hierarchical as well as conceptual process modeling suggest that while inefficiency is generally associated with more rumination and negative affect, additional amplifying mechanisms between these variables exist specifically in recovered participants with a history of AN. DISCUSSION Inefficiency as a core aspect of AN appears to trigger dysfunctional cognitive-affective processes which may contribute to vulnerability for AN.
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Affiliation(s)
- Sophia Fürtjes
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Maria Seidel
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Joseph A King
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Ilka Boehm
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Charlotte Jaite
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité--Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Veit Roessner
- Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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Geisler D, Borchardt V, Boehm I, King JA, Tam FI, Marxen M, Biemann R, Roessner V, Walter M, Ehrlich S. Altered global brain network topology as a trait marker in patients with anorexia nervosa. Psychol Med 2020; 50:107-115. [PMID: 30621808 DOI: 10.1017/s0033291718004002] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Resting state functional magnetic resonance imaging studies have identified functional connectivity patterns associated with acute undernutrition in anorexia nervosa (AN), but few have investigated recovered patients. Thus, a trait connectivity profile characteristic of the disorder remains elusive. Using state-of-the-art graph-theoretic methods in acute AN, the authors previously found abnormal global brain network architecture, possibly driven by local network alterations. To disentangle trait from starvation effects, the present study examines network organization in recovered patients. METHODS Graph-theoretic metrics were used to assess resting-state network properties in a large sample of female patients recovered from AN (recAN, n = 55) compared with pairwise age-matched healthy controls (HC, n = 55). RESULTS Indicative of an altered global network structure, recAN showed increased assortativity and reduced global clustering as well as small-worldness compared with HC, while no group differences at an intermediate or local network level were evident. However, using support-vector classifier on local metrics, recAN and HC could be separated with an accuracy of 70.4%. CONCLUSIONS This pattern of results suggests that long-term recovered patients have an aberrant global brain network configuration, similar to acutely underweight patients. While the finding of increased assortativity may represent a trait marker of AN, the remaining findings could be seen as a scar following prolonged undernutrition.
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Affiliation(s)
- Daniel Geisler
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Viola Borchardt
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
- Department of Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Ilka Boehm
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Joseph A King
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Friederike I Tam
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Department of Child and Adolescent Psychiatry, Eating Disorder Treatment and Research Center, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Michael Marxen
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Ronald Biemann
- Institute of Clinical Chemistry and Pathobiochemistry, Otto-von-Guericke University, Magdeburg, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Eating Disorder Treatment and Research Center, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Martin Walter
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
- Department of Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany
- Clinic for Psychiatry and Psychotherapy, Eberhard-Karls University, Tuebingen, Germany
- Center for Behavioral Brain Sciences (CBBS), Magdeburg, Germany
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Department of Child and Adolescent Psychiatry, Eating Disorder Treatment and Research Center, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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14
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Boehm I, Walton E, Alexander N, Batury VL, Seidel M, Geisler D, King JA, Weidner K, Roessner V, Ehrlich S. Peripheral serotonin transporter DNA methylation is linked to increased salience network connectivity in females with anorexia nervosa. J Psychiatry Neurosci 2019; 45:8. [PMID: 31804778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2024] Open
Abstract
Background Epigenetic variation in the serotonin transporter gene (SLC6A4) has been shown to modulate the functioning of brain circuitry associated with the salience network and may heighten the risk for mental illness. This study is, to our knowledge, the first to test this epigenome–brain–behaviour pathway in patients with anorexia nervosa. Methods We obtained resting-state functional connectivity (rsFC) data and blood samples from 55 acutely underweight female patients with anorexia nervosa and 55 age-matched female healthy controls. We decomposed imaging data using independent component analysis. We used bisulfite pyrosequencing to analyze blood DNA methylation within the promoter region of SLC6A4. We then explored salience network rsFC patterns in the group × methylation interaction. Results We identified a positive relationship between SLC6A4 methylation levels and rsFC between the dorsolateral prefrontal cortex and the salience network in patients with anorexia nervosa compared to healthy controls. Increased rsFC in the salience network mediated the link between SLC6A4 methylation and eating disorder symptoms in patients with anorexia nervosa. We confirmed findings of rsFC alterations for CpG-specific methylation at a locus with evidence of methylation correspondence between brain and blood tissue. Limitations This study was cross-sectional in nature, the sample size was modest for the method and methylation levels were measured peripherally, so findings cannot be fully generalized to brain tissue. Conclusion This study sheds light on the neurobiological process of how epigenetic variation in the SLC6A4 gene may relate to rsFC in the salience network that is linked to psychopathology in anorexia nervosa.
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15
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Seidel M, Borchardt V, Geisler D, King JA, Boehm I, Pauligk S, Bernardoni F, Biemann R, Roessner V, Walter M, Ehrlich S. Abnormal Spontaneous Regional Brain Activity in Young Patients With Anorexia Nervosa. J Am Acad Child Adolesc Psychiatry 2019; 58:1104-1114. [PMID: 30768380 DOI: 10.1016/j.jaac.2019.01.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 01/18/2019] [Accepted: 02/11/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Functional magnetic resonance imaging (fMRI) studies have repeatedly shown alterations in patients with anorexia nervosa (AN). These alterations might be driven by baseline signal characteristics such as the (fractional) amplitude of low frequency fluctuations (fALFF/ALFF), as well as regional signal consistency (ie, regional homogeneity [ReHo]) within circumscribed brain regions. Previous studies have also demonstrated gray matter (pseudo-) atrophy in underweight individuals with AN. Here we study fALFF/ALFF and ReHo in predominantly adolescent patients with AN, while taking gray matter changes into consideration. METHOD Resting state fMRI data were acquired from a sample of 148 female volunteers: 74 underweight patients with AN and 74 age-matched female healthy controls (HC). RESULTS Group differences for fALFF and ReHo measures were found in several AN-relevant brain regions, including networks related to cognitive control, habit formation, and the ventral visual stream. Furthermore, the magnitude of correlation between gray matter volume/thickness and fALFF and ReHo were reduced in AN compared to HC. CONCLUSION Abnormal local resting state characteristics in AN-related brain-networks as well as reduced structure-function relationships may help to explain previously reported task-related and classical resting state neural alterations in underweight AN. Patients with AN may serve as a valuable population for investigating dynamic changes in the relationships between brain structure and function.
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Affiliation(s)
- Maria Seidel
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Viola Borchardt
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany, and the Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Daniel Geisler
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Joseph A King
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Ilka Boehm
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Sophie Pauligk
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Fabio Bernardoni
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Ronald Biemann
- Institute of Clinical Chemistry and Pathobiochemistry, Otto-von-Guericke University, Magdeburg, Germany
| | - Veit Roessner
- Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Martin Walter
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany, and the Leibniz Institute for Neurobiology, Magdeburg, Germany; Clinic for Psychiatry and Psychotherapy, Eberhard-Karls University, Tuebingen, Germany
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
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16
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Steding J, Boehm I, King JA, Geisler D, Ritschel F, Seidel M, Doose A, Jaite C, Roessner V, Smolka MN, Ehrlich S. Goal-directed vs. habitual instrumental behavior during reward processing in anorexia nervosa: an fMRI study. Sci Rep 2019; 9:13529. [PMID: 31537862 PMCID: PMC6753148 DOI: 10.1038/s41598-019-49884-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 08/30/2019] [Indexed: 12/18/2022] Open
Abstract
Previous studies have proposed that altered reward processing and elevated cognitive control underlie the etiology of anorexia nervosa (AN). A newly debated notion suggests altered habit learning and an overreliance on habits may contribute to the persistence of AN. In weight-recovered AN patients, we previously found neuroimaging-based evidence for unaltered reward processing, but elevated cognitive control. In order to differentiate between state versus trait factors, we here contrast the aforementioned hypotheses in a sample of acutely underweight AN (acAN) patients. 37 acAN patients and 37 closely matched healthy controls (HC) underwent a functional MRI while performing an established instrumental motivation task. We found no group differences with respect to neural responses during the anticipation or receipt of reward. However, the behavioral response data showed a bimodal distribution, indicative for a goal-directed (gAN) and a habit-driven (hAN) patient subgroup. Additional analyses revealed decreased mOFC activation during reward anticipation in hAN, which would be in line with a habit-driven response. These findings provide a new perspective on the debate regarding the notion of increased goal-directed versus habitual behavior in AN. If replicable, the observed dissociation between gAN and hAN might help to tailor therapeutic approaches to individual patient characteristics.
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Affiliation(s)
- Julius Steding
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Ilka Boehm
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Joseph A King
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Daniel Geisler
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Franziska Ritschel
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Maria Seidel
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Arne Doose
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Charlotte Jaite
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Michael N Smolka
- Department of Psychiatry and Neuroimaging Center, TU Dresden, Dresden, Germany
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany. .,Translational Developmental Neuroscience Section, Department of Child and Adolescent Psychiatry, Eating Disorders Research and Treatment Center, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany.
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Boehm I, Miller J, Wishart T, Wigmore S, Jones R, Skipworth R, Gillingwater T. SUN-LB665: Stability of the Neuromuscular Junction in Cancer Cachexia. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32631-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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18
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Watson HJ, Yilmaz Z, Thornton LM, Hübel C, Coleman JRI, Gaspar HA, Bryois J, Hinney A, Leppä VM, Mattheisen M, Medland SE, Ripke S, Yao S, Giusti-Rodríguez P, Hanscombe KB, Purves KL, Adan RAH, Alfredsson L, Ando T, Andreassen OA, Baker JH, Berrettini WH, Boehm I, Boni C, Perica VB, Buehren K, Burghardt R, Cassina M, Cichon S, Clementi M, Cone RD, Courtet P, Crow S, Crowley JJ, Danner UN, Davis OSP, de Zwaan M, Dedoussis G, Degortes D, DeSocio JE, Dick DM, Dikeos D, Dina C, Dmitrzak-Weglarz M, Docampo E, Duncan LE, Egberts K, Ehrlich S, Escaramís G, Esko T, Estivill X, Farmer A, Favaro A, Fernández-Aranda F, Fichter MM, Fischer K, Föcker M, Foretova L, Forstner AJ, Forzan M, Franklin CS, Gallinger S, Giegling I, Giuranna J, Gonidakis F, Gorwood P, Mayora MG, Guillaume S, Guo Y, Hakonarson H, Hatzikotoulas K, Hauser J, Hebebrand J, Helder SG, Herms S, Herpertz-Dahlmann B, Herzog W, Huckins LM, Hudson JI, Imgart H, Inoko H, Janout V, Jiménez-Murcia S, Julià A, Kalsi G, Kaminská D, Kaprio J, Karhunen L, Karwautz A, Kas MJH, Kennedy JL, Keski-Rahkonen A, Kiezebrink K, Kim YR, Klareskog L, Klump KL, Knudsen GPS, La Via MC, Le Hellard S, Levitan RD, Li D, Lilenfeld L, Lin BD, Lissowska J, Luykx J, Magistretti PJ, Maj M, Mannik K, Marsal S, Marshall CR, Mattingsdal M, McDevitt S, McGuffin P, Metspalu A, Meulenbelt I, Micali N, Mitchell K, Monteleone AM, Monteleone P, Munn-Chernoff MA, Nacmias B, Navratilova M, Ntalla I, O'Toole JK, Ophoff RA, Padyukov L, Palotie A, Pantel J, Papezova H, Pinto D, Rabionet R, Raevuori A, Ramoz N, Reichborn-Kjennerud T, Ricca V, Ripatti S, Ritschel F, Roberts M, Rotondo A, Rujescu D, Rybakowski F, Santonastaso P, Scherag A, Scherer SW, Schmidt U, Schork NJ, Schosser A, Seitz J, Slachtova L, Slagboom PE, Slof-Op 't Landt MCT, Slopien A, Sorbi S, Świątkowska B, Szatkiewicz JP, Tachmazidou I, Tenconi E, Tortorella A, Tozzi F, Treasure J, Tsitsika A, Tyszkiewicz-Nwafor M, Tziouvas K, van Elburg AA, van Furth EF, Wagner G, Walton E, Widen E, Zeggini E, Zerwas S, Zipfel S, Bergen AW, Boden JM, Brandt H, Crawford S, Halmi KA, Horwood LJ, Johnson C, Kaplan AS, Kaye WH, Mitchell JE, Olsen CM, Pearson JF, Pedersen NL, Strober M, Werge T, Whiteman DC, Woodside DB, Stuber GD, Gordon S, Grove J, Henders AK, Juréus A, Kirk KM, Larsen JT, Parker R, Petersen L, Jordan J, Kennedy M, Montgomery GW, Wade TD, Birgegård A, Lichtenstein P, Norring C, Landén M, Martin NG, Mortensen PB, Sullivan PF, Breen G, Bulik CM. Genome-wide association study identifies eight risk loci and implicates metabo-psychiatric origins for anorexia nervosa. Nat Genet 2019; 51:1207-1214. [PMID: 31308545 PMCID: PMC6779477 DOI: 10.1038/s41588-019-0439-2] [Citation(s) in RCA: 486] [Impact Index Per Article: 97.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 05/14/2019] [Indexed: 12/14/2022]
Abstract
Characterized primarily by a low body-mass index, anorexia nervosa is a complex and serious illness1, affecting 0.9-4% of women and 0.3% of men2-4, with twin-based heritability estimates of 50-60%5. Mortality rates are higher than those in other psychiatric disorders6, and outcomes are unacceptably poor7. Here we combine data from the Anorexia Nervosa Genetics Initiative (ANGI)8,9 and the Eating Disorders Working Group of the Psychiatric Genomics Consortium (PGC-ED) and conduct a genome-wide association study of 16,992 cases of anorexia nervosa and 55,525 controls, identifying eight significant loci. The genetic architecture of anorexia nervosa mirrors its clinical presentation, showing significant genetic correlations with psychiatric disorders, physical activity, and metabolic (including glycemic), lipid and anthropometric traits, independent of the effects of common variants associated with body-mass index. These results further encourage a reconceptualization of anorexia nervosa as a metabo-psychiatric disorder. Elucidating the metabolic component is a critical direction for future research, and paying attention to both psychiatric and metabolic components may be key to improving outcomes.
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Affiliation(s)
- Hunna J Watson
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- School of Psychology, Curtin University, Perth, Western Australia, Australia
- School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia
| | - Zeynep Yilmaz
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Laura M Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Christopher Hübel
- Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry (SGDP) Centre, King's College London, London, UK
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jonathan R I Coleman
- Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry (SGDP) Centre, King's College London, London, UK
- National Institute for Health Research Biomedical Research Centre, King's College London and South London and Maudsley National Health Service Foundation Trust, London, UK
| | - Héléna A Gaspar
- Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry (SGDP) Centre, King's College London, London, UK
- National Institute for Health Research Biomedical Research Centre, King's College London and South London and Maudsley National Health Service Foundation Trust, London, UK
| | - Julien Bryois
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anke Hinney
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Virpi M Leppä
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Manuel Mattheisen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Center for Psychiatry Research, Stockholm Health Care Services, Stockholm City Council, Stockholm, Sweden
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Sarah E Medland
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Stephan Ripke
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
| | - Shuyang Yao
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paola Giusti-Rodríguez
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ken B Hanscombe
- Department of Medical and Molecular Genetics, King's College London, Guy's Hospital, London, UK
| | - Kirstin L Purves
- Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry (SGDP) Centre, King's College London, London, UK
| | - Roger A H Adan
- Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht, the Netherlands
- Center for Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, the Netherlands
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Lars Alfredsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Tetsuya Ando
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Ole A Andreassen
- NORMENT KG Jebsen Centre, Division of Mental Health and Addiction, University of Oslo, Oslo University Hospital, Oslo, Norway
| | - Jessica H Baker
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Wade H Berrettini
- Department of Psychiatry, Center for Neurobiology and Behavior, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Ilka Boehm
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Claudette Boni
- INSERM 1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
| | - Vesna Boraska Perica
- Wellcome Sanger Institute, Hinxton, UK
- Department of Medical Biology, School of Medicine, University of Split, Split, Croatia
| | - Katharina Buehren
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany
| | - Roland Burghardt
- Department of Child and Adolescent Psychiatry, Klinikum Frankfurt/Oder, Frankfurt, Germany
| | - Matteo Cassina
- Clinical Genetics Unit, Department of Woman and Child Health, University of Padova, Padova, Italy
| | - Sven Cichon
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Maurizio Clementi
- Clinical Genetics Unit, Department of Woman and Child Health, University of Padova, Padova, Italy
| | - Roger D Cone
- Life Sciences Institute and Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA
| | - Philippe Courtet
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, University of Montpellier, Montpellier, France
| | - Scott Crow
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - James J Crowley
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Unna N Danner
- Center for Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, the Netherlands
| | - Oliver S P Davis
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - George Dedoussis
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Daniela Degortes
- Department of Neurosciences, University of Padova, Padova, Italy
| | | | - Danielle M Dick
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Dimitris Dikeos
- Department of Psychiatry, Athens University Medical School, Athens University, Athens, Greece
| | - Christian Dina
- L'institut du thorax, INSERM, CNRS, UNIV Nantes, CHU Nantes, Nantes, France
| | | | - Elisa Docampo
- Barcelona Institute of Science and Technology, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Laramie E Duncan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Karin Egberts
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Würzburg, Centre for Mental Health, Würzburg, Germany
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Geòrgia Escaramís
- Barcelona Institute of Science and Technology, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Tõnu Esko
- Estonian Genome Center, University of Tartu, Tartu, Estonia
- Program in Medical and Population Genetics, Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA
| | - Xavier Estivill
- Barcelona Institute of Science and Technology, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Genomics and Disease, Bioinformatics and Genomics Programme, Centre for Genomic Regulation, Barcelona, Spain
| | - Anne Farmer
- Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry (SGDP) Centre, King's College London, London, UK
| | - Angela Favaro
- Department of Neurosciences, University of Padova, Padova, Italy
| | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge -IDIBELL and CIBERobn, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Manfred M Fichter
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University (LMU), Munich, Germany
- Schön Klinik Roseneck affiliated with the Medical Faculty of the University of Munich (LMU), Munich, Germany
| | - Krista Fischer
- Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - Manuel Föcker
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Lenka Foretova
- Department of Cancer, Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Andreas J Forstner
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Department of Genomics, Life and Brain Center, University of Bonn, Bonn, Germany
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Monica Forzan
- Clinical Genetics Unit, Department of Woman and Child Health, University of Padova, Padova, Italy
| | | | - Steven Gallinger
- Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ina Giegling
- Department of Psychiatry, Psychotherapy and Psychosomatics, Martin Luther University of Halle-Wittenberg, Halle, Germany
| | - Johanna Giuranna
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Fragiskos Gonidakis
- First Psychiatric Department, National and Kapodistrian University of Athens, Medical School, Eginition Hospital, Athens, Greece
| | - Philip Gorwood
- INSERM 1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
- CMME, Hôpital Sainte-Anne (GHU Paris Psychiatrie et Neurosciences), Paris Descartes University, Paris, France
| | - Monica Gratacos Mayora
- Barcelona Institute of Science and Technology, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Sébastien Guillaume
- Department of Emergency Psychiatry and Post-Acute Care, CHRU Montpellier, University of Montpellier, Montpellier, France
| | - Yiran Guo
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Hakon Hakonarson
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Konstantinos Hatzikotoulas
- Wellcome Sanger Institute, Hinxton, UK
- Institute of Translational Genomics, Helmholtz Zentrum München, Neuherberg, Germany
| | - Joanna Hauser
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Sietske G Helder
- Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry (SGDP) Centre, King's College London, London, UK
- Zorg op Orde, Leidschendam, the Netherlands
| | - Stefan Herms
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Department of Genomics, Life and Brain Center, University of Bonn, Bonn, Germany
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Beate Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany
| | - Wolfgang Herzog
- Department of General Internal Medicine and Psychosomatics, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Laura M Huckins
- Wellcome Sanger Institute, Hinxton, UK
- Department of Psychiatry, and Genetics and Genomics Sciences, Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - James I Hudson
- Biological Psychiatry Laboratory, McLean Hospital/Harvard Medical School, Boston, MA, USA
| | - Hartmut Imgart
- Eating Disorders Unit, Parklandklinik, Bad Wildungen, Germany
| | - Hidetoshi Inoko
- Department of Molecular Life Science, Division of Basic Medical Science and Molecular Medicine, School of Medicine, Tokai University, Isehara, Japan
| | - Vladimir Janout
- Faculty of Health Sciences, Palacky University, Olomouc, Czech Republic
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge -IDIBELL and CIBERobn, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Antonio Julià
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Gursharan Kalsi
- Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry (SGDP) Centre, King's College London, London, UK
| | - Deborah Kaminská
- Department of Psychiatry, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jaakko Kaprio
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Leila Karhunen
- Institute of Public Health and Clinical Nutrition, Department of Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Andreas Karwautz
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Martien J H Kas
- Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht, the Netherlands
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, the Netherlands
| | - James L Kennedy
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | | | - Kirsty Kiezebrink
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Youl-Ri Kim
- Department of Psychiatry, Seoul Paik Hospital, Inje University, Seoul, Korea
| | - Lars Klareskog
- Rheumatology Unit, Department of Medicine, Center for Molecular Medicine, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Kelly L Klump
- Department of Psychology, Michigan State University, East Lansing, MI, USA
| | - Gun Peggy S Knudsen
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Maria C La Via
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Stephanie Le Hellard
- Department of Clinical Science, K.G. Jebsen Centre for Psychosis Research, Norwegian Centre for Mental Disorders Research (NORMENT), University of Bergen, Bergen, Norway
- Dr. Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, Laboratory Building, Haukeland University Hospital, Bergen, Norway
| | - Robert D Levitan
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Dong Li
- Center for Applied Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Lisa Lilenfeld
- American School of Professional Psychology, Argosy University, Northern Virginia, Arlington, VA, USA
| | - Bochao Danae Lin
- Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jolanta Lissowska
- Department of Cancer Epidemiology and Prevention, M Skłodowska-Curie Cancer Center - Oncology Center, Warsaw, Poland
| | - Jurjen Luykx
- Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Pierre J Magistretti
- BESE Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
- Department of Psychiatry, University of Lausanne-University Hospital of Lausanne (UNIL-CHUV), Lausanne, Switzerland
| | - Mario Maj
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Katrin Mannik
- Estonian Genome Center, University of Tartu, Tartu, Estonia
- Center for Integrative Genomics, University of Lausanne, Lausanne, Switzerland
| | - Sara Marsal
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Christian R Marshall
- Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Morten Mattingsdal
- NORMENT KG Jebsen Centre, Division of Mental Health and Addiction, University of Oslo, Oslo University Hospital, Oslo, Norway
| | - Sara McDevitt
- Department of Psychiatry, University College Cork, Cork, Ireland
- HSE National Clinical Programme for Eating Disorders, Cork, Ireland
| | - Peter McGuffin
- Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry (SGDP) Centre, King's College London, London, UK
| | - Andres Metspalu
- Estonian Genome Center, University of Tartu, Tartu, Estonia
- Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
| | - Ingrid Meulenbelt
- Department of Biomedical Data Science, Leiden University Medical Centre, Leiden, the Netherlands
| | - Nadia Micali
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Child and Adolescent Psychiatry, Geneva University Hospital, Geneva, Switzerland
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Karen Mitchell
- National Center for PTSD, VA Boston Healthcare System, Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | | | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | | | - Benedetta Nacmias
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Marie Navratilova
- Department of Cancer, Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Ioanna Ntalla
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | - Roel A Ophoff
- Brain Center Rudolf Magnus, Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht, the Netherlands
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Leonid Padyukov
- Rheumatology Unit, Department of Medicine, Center for Molecular Medicine, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Aarno Palotie
- Program in Medical and Population Genetics, Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
- Center for Human Genome Research at the Massachusetts General Hospital, Boston, MA, USA
| | - Jacques Pantel
- INSERM 1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
| | - Hana Papezova
- Department of Psychiatry, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Dalila Pinto
- Department of Psychiatry, and Genetics and Genomics Sciences, Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Raquel Rabionet
- Saint Joan de Déu Research Institute, Saint Joan de Déu Barcelona Children's Hospital, Barcelona, Spain
- Institute of Biomedicine (IBUB), University of Barcelona, Barcelona, Spain
- Department of Genetics, Microbiology and Statistics, University of Barcelona, Barcelona, Spain
| | - Anu Raevuori
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Nicolas Ramoz
- INSERM 1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
| | - Ted Reichborn-Kjennerud
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Valdo Ricca
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
- Department of Health Science, University of Florence, Florence, Italy
| | - Samuli Ripatti
- Program in Medical and Population Genetics, Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Institute for Molecular Medicine Finland (FIMM), HiLIFE Unit, University of Helsinki, Helsinki, Finland
| | - Franziska Ritschel
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Eating Disorders Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Marion Roberts
- Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry (SGDP) Centre, King's College London, London, UK
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
- Faculty of Medicine & Health Sciences, University of Aukland, Aukland, New Zealand
| | - Alessandro Rotondo
- Department of Psychiatry, Neurobiology, Pharmacology, and Biotechnologies, University of Pisa, Pisa, Italy
| | - Dan Rujescu
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University (LMU), Munich, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Martin Luther University of Halle-Wittenberg, Halle, Germany
| | - Filip Rybakowski
- Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Paolo Santonastaso
- Department of Neurosciences, Padua Neuroscience Center, University of Padova, Padova, Italy
| | - André Scherag
- Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital, Jena, Germany
| | - Stephen W Scherer
- Department of Genetics and Genomic Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ulrike Schmidt
- National Institute for Health Research Biomedical Research Centre, King's College London and South London and Maudsley National Health Service Foundation Trust, London, UK
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, King's College London, London, UK
| | | | - Alexandra Schosser
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Jochen Seitz
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany
| | - Lenka Slachtova
- Department of Pediatrics and Center of Applied Genomics, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - P Eline Slagboom
- Department of Biomedical Data Science, Leiden University Medical Centre, Leiden, the Netherlands
| | - Margarita C T Slof-Op 't Landt
- Center for Eating Disorders Ursula, Rivierduinen, Leiden, the Netherlands
- Department of Psychiatry, Leiden University Medical Centre, Leiden, the Netherlands
| | - Agnieszka Slopien
- Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
- IRCSS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Beata Świątkowska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Jin P Szatkiewicz
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Elena Tenconi
- Department of Neurosciences, University of Padova, Padova, Italy
| | - Alfonso Tortorella
- Department of Psychiatry, University of Naples SUN, Naples, Italy
- Department of Psychiatry, University of Perugia, Perugia, Italy
| | - Federica Tozzi
- Brain Sciences Department, Stremble Ventures, Limassol, Cyprus
| | - Janet Treasure
- National Institute for Health Research Biomedical Research Centre, King's College London and South London and Maudsley National Health Service Foundation Trust, London, UK
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, King's College London, London, UK
| | - Artemis Tsitsika
- Adolescent Health Unit, Second Department of Pediatrics, "P. & A. Kyriakou" Children's Hospital, University of Athens, Athens, Greece
| | - Marta Tyszkiewicz-Nwafor
- Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Konstantinos Tziouvas
- Pediatric Intensive Care Unit, "P. & A. Kyriakou" Children's Hospital, University of Athens, Athens, Greece
| | - Annemarie A van Elburg
- Center for Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, the Netherlands
- Faculty of Social and Behavioral Sciences, Utrecht University, Utrecht, the Netherlands
| | - Eric F van Furth
- Center for Eating Disorders Ursula, Rivierduinen, Leiden, the Netherlands
- Department of Psychiatry, Leiden University Medical Centre, Leiden, the Netherlands
| | - Gudrun Wagner
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Esther Walton
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Elisabeth Widen
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Eleftheria Zeggini
- Wellcome Sanger Institute, Hinxton, UK
- Institute of Translational Genomics, Helmholtz Zentrum München, Neuherberg, Germany
| | - Stephanie Zerwas
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Stephan Zipfel
- Department of Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tuebingen, Tuebingen, Germany
| | - Andrew W Bergen
- BioRealm, LLC, Walnut, CA, USA
- Oregon Research Institute, Eugene, OR, USA
| | - Joseph M Boden
- Christchurch Health and Development Study, University of Otago, Christchurch, New Zealand
| | - Harry Brandt
- The Center for Eating Disorders at Sheppard Pratt, Baltimore, MD, USA
| | - Steven Crawford
- The Center for Eating Disorders at Sheppard Pratt, Baltimore, MD, USA
| | - Katherine A Halmi
- Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA
| | - L John Horwood
- Christchurch Health and Development Study, University of Otago, Christchurch, New Zealand
| | | | - Allan S Kaplan
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Walter H Kaye
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - James E Mitchell
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Catherine M Olsen
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - John F Pearson
- Biostatistics and Computational Biology Unit, University of Otago, Christchurch, New Zealand
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Michael Strober
- Department of Psychiatry and Biobehavioral Science, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Thomas Werge
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - David C Whiteman
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - D Blake Woodside
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Mental Health, University Health Network, Toronto, Ontario, Canada
- Program for Eating Disorders, University Health Network, Toronto, Ontario, Canada
| | - Garret D Stuber
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Scott Gordon
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Jakob Grove
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
- Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
| | - Anjali K Henders
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Anders Juréus
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Katherine M Kirk
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Janne T Larsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- National Centre for Register-Based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark
| | - Richard Parker
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Liselotte Petersen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- National Centre for Register-Based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark
| | - Jennifer Jordan
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
- Canterbury District Health Board, Christchurch, New Zealand
| | - Martin Kennedy
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - Grant W Montgomery
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Tracey D Wade
- School of Psychology, Flinders University, Adelaide, South Australia, Australia
| | - Andreas Birgegård
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Center for Psychiatry Research, Stockholm Health Care Services, Stockholm City Council, Stockholm, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Claes Norring
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Center for Psychiatry Research, Stockholm Health Care Services, Stockholm City Council, Stockholm, Sweden
| | - Mikael Landén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Nicholas G Martin
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Preben Bo Mortensen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- National Centre for Register-Based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark
| | - Patrick F Sullivan
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Gerome Breen
- Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry (SGDP) Centre, King's College London, London, UK
- National Institute for Health Research Biomedical Research Centre, King's College London and South London and Maudsley National Health Service Foundation Trust, London, UK
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Ehrlich S, King JA, Boehm I. Editorial: To Eat or Not to Eat: Advancing the Neuroscience of Hedonic Versus Controlled Eating Across Weight and Eating Disorders. J Am Acad Child Adolesc Psychiatry 2019; 58:151-153. [PMID: 30738539 DOI: 10.1016/j.jaac.2018.07.902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 08/16/2018] [Indexed: 10/27/2022]
Abstract
Excessive weight and obesity, especially with childhood onset, is associated with long-term morbidity and mortality and places a major burden on the health care system. In the United States, 17% of children and adolescents are obese (32% overweight). By adulthood, the number rises to 34% or even 68% when also considering overweight individuals.1 Conventional nonsurgical treatments are often ineffective, and weight loss achieved with behaviorally oriented therapy programs is usually small (∼5%) and short-lived.2 A better understanding of the associated psychological mechanisms and their neurobiological underpinnings may allow for the development of more efficient, potentially brain-based, therapeutic interventions. A growing number of human functional magnetic resonance imaging (fMRI) studies point to alterations in reward-related corticostriatal circuity and the hypothalamus, a key area in energy homeostasis.3 Recent studies have analyzed resting state functional connectivity (rsFC), a technique sensitive to changes in the interaction between distant brain regions, which is particularly advantageous in clinical samples, as it requires little compliance and as scanning time is relatively short.
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Affiliation(s)
- Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany.
| | - Joseph A King
- Division of Psychological and Social Medicine and Developmental Neurosciences, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany
| | - Ilka Boehm
- Division of Psychological and Social Medicine and Developmental Neurosciences, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany
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20
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Boehm I, King JA, Bernardoni F, Geisler D, Seidel M, Ritschel F, Goschke T, Haynes JD, Roessner V, Ehrlich S. Subliminal and supraliminal processing of reward-related stimuli in anorexia nervosa. Psychol Med 2018; 48:790-800. [PMID: 28832300 DOI: 10.1017/s0033291717002161] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Previous studies have highlighted the role of the brain reward and cognitive control systems in the etiology of anorexia nervosa (AN). In an attempt to disentangle the relative contribution of these systems to the disorder, we used functional magnetic resonance imaging (fMRI) to investigate hemodynamic responses to reward-related stimuli presented both subliminally and supraliminally in acutely underweight AN patients and age-matched healthy controls (HC). METHODS fMRI data were collected from a total of 35 AN patients and 35 HC, while they passively viewed subliminally and supraliminally presented streams of food, positive social, and neutral stimuli. Activation patterns of the group × stimulation condition × stimulus type interaction were interrogated to investigate potential group differences in processing different stimulus types under the two stimulation conditions. Moreover, changes in functional connectivity were investigated using generalized psychophysiological interaction analysis. RESULTS AN patients showed a generally increased response to supraliminally presented stimuli in the inferior frontal junction (IFJ), but no alterations within the reward system. Increased activation during supraliminal stimulation with food stimuli was observed in the AN group in visual regions including superior occipital gyrus and the fusiform gyrus/parahippocampal gyrus. No group difference was found with respect to the subliminal stimulation condition and functional connectivity. CONCLUSION Increased IFJ activation in AN during supraliminal stimulation may indicate hyperactive cognitive control, which resonates with clinical presentation of excessive self-control in AN patients. Increased activation to food stimuli in visual regions may be interpreted in light of an attentional food bias in AN.
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Affiliation(s)
- I Boehm
- Division of Psychological and Social Medicine and Developmental Neurosciences,University Hospital Carl Gustav Carus, Technische Universität Dresden,Dresden,Germany
| | - J A King
- Division of Psychological and Social Medicine and Developmental Neurosciences,University Hospital Carl Gustav Carus, Technische Universität Dresden,Dresden,Germany
| | - F Bernardoni
- Division of Psychological and Social Medicine and Developmental Neurosciences,University Hospital Carl Gustav Carus, Technische Universität Dresden,Dresden,Germany
| | - D Geisler
- Division of Psychological and Social Medicine and Developmental Neurosciences,University Hospital Carl Gustav Carus, Technische Universität Dresden,Dresden,Germany
| | - M Seidel
- Division of Psychological and Social Medicine and Developmental Neurosciences,University Hospital Carl Gustav Carus, Technische Universität Dresden,Dresden,Germany
| | - F Ritschel
- Division of Psychological and Social Medicine and Developmental Neurosciences,University Hospital Carl Gustav Carus, Technische Universität Dresden,Dresden,Germany
| | - T Goschke
- Department of Psychology,Technische Universität Dresden,Dresden,Germany
| | - J-D Haynes
- Bernstein Center for Computational Neuroscience, Charité Universitäts-Medizin,Berlin,Germany
| | - V Roessner
- Department of Child and Adolescent Psychiatry,University Hospital Carl Gustav Carus, Technische Universität Dresden,Dresden,Germany
| | - S Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences,University Hospital Carl Gustav Carus, Technische Universität Dresden,Dresden,Germany
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21
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Seidel M, King JA, Ritschel F, Boehm I, Geisler D, Bernardoni F, Beck M, Pauligk S, Biemann R, Strobel A, Goschke T, Walter H, Roessner V, Ehrlich S. Processing and regulation of negative emotions in anorexia nervosa: An fMRI study. Neuroimage Clin 2017; 18:1-8. [PMID: 29321971 PMCID: PMC5756056 DOI: 10.1016/j.nicl.2017.12.035] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 12/19/2017] [Accepted: 12/22/2017] [Indexed: 01/23/2023]
Abstract
Theoretical models and recent advances in the treatment of anorexia nervosa (AN) have increasingly focused on the role of alterations in the processing and regulation of emotions. To date, however, our understanding of these changes is still limited and reports of emotional dysregulation in AN have been based largely on self-report data, and there is a relative lack of objective experimental evidence or neurobiological data. The current functional magnetic resonance imaging (fMRI) study investigated the hemodynamic correlates of passive viewing and voluntary downregulation of negative emotions by means of the reappraisal strategy detachment in AN patients. Detachment is regarded as adaptive regulation strategy associated with a reduction in emotion-related amygdala activity and increased recruitment of prefrontal brain regions associated with cognitive control processes. Emotion regulation efficacy was assessed via behavioral arousal ratings and fMRI activation elicited by an established experimental paradigm including negative images. Participants were instructed to either simply view emotional pictures or detach themselves from feelings triggered by the stimuli. The sample consisted of 36 predominantly adolescent female AN patients and a pairwise age-matched healthy control group. Behavioral and neuroimaging data analyses indicated a reduction of arousal and amygdala activity during the regulation condition for both patients and controls. However, compared with controls, individuals with AN showed increased activation in the amygdala as well as in the right dorsolateral prefrontal cortex (dlPFC) during the passive viewing of aversive compared with neutral pictures. These results extend previous findings indicative of altered processing of salient emotional stimuli in AN, but do not point to a general deficit in the voluntary regulation of negative emotions. Increased dlPFC activation in AN during passive viewing of negative stimuli is in line with the hypothesis that the disorder may be characterized by excessive self-control. Taken together, the data seem to suggest that reappraisal via detachment may be an effective strategy to reduce negative arousal for individuals with AN.
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Affiliation(s)
- Maria Seidel
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Joseph A King
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Franziska Ritschel
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Ilka Boehm
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Daniel Geisler
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Fabio Bernardoni
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Matthias Beck
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Sophie Pauligk
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Ronald Biemann
- Institute of Clinical Chemistry and Pathobiochemistry, Otto-von-Guericke University, Magdeburg, Germany
| | - Alexander Strobel
- Department of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Thomas Goschke
- Department of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Henrik Walter
- Department of Psychology, Charité Berlin, Berlin, Germany
| | - Veit Roessner
- Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
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22
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Boehm I, Flohr L, Steding J, Holzapfel L, Seitz J, Roessner V, Ehrlich S. The Trajectory of Anhedonic and Depressive Symptoms in Anorexia Nervosa: A Longitudinal and Cross-Sectional Approach. Eur Eat Disorders Rev 2017; 26:69-74. [DOI: 10.1002/erv.2565] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 08/30/2017] [Accepted: 10/11/2017] [Indexed: 11/10/2022]
Affiliation(s)
- Ilka Boehm
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine; Technische Universität Dresden; Dresden Germany
| | - Luisa Flohr
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine; Technische Universität Dresden; Dresden Germany
| | - Julius Steding
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine; Technische Universität Dresden; Dresden Germany
| | - Larissa Holzapfel
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine; Technische Universität Dresden; Dresden Germany
| | - Jochen Seitz
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy; RWTH Aachen University; Aachen Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine; Technische Universität Dresden; Dresden Germany
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine; Technische Universität Dresden; Dresden Germany
- Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine; Technische Universität Dresden; Dresden Germany
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23
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Geisler D, Ritschel F, King JA, Bernardoni F, Seidel M, Boehm I, Runge F, Goschke T, Roessner V, Smolka MN, Ehrlich S. Increased anterior cingulate cortex response precedes behavioural adaptation in anorexia nervosa. Sci Rep 2017; 7:42066. [PMID: 28198813 PMCID: PMC5304157 DOI: 10.1038/srep42066] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 12/07/2016] [Indexed: 01/28/2023] Open
Abstract
Patients with anorexia nervosa (AN) are characterised by increased self-control, cognitive rigidity and impairments in set-shifting, but the underlying neural mechanisms are poorly understood. Here we used functional magnetic resonance imaging (fMRI) to elucidate the neural correlates of behavioural adaptation to changes in reward contingencies in young acutely ill AN patients. Thirty-six adolescent/young adult, non-chronic female AN patients and 36 age-matched healthy females completed a well-established probabilistic reversal learning task during fMRI. We analysed hemodynamic responses in empirically-defined regions of interest during positive feedback and negative feedback not followed/followed by behavioural adaptation and conducted functional connectivity analyses. Although overall task performance was comparable between groups, AN showed increased shifting after receiving negative feedback (lose-shift behaviour) and altered dorsal anterior cingulate cortex (dACC) responses as a function of feedback. Specifically, patients had increased dACC responses (which correlated with perfectionism) and task-related coupling with amygdala preceding behavioural adaption. Given the generally preserved task performance in young AN, elevated dACC responses specifically during behavioural adaption is suggestive of increased monitoring for the need to adjust performance strategies. Higher dACC-amygdala coupling and increased adaptation after negative feedback underlines this interpretation and could be related to intolerance of uncertainty which has been suggested for AN.
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Affiliation(s)
- Daniel Geisler
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Franziska Ritschel
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Joseph A King
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Fabio Bernardoni
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Maria Seidel
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Ilka Boehm
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Franziska Runge
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Thomas Goschke
- Department of Psychology, Institute of General Psychology, Biopsychology and Methods of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Veit Roessner
- Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Michael N Smolka
- Department of Psychiatry and Neuroimaging, Technische Universität Dresden, Dresden, Germany
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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24
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Boehm I, Finke B, Tam FI, Fittig E, Scholz M, Gantchev K, Roessner V, Ehrlich S. Effects of perceptual body image distortion and early weight gain on long-term outcome of adolescent anorexia nervosa. Eur Child Adolesc Psychiatry 2016; 25:1319-1326. [PMID: 27154049 DOI: 10.1007/s00787-016-0854-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 04/18/2016] [Indexed: 11/29/2022]
Abstract
Anorexia nervosa (AN), a severe mental disorder with an onset during adolescence, has been found to be difficult to treat. Identifying variables that predict long-term outcome may help to develop better treatment strategies. Since body image distortion and weight gain are central elements of diagnosis and treatment of AN, the current study investigated perceptual body image distortion, defined as the accuracy of evaluating one's own perceived body size in relation to the actual body size, as well as total and early weight gain during inpatient treatment as predictors for long-term outcome in a sample of 76 female adolescent AN patients. Long-term outcome was defined by physical, psychological and psychosocial adjustment using the Morgan-Russell outcome assessment schedule as well as by the mere physical outcome consisting of menses and/or BMI approximately 3 years after treatment. Perceptual body image distortion and early weight gain predicted long-term outcome (explained variance 13.3 %), but not the physical outcome alone. This study provides first evidence for an association of perceptual body image distortion with long-term outcome of adolescent anorexia nervosa and underlines the importance of sufficient early weight gain.
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Affiliation(s)
- Ilka Boehm
- Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Faculty of Medicine, Technische Universität Dresden, University Hospital C. G. Carus, Dresden, Germany
| | - Beatrice Finke
- Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Faculty of Medicine, Technische Universität Dresden, University Hospital C. G. Carus, Dresden, Germany
| | - Friederike I Tam
- Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Faculty of Medicine, Technische Universität Dresden, University Hospital C. G. Carus, Dresden, Germany
| | - Eike Fittig
- Celenius Klinik Carolabad, Medical Rehabilitation Center for Psychotherapy, Psychiatry and Psychosomatic Medicine, Chemnitz, Germany
| | - Michael Scholz
- Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Faculty of Medicine, Technische Universität Dresden, University Hospital C. G. Carus, Dresden, Germany
| | - Krassimir Gantchev
- Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Faculty of Medicine, Technische Universität Dresden, University Hospital C. G. Carus, Dresden, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Faculty of Medicine, Technische Universität Dresden, University Hospital C. G. Carus, Dresden, Germany
| | - Stefan Ehrlich
- Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Faculty of Medicine, Technische Universität Dresden, University Hospital C. G. Carus, Dresden, Germany.
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25
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Seidel M, Petermann J, Diestel S, Ritschel F, Boehm I, King JA, Geisler D, Bernardoni F, Roessner V, Goschke T, Ehrlich S. A naturalistic examination of negative affect and disorder-related rumination in anorexia nervosa. Eur Child Adolesc Psychiatry 2016; 25:1207-1216. [PMID: 27033353 DOI: 10.1007/s00787-016-0844-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 03/14/2016] [Indexed: 01/18/2023]
Abstract
In anorexia nervosa (AN), volitional inhibition of rewarding behaviors, such as eating, involves a conflict between the desire to suppress appetite and the inherent motive to consume. This conflict is thought to have costs that carry over into daily life, e.g., triggering negative affect and/or recurring ruminations, which may ultimately impact long term outcome. Hence, increasing research effort is being dedicated to understand the link between emotional and ruminative processes in the etiology and maintenance of AN. We investigated whether affective states influence disorder-related rumination in AN applying "ecological momentary assessment", a method which allows the experimenter to gain insight into psychological processes in the natural environment and assess data in real time. Participants (AN = 37, healthy controls = 33) were given a smartphone for 14 days. A ringtone signaled at six random time-points each day to fill in a questionnaire, which gauged disorder-typical thoughts about food and weight as well as affective state. Analyses, applying hierarchical linear models confirmed that AN patients spend more time thinking about food, body shape and weight than controls (p < 0.001). Additionally, the results support the hypothesis that momentary negative affect (but not baseline depression (p = 0.56) or anxiety symptoms (p = 0.60) are positively associated with a higher amount of disorder-related rumination in patients (p < 0.001). Our findings are in line with theories which claim that ruminative thinking induces a vulnerability to negative stimuli which, in turn, fosters heightened negative affect. Thus, therapeutic interventions could be improved by implementing modules that specifically target disorder-related rumination.
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Affiliation(s)
- Maria Seidel
- Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Juliane Petermann
- Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Stefan Diestel
- International School of Management and Technical University of Dortmund, Dortmund, Germany
| | - Franziska Ritschel
- Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Ilka Boehm
- Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Joseph A King
- Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Daniel Geisler
- Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Fabio Bernardoni
- Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Veit Roessner
- Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Thomas Goschke
- Department of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Stefan Ehrlich
- Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
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26
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Boehm I, Geisler D, Tam F, King JA, Ritschel F, Seidel M, Bernardoni F, Murr J, Goschke T, Calhoun VD, Roessner V, Ehrlich S. Partially restored resting-state functional connectivity in women recovered from anorexia nervosa. J Psychiatry Neurosci 2016; 41:377-385. [PMID: 27045551 PMCID: PMC5082508 DOI: 10.1503/jpn.150259] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND We have previously shown increased resting-state functional connectivity (rsFC) in the frontoparietal network (FPN) and the default mode network (DMN) in patients with acute anorexia nervosa. Based on these findings we investigated within-network rsFC in patients recovered from anorexia nervosa to examine whether these abnormalities are a state or trait marker of the disease. To extend the understanding of functional connectivity in patients with anorexia nervosa, we also estimated rsFC between large-scale networks. METHODS Girls and women recovered from anorexia nervosa and pair-wise, age- and sex-matched healthy controls underwent a resting-state fMRI scan. Using independent component analyses (ICA), we isolated the FPN, DMN and salience network. We used standard comparisons as well as a hypothesis-based approach to test the findings of our previous rsFC study in this recovered cohort. Temporal correlations between network time-course pairs were computed to investigate functional network connectivity (FNC). RESULTS Thirty-one patients recovered from anorexia nervosa and 31 controls participated in our study. Standard group comparisons revealed reduced rsFC between the dorsolateral prefrontal cortex (dlPFC) and the FPN in the recovered group. Using a hypothesis-based approach we extended the previous finding of increased rsFC between the angular gyrus and the FPN in patients recovered from anorexia nervosa. No group differences in FNC were revealed. LIMITATIONS The study design did not allow us to conclude that the difference found in rsFC constitutes a scar effect of the disease. CONCLUSION This study suggests that some abnormal rsFC patterns found in patients recovered from anorexia nervosa normalize after long-term weight restoration, while distorted rsFC in the FPN, a network that has been associated with cognitive control, may constitute a trait marker of the disorder.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Stefan Ehrlich
- Correspondence to: S. Ehrlich, Technische Universität Dresden, Faculty of Medicine, University Hospital CG Carus, Dresden, Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Fetscherstraße 74, 01307 Dresden;
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27
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Bernardoni F, King JA, Geisler D, Stein E, Jaite C, Nätsch D, Tam FI, Boehm I, Seidel M, Roessner V, Ehrlich S. Weight restoration therapy rapidly reverses cortical thinning in anorexia nervosa: A longitudinal study. Neuroimage 2016; 130:214-222. [PMID: 26876474 DOI: 10.1016/j.neuroimage.2016.02.003] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 12/23/2015] [Accepted: 02/04/2016] [Indexed: 01/07/2023] Open
Abstract
Structural magnetic resonance imaging studies have documented reduced gray matter in acutely ill patients with anorexia nervosa to be at least partially reversible following weight restoration. However, few longitudinal studies exist and the underlying mechanisms of these structural changes are elusive. In particular, the relative speed and completeness of brain structure normalization during realimentation remain unknown. Here we report from a structural neuroimaging study including a sample of adolescent/young adult female patients with acute anorexia nervosa (n=47), long-term recovered patients (n=34), and healthy controls (n=75). The majority of acutely ill patients were scanned longitudinally (n=35): at the beginning of standardized weight restoration therapy and again after partial weight normalization (>10% body mass index increase). High-resolution structural images were processed and analyzed with the longitudinal stream of FreeSurfer software to test for changes in cortical thickness and volumes of select subcortical regions of interest. We found globally reduced cortical thickness in acutely ill patients to increase rapidly (0.06 mm/month) during brief weight restoration therapy (≈3 months). This significant increase was predicted by weight restoration alone and could not be ascribed to potentially mediating factors such as duration of illness, hydration status, or symptom improvements. By comparing cortical thickness in partially weight-restored patients with that measured in healthy controls, we confirmed that cortical thickness had normalized already at follow-up. This pattern of thinning in illness and rapid normalization during weight rehabilitation was largely mirrored in subcortical volumes. Together, our findings indicate that structural brain insults inflicted by starvation in anorexia nervosa may be reversed at a rate much faster than previously thought if interventions are successful before the disorder becomes chronic. This provides evidence drawing previously speculated mechanisms such as (de-)hydration and neurogenesis into question and suggests that neuronal and/or glial remodeling including changes in macromolecular content may underlie the gray matter alterations observed in anorexia nervosa.
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Affiliation(s)
- Fabio Bernardoni
- Eating Disorder Services and Researech Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Joseph A King
- Eating Disorder Services and Researech Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Daniel Geisler
- Eating Disorder Services and Researech Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Elisa Stein
- Eating Disorder Services and Researech Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Charlotte Jaite
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Dagmar Nätsch
- Eating Disorder Services and Researech Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Friederike I Tam
- Eating Disorder Services and Researech Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Ilka Boehm
- Eating Disorder Services and Researech Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Maria Seidel
- Eating Disorder Services and Researech Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Veit Roessner
- Eating Disorder Services and Researech Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Stefan Ehrlich
- Eating Disorder Services and Researech Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; MGH/MIT/HMS Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA; Harvard Medical School, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
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28
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Geisler D, Borchardt V, Lord AR, Boehm I, Ritschel F, Zwipp J, Clas S, King JA, Wolff-Stephan S, Roessner V, Walter M, Ehrlich S. Abnormal functional global and local brain connectivity in female patients with anorexia nervosa. J Psychiatry Neurosci 2016; 41:6-15. [PMID: 26252451 PMCID: PMC4688030 DOI: 10.1503/jpn.140310] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Previous resting-state functional connectivity studies in patients with anorexia nervosa used independent component analysis or seed-based connectivity analysis to probe specific brain networks. Instead, modelling the entire brain as a complex network allows determination of graph-theoretical metrics, which describe global and local properties of how brain networks are organized and how they interact. METHODS To determine differences in network properties between female patients with acute anorexia nervosa and pairwise matched healthy controls, we used resting-state fMRI and computed well-established global and local graph metrics across a range of network densities. RESULTS Our analyses included 35 patients and 35 controls. We found that the global functional network structure in patients with anorexia nervosa is characterized by increases in both characteristic path length (longer average routes between nodes) and assortativity (more nodes with a similar connectedness link together). Accordingly, we found locally decreased connectivity strength and increased path length in the posterior insula and thalamus. LIMITATIONS The present results may be limited to the methods applied during preprocessing and network construction. CONCLUSION We demonstrated anorexia nervosa-related changes in the network configuration for, to our knowledge, the first time using resting-state fMRI and graph-theoretical measures. Our findings revealed an altered global brain network architecture accompanied by local degradations indicating wide-scale disturbance in information flow across brain networks in patients with acute anorexia nervosa. Reduced local network efficiency in the thalamus and posterior insula may reflect a mechanism that helps explain the impaired integration of visuospatial and homeostatic signals in patients with this disorder, which is thought to be linked to abnormal representations of body size and hunger.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Stefan Ehrlich
- Correspondence to: S. Ehrlich, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden, Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Fetscherstraße 74, 01307 Dresden, Germany;
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Ehrlich S, Geisler D, Ritschel F, King JA, Seidel M, Boehm I, Breier M, Clas S, Weiss J, Marxen M, Smolka MN, Roessner V, Kroemer NB. Elevated cognitive control over reward processing in recovered female patients with anorexia nervosa. J Psychiatry Neurosci 2015; 40:307-15. [PMID: 26107161 PMCID: PMC4543093 DOI: 10.1503/jpn.140249] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Individuals with anorexia nervosa are thought to exert excessive self-control to inhibit primary drives. METHODS This study used functional MRI (fMRI) to interrogate interactions between the neural correlates of cognitive control and motivational processes in the brain reward system during the anticipation of monetary reward and reward-related feedback. In order to avoid confounding effects of undernutrition, we studied female participants recovered from anorexia nervosa and closely matched healthy female controls. The fMRI analysis (including node-to-node functional connectivity) followed a region of interest approach based on models of the brain reward system and cognitive control regions implicated in anorexia nervosa: the ventral striatum, medial orbitofrontal cortex (mOFC) and dorsolateral prefrontal cortex (DLPFC). RESULTS We included 30 recovered patients and 30 controls in our study. There were no behavioural differences and no differences in hemodynamic responses of the ventral striatum and the mOFC in the 2 phases of the task. However, relative to controls, recovered patients showed elevated DLPFC activity during the anticipation phase, failed to deactivate this region during the feedback phase and displayed greater functional coupling between the DLPFC and mOFC. Recovered patients also had stronger associations than controls between anticipation-related DLPFC responses and instrumental responding. LIMITATIONS The results we obtained using monetary stimuli might not generalize to other forms of reward. CONCLUSION Unaltered neural responses in ventral limbic reward networks but increased recruitment of and connectivity with lateral-frontal brain circuitry in recovered patients suggests an elevated degree of selfregulatory processes in response to rewarding stimuli. An imbalance between brain systems subserving bottom-up and top-down processes may be a trait marker of the disorder.
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Affiliation(s)
- Stefan Ehrlich
- Correspondence to: S. Ehrlich, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden, Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Fetscherstraße 74, 01307 Dresden, Germany;
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Ritschel F, King JA, Geisler D, Flohr L, Neidel F, Boehm I, Seidel M, Zwipp J, Ripke S, Smolka MN, Roessner V, Ehrlich S. Temporal delay discounting in acutely ill and weight-recovered patients with anorexia nervosa. Psychol Med 2015; 45:1229-1239. [PMID: 25579471 DOI: 10.1017/s0033291714002311] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Patients with anorexia nervosa (AN) are characterized by a very low body weight but readily give up immediate rewards (food) for long-term goals (slim figure), which might indicate an unusual level of self-control. This everyday clinical observation may be quantifiable in the framework of the anticipation-discounting dilemma. METHOD Using a cross-sectional design, this study compared the capacity to delay reward in 34 patients suffering from acute AN (acAN), 33 weight-recovered AN patients (recAN) and 54 healthy controls. We also used a longitudinal study to reassess 21 acAN patients after short-term weight restoration. A validated intertemporal choice task and a hyperbolic model were used to estimate temporal discounting rates. RESULTS Confirming the validity of the task used, decreased delay discounting was associated with age and low self-reported impulsivity. However, no group differences in key measures of temporal discounting of monetary rewards were found. CONCLUSIONS Increased cognitive control, which has been suggested as a key characteristic of AN, does not seem to extend the capacity to wait for delayed monetary rewards. Differences between our study and the only previous study reporting decreased delay discounting in adult AN patients may be explained by the different age range and chronicity of acute patients, but the fact that weight recovery was not associated with changes in discount rates suggests that discounting behavior is not a trait marker in AN. Future studies using paradigms with disorder-specific stimuli may help to clarify the role of delay discounting in AN.
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Affiliation(s)
- F Ritschel
- Department of Child and Adolescent Psychiatry,Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden,Dresden,Germany
| | - J A King
- Department of Child and Adolescent Psychiatry,Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden,Dresden,Germany
| | - D Geisler
- Department of Child and Adolescent Psychiatry,Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden,Dresden,Germany
| | - L Flohr
- Department of Child and Adolescent Psychiatry,Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden,Dresden,Germany
| | - F Neidel
- Department of Child and Adolescent Psychiatry,Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden,Dresden,Germany
| | - I Boehm
- Department of Child and Adolescent Psychiatry,Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden,Dresden,Germany
| | - M Seidel
- Department of Child and Adolescent Psychiatry,Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden,Dresden,Germany
| | - J Zwipp
- Department of Child and Adolescent Psychiatry,Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden,Dresden,Germany
| | - S Ripke
- Department of Psychiatry and Neuroimaging Center,Technische Universität Dresden,Dresden,Germany
| | - M N Smolka
- Department of Psychiatry and Neuroimaging Center,Technische Universität Dresden,Dresden,Germany
| | - V Roessner
- Department of Child and Adolescent Psychiatry,Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden,Dresden,Germany
| | - S Ehrlich
- Department of Child and Adolescent Psychiatry,Faculty of Medicine Carl Gustav Carus of the Technische Universität Dresden,Dresden,Germany
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King JA, Geisler D, Ritschel F, Boehm I, Seidel M, Roschinski B, Soltwedel L, Zwipp J, Pfuhl G, Marxen M, Roessner V, Ehrlich S. Global cortical thinning in acute anorexia nervosa normalizes following long-term weight restoration. Biol Psychiatry 2015; 77:624-32. [PMID: 25433902 DOI: 10.1016/j.biopsych.2014.09.005] [Citation(s) in RCA: 120] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 09/11/2014] [Accepted: 09/11/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Anorexia nervosa (AN) is a serious eating disorder characterized by self-starvation, extreme weight loss, and alterations in brain structure. Structural magnetic resonance imaging studies have documented brain volume reductions in acute AN, but it is unclear whether they are 1) regionally specific, or 2) reversible following weight restoration. Here, we measured cortical thickness (CT) for the first time in AN. METHODS Structural magnetic resonance imaging data were acquired from adolescent and young adult female patients with acute AN (n = 40), recovered patients following long-term weight restoration (n = 34), and an equal number of age-matched healthy control subjects. Group differences in CT were tested with well-validated procedures implemented in FreeSurfer. The mediating role of clinical variables including body mass index and drive for thinness were explored. For completeness, we also used FreeSurfer's subcortical segmentation stream to test group differences in volumes of select gray matter regions of interest. RESULTS Vertex-wise analyses revealed significant thinning of over 85% of the cortical surface in patients with acute AN and CT normalization in recovered patients following long-term weight restoration, although normal age-related trajectories were absent in the disorder. This pattern of results was largely mirrored in subcortical volumes. We also observed a strong negative correlation between CT and drive for thinness in extrastriate regions involved in body perception. CONCLUSIONS Structural brain anomalies in AN as expressed in CT and subcortical volume are primarily the consequence of malnutrition and unlikely to reflect premorbid trait markers or permanent scars, but longitudinal data are needed.
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Affiliation(s)
- Joseph A King
- Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden
| | - Daniel Geisler
- Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden
| | - Franziska Ritschel
- Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden
| | - Ilka Boehm
- Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden
| | - Maria Seidel
- Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden
| | - Benjamin Roschinski
- Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden
| | - Laura Soltwedel
- Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden
| | - Johannes Zwipp
- Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden
| | - Gerit Pfuhl
- Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden; Department of Psychology, University of Tromsø, Tromsø, Norway
| | - Michael Marxen
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden
| | - Stefan Ehrlich
- Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden; Massachusetts General Hospital/Massachusetts Institute of Technology /Harvard Medical School Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown; Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts.
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Ehrlich S, Lord AR, Geisler D, Borchardt V, Boehm I, Seidel M, Ritschel F, Schulze A, King JA, Weidner K, Roessner V, Walter M. Reduced functional connectivity in the thalamo-insular subnetwork in patients with acute anorexia nervosa. Hum Brain Mapp 2015; 36:1772-81. [PMID: 25611053 DOI: 10.1002/hbm.22736] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 01/05/2015] [Indexed: 12/17/2022] Open
Abstract
The neural underpinnings of anorexia nervosa (AN) are poorly understood. Results from existing functional brain imaging studies using disorder-relevant food- or body-stimuli have been heterogeneous and may be biased due to varying compliance or strategies of the participants. In this study, resting state functional connectivity imaging was used. To explore the distributed nature and complexity of brain function we characterized network patterns in patients with acute AN. Thirty-five unmedicated female acute AN patients and 35 closely matched healthy female participants underwent resting state functional magnetic resonance imaging. We used a network-based statistic (NBS) approach [Zalesky et al., 2010a] to identify differences between groups by isolating a network of interconnected nodes with a deviant connectivity pattern. Group comparison revealed a subnetwork of connections with decreased connectivity including the amygdala, thalamus, fusiform gyrus, putamen and the posterior insula as the central hub in the patient group. Results were not driven by changes in intranodal or global connectivity. No network could be identified where AN patients had increased coupling. Given the known involvement of the identified thalamo-insular subnetwork in interoception, decreased connectivity in AN patients in these nodes might reflect changes in the propagation of sensations that alert the organism to urgent homeostatic imbalances and pain-processes that are known to be severely disturbed in AN and might explain the striking discrepancy between patient's actual and perceived internal body state.
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Affiliation(s)
- Stefan Ehrlich
- Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden, Germany; MGH/MIT/HMS Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts; Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
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Boehm I, Geisler D, King JA, Ritschel F, Seidel M, Deza Araujo Y, Petermann J, Lohmeier H, Weiss J, Walter M, Roessner V, Ehrlich S. Increased resting state functional connectivity in the fronto-parietal and default mode network in anorexia nervosa. Front Behav Neurosci 2014; 8:346. [PMID: 25324749 PMCID: PMC4183185 DOI: 10.3389/fnbeh.2014.00346] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2014] [Accepted: 09/13/2014] [Indexed: 11/13/2022] Open
Abstract
The etiology of anorexia nervosa (AN) is poorly understood. Results from functional brain imaging studies investigating the neural profile of AN using cognitive and emotional task paradigms are difficult to reconcile. Task-related imaging studies often require a high level of compliance and can only partially explore the distributed nature and complexity of brain function. In this study, resting state functional connectivity imaging was used to investigate well-characterized brain networks potentially relevant to understand the neural mechanisms underlying the symptomatology and etiology of AN. Resting state functional magnetic resonance imaging data was obtained from 35 unmedicated female acute AN patients and 35 closely matched healthy controls female participants (HC) and decomposed using spatial group independent component analyses (ICA). Using validated templates, we identified components covering the fronto-parietal “control” network, the default mode network (DMN), the salience network, the visual and the sensory-motor network. Group comparison revealed an increased functional connectivity between the angular gyrus and the other parts of the fronto-parietal network in patients with AN in comparison to HC. Connectivity of the angular gyrus was positively associated with self-reported persistence in HC. In the DMN, AN patients also showed an increased functional connectivity strength in the anterior insula in comparison to HC. Anterior insula connectivity was associated with self-reported problems with interoceptive awareness. This study, with one of the largest sample to date, shows that acute AN is associated with abnormal brain connectivity in two major resting state networks (RSN). The finding of an increased functional connectivity in the fronto-parietal network adds novel support for the notion of AN as a disorder of excessive cognitive control, whereas the elevated functional connectivity of the anterior insula with the DMN may reflect the high levels of self- and body-focused ruminations when AN patients are at rest.
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Affiliation(s)
- Ilka Boehm
- Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany
| | - Daniel Geisler
- Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany
| | - Joseph A King
- Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany
| | - Franziska Ritschel
- Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany
| | - Maria Seidel
- Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany
| | - Yacila Deza Araujo
- Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany
| | - Juliane Petermann
- Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany
| | - Heidi Lohmeier
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany
| | - Jessika Weiss
- Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany
| | - Martin Walter
- Department of Psychiatry, Otto-von-Guericke University Magdeburg, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany
| | - Stefan Ehrlich
- Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany ; MGH/MIT/HMS Martinos Center for Biomedical Imaging, Massachusetts General Hospital Charlestown, MA, USA ; Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital Boston, MA, USA
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Affiliation(s)
- I. Boehm
- Department of Radiology, Center for Molecular Imaging research MBMB, University of Marburg, Marburg, Germany Department of Radiology, University of Bonn, Bonn, Germany
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Boehm I. Which laboratory parameters are characteristic for nephrogenic systemic fibrosis? Nephrol Dial Transplant 2009; 24:2293; author reply 2293-4. [DOI: 10.1093/ndt/gfp147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Affiliation(s)
- I. Boehm
- Center for Molecular Imaging Research MBMB, Department of Radiology, University of Bonn, Bonn, Germany
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Abstract
BACKGROUND Some patients suffering from cutaneous lupus erythematosus (CLE) develop extracutaneous manifestations during the course of the disease: up to 5% of patients with discoid LE (DLE) and up to 30% of subacute cutaneous LE (SCLE) patients show systemic involvement. Recent studies revealed some markers indicating systemic manifestations of CLE patients. However, the significance of diminished peripheral lymphocyte numbers as a marker of systemic involvement in CLE has not been investigated before. OBJECTIVES To determine the value of lymphocytopenia (< 1500 cells microL(-1)) as a marker of extracutaneous manifestations in CLE patients. : Methods The records of 72 CLE patients (44 DLE; 28 SCLE) were investigated. Systemic involvement was defined in accordance with the criteria of the European Academy of Dermatology and Venereology. Analyses of peripheral lymphocyte numbers were done by fluorescence-activated cell sorter analysis. RESULTS Five CLE patients developed extracutaneous manifestations during the course of disease. All these patients were lymphocytopenic. Differences between peripheral lymphocyte numbers of CLE patients with and without additional systemic involvement were highly significant (P < 0.01). CONCLUSIONS Our results suggest that lymphocytopenia in patients with CLE is a high sensitive but low specific marker of systemic involvement.
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Affiliation(s)
- J Wenzel
- Department of Dermatology, University of Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany.
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Wenzel J, Gerdsen R, Uerlich M, Bauer R, Bieber T, Boehm I. Antibodies targeting extractable nuclear antigens: historical development and current knowledge. Br J Dermatol 2001; 145:859-67. [PMID: 11899137 DOI: 10.1046/j.1365-2133.2001.04577.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- J Wenzel
- Department of Dermatology, University of Bonn, Germany.
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Abstract
We present the case of a 38-year-old female patient with systemic lupus erythematosus and atypical urticarial skin lesions with an alteration in shape, but not complete disappearance, within 24 hours. Hematoxylin-eosin-stained sections revealed flame figures. We review urticarial lesions in lupus erythematosus and discuss the possible pathomechanisms.
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Affiliation(s)
- J Wenzel
- Department of Dermatology, University of Bonn, Germany.
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Abstract
We present the case of a 71-year-old man with inclusion body myositis combined with subacute cutaneous lupus erythematosus and dysphagia. Although inclusion body myositis is usually resistant to immunosuppressive therapy, this patient improved under treatment with corticosteroids. The presented case is discussed in the context of earlier reports of inclusion body myositis and lupus erythematosus.
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Affiliation(s)
- J Wenzel
- Department of Dermatology, University of Bonn, Germany.
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Boehm I, Bieber T. Chilblain lupus erythematosus Hutchinson: successful treatment with mycophenolate mofetil. Arch Dermatol 2001; 137:235-6. [PMID: 11176709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Affiliation(s)
- I Boehm
- Department of Dermatology, University of Bonn, Germany.
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Wenzel J, Bauer R, Bieber T, Boehm I. Discoid and subacute cutaneous lupus erythematosus: detection of differences in peripheral lymphocyte numbers. Acta Derm Venereol 2000; 80:456. [PMID: 11243649 DOI: 10.1080/000155500300080456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2022] Open
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Wenzel J, Bauer R, Bieber T, Boehm I. Presence of antinuclear antibodies in patients with lupus erythematosus is correlated with diminished T-helper cells. Br J Dermatol 2000; 143:1100-1. [PMID: 11069532 DOI: 10.1046/j.1365-2133.2000.03861.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Affiliation(s)
- I Boehm
- Department of Dermatology University of Bonn, Germany
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Wenzel J, Bauer R, Boehm I. Fluorescence-activated cell sorter analysis in patients with cutaneous lupus erythematosus. Arch Dermatol 1999; 135:720-1. [PMID: 10376710 DOI: 10.1001/archderm.135.6.720] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Macek M, Macek M, Stuhrmann M, Kulovaný E, Dolanská M, Koukolík F, Boehm I, Hronková J, Jezková Z, Paulová M. The direct early diagnosis of cystic fibrosis by the detection of the delta F508 CFTR gene mutation in a prematurely delivered boy. Clin Genet 1991; 39:219-22. [PMID: 1709842 DOI: 10.1111/j.1399-0004.1991.tb03015.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The suspicion of prenatal meconium ileus syndrome was raised in a pregnancy in a family with no history of cystic fibrosis because of significantly higher maternal serum alpha-fetoprotein in the 16th and 19th week of gestation, dispersed areas with increased echogenity in the fetal abdomen, slight fetal ascites in the 24th-25th weeks of gestation, decreased amniotic fluid gamma-glutamyltranspeptidase (GGT) activity and alpha-fetoprotein level in the 25th-26th weeks, and normal 46,XY karotype of the fetus. The detection of a homozygous deltaF508 cystic fibrosis transmembrane regulator (CFTR) gene mutation, by means of PCR from a small amount of white blood cells and urine sediment cells, substantiated the diagnosis of cystic fibrosis in a prematurely delivered boy in the 28th week of gestation. The repeated sweat test was unsuccessful. The autopsy examination confirmed the diagnosis of cystic fibrosis. Fetal meconium ileus syndrome was complicated by peritonitis and by formation of a meconium pseudocyst. Direct PCR typing improves postnatal diagnostic possibilities in the early neonatal period in prematurely delivered babies when the sweat test is difficult to perform.
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Affiliation(s)
- M Macek
- Institute of Human Genetics, Free University, Berlin, FRG
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Macek M, Vavrova V, Boehm I, Stuhrmann M, Reis A, Macek M, Duspisova R, Jelinkova E, Sperling K, Krawczak M. Frequency of the delta-F508 mutation and flanking marker haplotypes at the cystic fibrosis locus from 167 Czech families. Adv Exp Med Biol 1991; 290:373-5. [PMID: 1950752 DOI: 10.1007/978-1-4684-5934-0_42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- M Macek
- Department of Clinical Biochemistry, Faculty of Medicine, Charles University, Prague, Czechoslovakia
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