Association between the frontoparietal network, clinical symptoms and treatment response in individuals with untreated anorexia nervosa

Background Anorexia nervosa (AN) has been characterised as a psychiatric disorder associated with increased control. Currently, it remains difficult to predict treatment response in patients with AN. Their cognitive abilities are known to be resistant to treatment. It has been established that the f...

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Main Authors: Qiang Liu, Yan Chen, Zhen Wang, Ling Yue, Hui Zheng, Lei Guo, Jue Chen, Yuping Wang, Qianqian He, Jialin Zhang, Qing Kang, Cheng Lian, Yanran Hu, Sufang Peng
Format: Article
Language:English
Published: BMJ Publishing Group 2024-06-01
Series:General Psychiatry
Online Access:https://gpsych.bmj.com/content/37/3/e101389.full
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author Qiang Liu
Yan Chen
Zhen Wang
Ling Yue
Hui Zheng
Lei Guo
Jue Chen
Yuping Wang
Qianqian He
Jialin Zhang
Qing Kang
Cheng Lian
Yanran Hu
Sufang Peng
author_facet Qiang Liu
Yan Chen
Zhen Wang
Ling Yue
Hui Zheng
Lei Guo
Jue Chen
Yuping Wang
Qianqian He
Jialin Zhang
Qing Kang
Cheng Lian
Yanran Hu
Sufang Peng
author_sort Qiang Liu
collection DOAJ
description Background Anorexia nervosa (AN) has been characterised as a psychiatric disorder associated with increased control. Currently, it remains difficult to predict treatment response in patients with AN. Their cognitive abilities are known to be resistant to treatment. It has been established that the frontoparietal control network (FPCN) is the direct counterpart of the executive control network. Therefore, the resting-state brain activity of the FPCN may serve as a biomarker to predict treatment response in AN.Aims The study aimed to investigate the association between resting-state functional connectivity (RSFC) of the FPCN, clinical symptoms and treatment response in patients with AN.Methods In this case-control study, 79 female patients with AN and no prior treatment from the Shanghai Mental Health Center and 40 matched healthy controls (HCs) were recruited from January 2015 to March 2022. All participants completed the Questionnaire Version of the Eating Disorder Examination (version 6.0) to assess the severity of their eating disorder symptoms. Additionally, RSFC data were obtained from all participants at baseline by functional magnetic resonance imaging. Patients with AN underwent routine outpatient treatment at the 4th and 12th week, during which time their clinical symptoms were evaluated using the same measures as at baseline.Results Among the 79 patients, 40 completed the 4-week follow-up and 35 completed the 12-week follow-up. The RSFC from the right posterior parietal cortex (PPC) and dorsolateral prefrontal cortex (dlPFC) increased in 79 patients with AN vs 40 HCs after controlling for depression and anxiety symptoms. By multiple linear regression, the RSFC of the PPC to the inferior frontal gyrus was found to be a significant factor for self-reported eating disorder symptoms at baseline and the treatment response to cognitive preoccupations about eating and body image, after controlling for age, age of onset and body mass index. The RSFC in the dlPFC to the middle temporal gyrus and the superior frontal gyrus may be significant factors in the treatment response to binge eating and loss of control/overeating in patients with AN.Conclusions Alterations in RSFC in the FPCN appear to affect self-reported eating disorder symptoms and treatment response in patients with AN. Our findings offer new insight into the pathogenesis of AN and could promote early prevention and treatment.
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spelling doaj-art-1b18153270d14ec4b46e83a1b45e67462024-12-26T06:30:08ZengBMJ Publishing GroupGeneral Psychiatry2517-729X2024-06-0137310.1136/gpsych-2023-101389Association between the frontoparietal network, clinical symptoms and treatment response in individuals with untreated anorexia nervosaQiang Liu0Yan Chen1Zhen Wang2Ling Yue3Hui Zheng4Lei Guo5Jue Chen6Yuping Wang7Qianqian He8Jialin Zhang9Qing Kang10Cheng Lian11Yanran Hu12Sufang Peng131 Department of Clinical Psychology, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China1 Department of Clinical Psychology, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China1 Department of Clinical Psychology, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China1 Department of Clinical Psychology, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China3 Shanghai Key Laboratory of Psychotic Disorders, Brain Health Institute, National Center for Mental Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China1 Department of Clinical Psychology, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China1 Department of Clinical Psychology, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China1 Department of Clinical Psychology, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China1 Department of Clinical Psychology, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China4 State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China1 Department of Clinical Psychology, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China1 Department of Clinical Psychology, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China1 Department of Clinical Psychology, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China1 Department of Clinical Psychology, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaBackground Anorexia nervosa (AN) has been characterised as a psychiatric disorder associated with increased control. Currently, it remains difficult to predict treatment response in patients with AN. Their cognitive abilities are known to be resistant to treatment. It has been established that the frontoparietal control network (FPCN) is the direct counterpart of the executive control network. Therefore, the resting-state brain activity of the FPCN may serve as a biomarker to predict treatment response in AN.Aims The study aimed to investigate the association between resting-state functional connectivity (RSFC) of the FPCN, clinical symptoms and treatment response in patients with AN.Methods In this case-control study, 79 female patients with AN and no prior treatment from the Shanghai Mental Health Center and 40 matched healthy controls (HCs) were recruited from January 2015 to March 2022. All participants completed the Questionnaire Version of the Eating Disorder Examination (version 6.0) to assess the severity of their eating disorder symptoms. Additionally, RSFC data were obtained from all participants at baseline by functional magnetic resonance imaging. Patients with AN underwent routine outpatient treatment at the 4th and 12th week, during which time their clinical symptoms were evaluated using the same measures as at baseline.Results Among the 79 patients, 40 completed the 4-week follow-up and 35 completed the 12-week follow-up. The RSFC from the right posterior parietal cortex (PPC) and dorsolateral prefrontal cortex (dlPFC) increased in 79 patients with AN vs 40 HCs after controlling for depression and anxiety symptoms. By multiple linear regression, the RSFC of the PPC to the inferior frontal gyrus was found to be a significant factor for self-reported eating disorder symptoms at baseline and the treatment response to cognitive preoccupations about eating and body image, after controlling for age, age of onset and body mass index. The RSFC in the dlPFC to the middle temporal gyrus and the superior frontal gyrus may be significant factors in the treatment response to binge eating and loss of control/overeating in patients with AN.Conclusions Alterations in RSFC in the FPCN appear to affect self-reported eating disorder symptoms and treatment response in patients with AN. Our findings offer new insight into the pathogenesis of AN and could promote early prevention and treatment.https://gpsych.bmj.com/content/37/3/e101389.full
spellingShingle Qiang Liu
Yan Chen
Zhen Wang
Ling Yue
Hui Zheng
Lei Guo
Jue Chen
Yuping Wang
Qianqian He
Jialin Zhang
Qing Kang
Cheng Lian
Yanran Hu
Sufang Peng
Association between the frontoparietal network, clinical symptoms and treatment response in individuals with untreated anorexia nervosa
General Psychiatry
title Association between the frontoparietal network, clinical symptoms and treatment response in individuals with untreated anorexia nervosa
title_full Association between the frontoparietal network, clinical symptoms and treatment response in individuals with untreated anorexia nervosa
title_fullStr Association between the frontoparietal network, clinical symptoms and treatment response in individuals with untreated anorexia nervosa
title_full_unstemmed Association between the frontoparietal network, clinical symptoms and treatment response in individuals with untreated anorexia nervosa
title_short Association between the frontoparietal network, clinical symptoms and treatment response in individuals with untreated anorexia nervosa
title_sort association between the frontoparietal network clinical symptoms and treatment response in individuals with untreated anorexia nervosa
url https://gpsych.bmj.com/content/37/3/e101389.full
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