Developing an EEG Paradigm to Study Prediction Error in Anorexia Nervosa

  • STATUS
    Recruiting
  • End date
    Jun 20, 2023
  • participants needed
    44
  • sponsor
    University of California, San Diego
Updated on 20 April 2022
Accepts healthy volunteers

Summary

Adolescent anorexia nervosa (AN) is an eating disorder associated with intense fear of weight gain, food refusal, and severe weight loss. AN is the third most common chronic illness among adolescent females with a mortality rate 12 times higher than expected for females 15-24 years old. Little is known about biomarkers in adolescent AN.

Neuroimaging studies have repeatedly suggested altered reward processing in AN including in studies using the dopamine associated prediction error (PE) model. The brain PE response is elicited during unexpected receipt or omission of reward stimuli and thought to reflect the functionality of brain dopamine circuits. This is an important research direction as the dopamine system can be manipulated pharmacologically. In ill and recovered adult AN, unexpected or randomly applied sucrose taste stimuli evoked higher insular and striatal responses and unexpected omission or receipt of monetary or taste reward was associated with a similar response pattern in adolescent AN. PE was also inversely related to weight gain in treatment. Thus, PE brain response promises to be an important biological marker for adolescent AN with predictive value for treatment outcome. However, functional brain imaging is costly, prohibitive for instance for individuals with braces or other metal in their body and only available at certain centers. In order to study PE in AN in larger scale studies, a more practical approach and method need to be developed. In this application, we will use the exploratory/developmental R21 mechanism to develop a study protocol using electroencephalography (EEG) to study PE signals in adolescent AN. Recent studies in healthy individuals support that this is a valid approach.

Our primary goal for this study is to test the feasibility of the use of EEG for prediction error and reversal learning studies in AN with the longer term goal of replacing fMRI that is costly and associated with frequent participant rule out.

In Aim 1. we test the feasibility of adapting a computational taste PE reinforcement learning paradigm from fMRI to EEG in adolescents with AN and healthy controls. We expect that we will find internal consistency of taste PE brain response across fMRI and EEG in adolescents with AN as well as age-matched healthy controls, within each group. We further expect that we will find preliminary evidence that the EEG paradigm will be able to discriminate the AN group from the HC adolescents based on feedback related negativity and higher event-related potential amplitudes, which will correlate with fMRI PE brain response.

In Aim 2., we test whether a monetary PE paradigm will show similar EEG brain response as taste PE in Aim 1. to establish the generalizability of EEG taste and non-taste paradigms.

The development of an EEG based reward PE study paradigm will enable us in the future to conduct large-scale studies that will be less costly and independent from brain imaging centers that are only available to a small subset of adolescents with AN.

Details
Condition Anorexia Nervosa
Treatment Prediction error tasks
Clinical Study IdentifierNCT04583774
SponsorUniversity of California, San Diego
Last Modified on20 April 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

Healthy Controls
Females ages 11 - 17 years
Healthy body weight between 90 and 110 % average body weight
Edinburgh Handedness Inventory Revised (EHI-R) LQ score > +200
English is primary language spoken
Restricting Type Anorexia Nervosa
Females ages 11 - 17 years
Diagnostic criteria. Current diagnosis of AN, including being underweight below 17.5 body mass index (BMI, kg/m2), will have a severe fear of weight gain, body image distortion and absence of the menstrual cycle over three consecutive months (if applicable)
First 1-2 weeks in treatment at The University of California San Diego Eating Disorders Center for Treatment and Research or Rady Children's Hospital San Diego Medical Behavioral Unit
Restricting subtype, that is without binge/purge behaviors
Edinburgh Handedness Inventory Revised (EHI-R) LQ score > +200
English is primary language spoken

Exclusion Criteria

Healthy Controls
Current pregnancy or breast feeding within last 3 months
Illiterate/Blind individuals
First degree relative with current or past eating disorder
Current Medications other than BCP or IUD
Past or present Axis I psychiatric disorder including substance or alcohol use disorder as determined through PI interview and MINI-Kid clinical interview
Major Medical illness (as determined through medical history in bioscreen and PI interview) such as
Conditions that are life threatening
cancer
heart disease
stroke
HIV/AIDS
Seizure Disorders
Conditions that are life threatening Conditions that cause serious disability
stroke
without necessarily being life threatening
closed head or spinal cord injuries
mental retardation
congenital malformations
severe allergies
Conditions that cause significant pain or discomfort that can cause serious
migraine
interruptions to life activities
arthritis
sickle cell disease
mobility disorders
blindness
Conditions that require major commitments of time and effort from care-givers for
Alzheimer's disease and other dementias
a substantial period of time
chronic obstructive pulmonary disease
paraplegia or quadriplegia
Down's syndrome
depression
Conditions that may require frequent monitoring
diabetes
conditions requiring anticoagulation treatment
severe asthma
severe allergies
schizophrenia and other psychotic illnesses
Conditions that predict or are associated with severe consequences
hypertension (associated with heart disease)
depression (associated with suicide)
diabetes (associated with blindness, kidney failure)
alcohol and other substance abuse (associated with intentional and unintentional injuries)
Metal implants or braces (as determined through fMRI screening form)
Anorexia Nervosa
Pregnancy or breast feeding within last 3 months
Recent history of suspected substance abuse or a lifetime history of psychostimulant
Lifetime history of bipolar disorder or psychosis
abuse and/or dependence
Illiterate/Blind individuals
Use of an anti-psychotic or other dopamine acting medication including stimulants within the past week at time of MRI
Recent history of substance abuse or dependence (within the last month)
Major Medical illness (as determined through medical history in bioscreen and PI interview) such as
Conditions that are life threatening
cancer
heart disease
stroke
HIV/AIDS
Seizure Disorders
stroke
closed head or spinal cord injuries
mental retardation
congenital malformations
Conditions that are life threatening Conditions that cause serious disability
without necessarily being life threatening
severe allergies
migraine
arthritis
sickle cell disease
Conditions that cause significant pain or discomfort that can cause serious
mobility disorders
interruptions to life activities
blindness
Alzheimer's disease and other dementias
chronic obstructive pulmonary disease
paraplegia or quadriplegia
Down's syndrome
Conditions that require major commitments of time and effort from care-givers for
Conditions that may require frequent monitoring
a substantial period of time
diabetes
conditions requiring anticoagulation treatment
severe asthma
severe allergies
schizophrenia and other psychotic illnesses
Conditions that predict or are associated with severe consequences
hypertension (associated with heart disease)
diabetes (associated with blindness, kidney failure)
alcohol and other substance abuse (associated with intentional and unintentional injuries) within the last month
Metal implants or braces (as determined through fMRI screening form)
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