Study Of Inhibitory Control And The Related Network In Patients With Anorexia Nervosa Based On Resting-state FMRI

ObjectiveAnorexia Nervosa is a chronic refractory psychiatric disorder characterized by"persistently restricted energy intake".Different subtypes of AN patients show different clinical features and eating control characteristics.In order to explore the inhibitory control ability and the related network of inhibitory control neural ciecuitry in patients with Anorexia Nervosa.Then,make a further comparision of inhibitory control related brain regions between different subtypes of ANMethodA case-control study was utilized in this research.49 patients with AN and 39 heathy-control(HC)matched with sex,age,and years of education were included in our study.All the subjects underwent a high-resolution T1 scanning as well as a resting-state fMRI scanning and a series of clinical psychoanalysis including the Barratt Implusiveness Scale-11(BIS-11),the Behavioral Inhibition/Activation System Scale(BIS/BAS),Eating Attitude Test-26(EAT-26)and Eating Disorder Examination Queationnaire(EDE-Q6.0).Then compared the inhibitory control ability and the functional connectivity in inhibitory control neural ciecuitry between AN group with HC group,as well as different subtypes of AN patientsResults1.Self-report inventory:We found no difference between AN group with HC group,as well as different subtypes of AN patients in the scores of BIS/BAS scale(P>0.05)The scores of BIS-11 scale and subscales(attentional imp.,Non-planning imp.)of AN(58.45±8.14,13.57±2.52,24.24±4.18)were higher than HC(53.72±9.89,12.08±2.02,21.05±3.87),and the difference was statistically significant(P<0.01).We found no difference between AN-R and HC in BIS-11 scale and subscales(P>0.05).The scores of BIS-11 scale and subscales(attentional imp.,Non-planning imp.)of AN-BP(60.55±9.27,15.00±2.16,24.82±4.21)were higher than HC(53.72±9.89,12.08±2.02,21.05±3.87),and the difference was statistically significant(P<0.01).The scores of BIS-11 subscales(attentional imp.)of AN-R(12.00±1.89)was lower than AN-BP(15.00±2.16),and the difference was statistically significant(P<0.01).We found no difference between AN-R and HC in total scores of EAT-26 and EDE-Q(P>0.05).2.Alteration of functional connectivity in resting-state fMRI:AN patients showed increased functional connectivity between left inferior frontal cortex and left supplementary motor area,as well as between the left externa globus pallidus and the left thalamus.But we found decreased functional connectivity between basal ganglia and the cortical regions(superior frontal gyrus,inferior frontal gyrus,rolandic operculum,supramarginal gyrus,angular gyrus,superior temporal gyrus,middle temporal gyrus),apart from this,the functional connectivity between basal ganglia and Vemis 4 5.There were no significant differences between AN-R and AN-BP in those regions above.But,when compared to HC,AN-R showed decreased functional connectivity between basal ganglia and Vemis 4 5,while AN-BP showed decreased functional connectivity between globus pallidus and the left supramarginal gyrus or the right superior temporal gyrus.And AN-BP also showed increased functional connectivity between the left externa globus pallidus and the left thalamus.3.In AN patients,the functional connectivity strength between left externa globus pallidus and the left thalamus positively correlated with EAT-26 total score(r=0.372,P=0.036).In addition,the functional connectivity strength between left caudate nucleus and left superior frontal gyrus also positively correlated with EDE-Q total score(r=0.346,P=0.045).Conclusion1.AN patients showed impaired inhibitory control ability,especially in AN-BP.Compared with AN-R and healthy controls,AN-BP was more likely to exhibit uncontrolled and impulsive behavior.2.In addition to the internal disruptive functional connectivity in Fronto-Basal Ganglia Circuit,there were also deceased functional connectivity between Basal ganglia and parietal lobe,temporal lobe or vemis.These results suggest regions above may assist Fronto-Basal Ganglia Circuit and play an important role in the inhibitiory control.3.There were significant differences of functional connection within basal ganglia and between between basal ganglia and vemis in two subtypes of AN patients.