Rachel Marsh

A self-regulatory control fMRI paradigm was employed to study adolescent girls with a short duration of bulimia nervosa compared with healthy comparison subjects. Adolescents with and without bulimia nervosa performed similarly on the behavioral study task. Those with bulimia nervosa showed less activation in the right frontostriatal regions and greater deactivation in left inferior and superior frontal gyri and right posterior cingulate cortex. The degree of neural deactivation among adolescents with bulimia nervosa was positively correlated with frequency of binge eating and vomiting and degree of preoccupation with body weight and shape. Objective:The authors examined functional activity in the frontostriatal systems that mediate self-regulatory capacities and conflict resolution in adolescents with bulimia nervosa. Method:Functional magnetic resonance imaging was used to compare blood-oxygen-level-dependent response in 18 female adolescents with bulimia nervosa and 18 healthy female age-matched subjects during performance on a Simon spatial incompatibility task. Bayesian analyses were used to compare the two groups on patterns of brain activation during correct responses to conflict stimuli and to explore the effects of antecedent stimulus context on group differences in self-regulation and conflict resolution. Results:Adolescents with and without bulimia nervosa performed similarly on the task. During correct responses in conflict trials, frontostriatal circuits—including the right inferolateral and dorsolateral prefrontal cortices and putamen—failed to activate to the same degree in adolescents with bulimia nervosa as in healthy compar...

Objective: Neuroimaging studies of healthy individuals inform us about the normative maturation of the frontostriatal circuits that subserve self-regulatory control processes. Findings from these studies can be used as a reference frame against which to compare the aberrant development of these processes in individuals across a wide range of childhood psychopathologies. Method: The authors reviewed extensive neuroimaging evidence for the presence of abnormalities in frontostriatal circuits in children and adults with Tourette’s syndrome and obsessive-compulsive disorder (OCD) as well as a more limited number of imaging studies of adolescents and adults with anorexia nervosa or bulimia nervosa that, together, implicate dysregulation of frontostriatal control systems in the pathogenesis of these eating disorders. Results: The presence of an impaired capacity for self-regulatory control that derives from abnormal development of frontostriatal circuits likely interacts in similar ways with normally occurring ...

Neuroimaging in Developmental Clinical Neuroscience - February 2009

Modern neuroimaging offers tremendous opportunities for gaining insights into normative development and a wide array of developmental neuropsychiatric disorders. Focusing on ontogeny, this text covers basic processes involved in both healthy and atypical maturation, and also addresses the range of neuroimaging techniques most widely used for studying children. This book will enable you to understand normative structural and functional brain maturation and the mechanisms underlying basic developmental processes; become familiar with current knowledge and hypotheses concerning the neural bases of developmental neuropsychiatric disorders; and learn about neuroimaging techniques, including their unique strengths and limitations. Coverage includes normal developmental processes, atypical processing in developmental neuropsychiatric disorders, ethical issues, neuroimaging techniques and their integration with psychopharmacologic and molecular genetic research approaches, and future directions. This comprehensive volume is an essential resource for neurologists, neuropsychologists, psychiatrists, pediatricians, and radiologists concerned with normal development and developmental neuropsychiatric disorders.

Bulimia nervosa (BN) typically begins in adolescence or young adulthood. Primarily affecting girls and women, it is characterized by recurrent episodes of binge eating followed by self-induced vomiting or another compensatory behavior to avoid weight gain. These episodes of binge eating are associated with a severe sense of loss of control.^1,2 Mood disturbances and impulsive behaviors are common in individuals with BN, suggesting the presence of more pervasive difficulties in behavioral self-regulation.² Thus, dysregulated control systems may contribute to the binge eating and associated purging behaviors, perhaps by releasing feeding behaviors from regulatory control. Concomitant with familial and sociocultural determinants,¹ disturbances in these systems likely contribute to the pathogenesis of BN.

Objective: Disturbances in the maturation of neural systems that mediate self-regulatory processes may contribute to the development of Tourette’s syndrome by releasing motor and vocal tics from re...