Neural Basis of Meal Related Interoceptive Dysfunction in Anorexia Nervosa
| Status: | Recruiting |
|---|---|
| Conditions: | Anxiety, Depression, Depression, Major Depression Disorder (MDD), Neurology, Psychiatric, Psychiatric |
| Therapuetic Areas: | Neurology, Psychiatry / Psychology, Pulmonary / Respiratory Diseases |
| Healthy: | No |
| Age Range: | 18 - 55 |
| Updated: | 8/9/2018 |
| Start Date: | October 2015 |
| End Date: | December 2027 |
| Contact: | Valerie Upshaw, RN |
| Email: | vupshaw@laureateinstitute.org |
| Phone: | 9185025176 |
This study aims to identify the brain regions responsible for encoding cardiorespiratory
'interoceptive' sensations and determine whether they are dysfunctional in individuals
affected by eating disorders, anxiety, depression, or brain injury. By evaluating the same
interoceptive sensations across different human illnesses, the investigators hope to provide
convergent evidence resulting in identification of core underlying neural processes, and to
discern relative contributions in each condition.
'interoceptive' sensations and determine whether they are dysfunctional in individuals
affected by eating disorders, anxiety, depression, or brain injury. By evaluating the same
interoceptive sensations across different human illnesses, the investigators hope to provide
convergent evidence resulting in identification of core underlying neural processes, and to
discern relative contributions in each condition.
The human brain has constant access to a multitude of complex signals, which it must simplify
and organize in order to sustain the integrity of the organism. Many of these signals
originate from outside of the body, such as lights, sounds, and smells, and much is known
about how humans consciously perceive these 'exteroceptive' signals and how the human brain
represents them. Comparatively little is known about how the human brain processes
'interoceptive' signals originating from inside of the body, despite the fact that the brain
has access to far more of them (for instance, intestinal tension, bladder distension, breath,
heartbeat, body temperature, blood pressure, serum osmolality, inflammation, proprioception
etc.).
The current study study therefore aims to identify the brain regions responsible for encoding
cardiorespiratory 'interoceptive' sensations and determine whether they are dysfunctional in
individuals affected by eating disorders, anxiety, depression, or brain injury. Participants
in this study will receive stimulation of the cardiorespiratory channel of the interoceptive
system using bolus intravenous infusions of isoproterenol, a peripherally acting medication
similar to adrenaline, and saline. Stimulation will occur during functional magnetic
resonance imaging (fMRI) as well as outside of the fMRI scanner. After the scan participants
will consume a meal. By evaluating the same interoceptive sensations across different human
illnesses, the investigators hope to provide convergent evidence resulting in identification
of core underlying neural processes, and to discern relative contributions in each condition.
and organize in order to sustain the integrity of the organism. Many of these signals
originate from outside of the body, such as lights, sounds, and smells, and much is known
about how humans consciously perceive these 'exteroceptive' signals and how the human brain
represents them. Comparatively little is known about how the human brain processes
'interoceptive' signals originating from inside of the body, despite the fact that the brain
has access to far more of them (for instance, intestinal tension, bladder distension, breath,
heartbeat, body temperature, blood pressure, serum osmolality, inflammation, proprioception
etc.).
The current study study therefore aims to identify the brain regions responsible for encoding
cardiorespiratory 'interoceptive' sensations and determine whether they are dysfunctional in
individuals affected by eating disorders, anxiety, depression, or brain injury. Participants
in this study will receive stimulation of the cardiorespiratory channel of the interoceptive
system using bolus intravenous infusions of isoproterenol, a peripherally acting medication
similar to adrenaline, and saline. Stimulation will occur during functional magnetic
resonance imaging (fMRI) as well as outside of the fMRI scanner. After the scan participants
will consume a meal. By evaluating the same interoceptive sensations across different human
illnesses, the investigators hope to provide convergent evidence resulting in identification
of core underlying neural processes, and to discern relative contributions in each condition.
Inclusion Criteria:
- Diagnostic and Statistical Manual 5 (DSM 5) criteria for anorexia nervosa and age 18
to 40, or generalized anxiety disorder, or panic disorder, or major depressive
disorder, or brain injury caused either by herpes simplex encephalitis or
Urbach-Wiethe disease.
Exclusion Criteria:
- DSM 5 diagnosis with any of the following: Schizophrenia spectrum and other psychotic
disorders, bipolar and related disorders, antisocial personality disorder, active
suicidal ideation with intent or plan
- Current cardiac arrhythmia
- Current respiratory disease
- Seizure disorder
- MRI contraindications including: cardiac pacemaker, metal fragments in eyes/skin/body
(shrapnel), aortic/aneurysm clips, prosthesis, by-pass surgery/coronary artery clips,
hearing aid, heart valve replacement, shunt (ventricular or spinal), electrodes, metal
plates/pins/screws/ wires, or neuro/bio-stimulators (TENS unit), persons who have ever
been a professional metal worker/welder, history of eye surgery/eyes washed out
because of metal, vision problems uncorrectable with lenses, inability to lie still on
one's back for 60-120 minutes; prior neurosurgery; tattoos or cosmetic makeup with
metal dyes, unwillingness to remove body piercings, and pregnancy.
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