Anorexia Nervosa (AN) is a complex and multifactorial psychiatric disease that affects mostly women and is characterized by a self-restriction of food intake leading to life-threatening consequences whose underlying mechanisms are largely unexplored. AN encompasses a constellation of risk factors including genetic, biological, neuro-psychological and social factors. Although AN has a prevalence of only 1-3% in the general population, it has the highest mortality rate amongst any psychiatric disorder. Recovery of normal feeding behaviour in patients often requires several months with a large between-patient variability and a high percentage of relapse, which can occur in 35 to 41% of the patients. There is a huge unmet need for optimal understanding of processes underlying relapse. Reward processing abnormalities represents an important hypothesis underlying AN development and perpetuation. We aim to investigate the mechanisms that contribute to the maintenance and chronicity of the disease after inpatient treatment with a longitudinal design across intensive standardized inpatient treatment. We will challenge our hypothesis through brain imaging, neuropsychological, metabolic and genetic approaches. One hundred twenty-five AN female patients admitted for intensive inpatient treatment will be recruited and evaluated: at admission, after weight recovery and at 6 months after discharge with neurocognitive tests (including the Delay Discounting Task), genetic/epigenetic examination, hormonal blood samples (at each visit and repeated sampling around a meal for a 10-patient subgroup) and brain imaging (including fMRI during a Delay Discounting Task for fifty patients). One hundred healthy controls will be also recruited and be subjected to the same study procedures.
Study Type
OBSERVATIONAL
Enrollment
275
Centre Hospitalier St Anne
Paris, France
RECRUITINGDelay Discounting Task score after weight recovery
Comparaison of this score to remission status six months post discharge
Time frame: after complete weight recovery (4+/-2 months after inclusion)
Delay Discounting Task score after weight recovery compared to control
Time frame: after weight recovery (4+/-2 months after baseline)
Bold signal difference during Delay Discounting Task in fMRI
Time frame: Baseline (M0) and after weight recovery for patient (4+/-2 months after baseline) ; Baseline and 4 months later for healthy controls
Evolution of brain volums in MRI
Time frame: Baseline (M0), after weight recovery (4+/-2 months after baseline)
Evolution of fronto striatal connectivity in MRI
Time frame: Baseline (M0), after weight recovery (4+/-2 months after baseline)
Evolution of total, acyl and desacyl ghrelin plasma level
Time frame: Baseline (M0), after weight recovery (4+/-2 months after baseline) and 6 months post discharge
Evolution of total, acyl and desacyl ghrelin plasma level around a meal
Time frame: Baseline (Month 0), after weight recovery (4+/-2 months after baseline) during meal
Exome analysis
Time frame: Baseline (M0)
Evolution of BDNF gene methylation
Time frame: Baseline (M0), after weight recovery (4+/-2 months after baseline)
Evolution of EDI-2 score
Evaluate the evolution of eating disorder dimensions during weight recovery predicting relapse
Time frame: Baseline (M0), after weight recovery (4+/-2 months after baseline) and 6 months post discharge
Evolution of EAI score
Evaluate the evolution of physical activity addiction during weight recovery predicting relapse
Time frame: Baseline (M0), after weight recovery (4+/-2 months after baseline) and 6 months post discharge
Evolution of GLT score
Evaluate the evolution of the level of physical activity during weight recovery predicting relapse
Time frame: Baseline (M0), after weight recovery (4+/-2 months after baseline) and 6 months post discharge
Evolution of YBS score
Evaluate the evolution of obession and compulsion during weight recovery predicting relapse
Time frame: Baseline (M0), after weight recovery (4+/-2 months after baseline) and 6 months post discharge
Evolution of HADS score
Evaluate the evolution of anxiety and depression during weight recovery predicting relapse
Time frame: Baseline (M0), after weight recovery (4+/-2 months after baseline) and 6 months post discharge
Evolution of Brixton score
Evaluate the evolution of neuropsychological performance during weight recovery predicting relapse
Time frame: Baseline (M0), after weight recovery (4+/-2 months after baseline) and 6 months post discharge
Evolution of TMT score
Evaluate the evolution of neuropsychological performance during weight recovery predicting relapse
Time frame: Baseline (M0), after weight recovery (4+/-2 months after baseline) and 6 months post discharge
Evolution of Slips of action neurocognitive score
Evaluate the evolution of neuropsychological performance during weight recovery predicting relapse
Time frame: Baseline (M0), after weight recovery (4+/-2 months after baseline) and 6 months post discharge
Evolution of pupillometry to social, food and body image pictures
Evaluate the evolution of neuropsychological performance during weight recovery predicting relapse
Time frame: Baseline (M0), after weight recovery (4+/-2 months after baseline) and 6 months post discharge
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.