Martinez-Barona Soyer, Manuela; (2020) Children at high-familial risk for Eating Disorders: study of psychopathology, neuropsychology and neuroimaging. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Evidence suggest that a diagnosis of an eating disorder (ED) is associated with differential neurocognitive functioning and neural mechanisms. However, whether differences are present prior to the onset of the disorder (‘trait’), possibly affecting risk status for development of an ED; or whether differences are a consequence of secondary features of the disorder such as low nutritional intake (‘state’), is not clear. Family studies have established that first-degree relatives of individuals with ED are at higher risk of developing an ED than the general population, therefore, children of mothers with an ED (current or history) are the perfect group to study risk pathways to developing ED. This is the first study to explore neural alterations as well as neurocognitive functioning in girls at high-familial risk of developing an ED, in comparison to children who are not. High risk status of girls were defined using a maternal clinical interview to confirm lifetime ED diagnosis. Intelligence, social cognition, reward responsiveness, neuropsychological function and brain imaging were investigated in girls at high-familial risk. Girls at high familial risk demonstrated difficulties in set-shifting (cognitive flexibility) and increased reward responsiveness when compared to girls at low risk. Girls at risk also had overall increased Gray matter (GM) volume, and specifically increased GM in amygdala, caudate, hippocampus and orbitofrontal cortex when compared to girls at low risk. There were no differences in white matter (WM) connectivity from amygdala to areas of the cortex in girls at risk compared to girls at low risk. Results suggest that differences observed may constitute putative intermediate phenotypes for ED, although this requires further study with larger samples. Findings are important as they support hypothesis of altered set-shifting as an endophenotype for ED. They also provide evidence of alterations in ventral (limbic) neurcircuit that includes the amygdala and caudate, both of which are of importance for identifying emotional stimuli and generation of affective response to these as well as playing a role in reward processes and behaviour regulation.

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