Neural Correlates of Autistic Individuals With Anorexia Nervosa

Официальное название

Neuroanatomical Differences Associated With Anorexia Nervosa and Masking Behaviour in Autistic Individuals

Обзор

Masking is a behaviour or strategy used by many Autistic people to appear non-Autistic and blend in with a neurotypical society. The goal of this observational study is to understand the relationship between masking, anorexia nervosa symptoms and brain structure in Autistic people. The main questions this study aims to answer are: * Do Autistic individuals with anorexia nervosa show differences in structure or function of the brain relation to Autistic individuals without anorexia nervosa? * Do Autistic individuals with anorexia nervosa display higher levels of masking than Autistic individuals without anorexia nervosa? * Are there indeed relationships between levels of masking, anorexia nervosa symptoms and brain structure in Autistic people? Researchers will compare Autistic people without anorexia nervosa to Autistic people with anorexia nervosa to see if there are differences between groups. Participants will: * Complete a series of questionnaires focused on eating disorder symptoms, autistic traits, autistic masking and psychological well-being * Undergo an MRI scan at the Aberdeen Royal Infirmary

Подробное описание

Autism is a neurodevelopmental condition and presents as a distinct neurotype, characterised by a wide range of social and behavioural differences, including divergences in cognitive thinking and methods of communication. Autism shares significant behavioural features with restrictive eating disorders (EDs) such as anorexia nervosa (AN). Those with AN exhibit significantly elevated levels of Autistic characteristics, ranging between 2%-53%. Importantly, a characteristic shown by some Autistic people is the presence of masking, a term describing a strategy used by Autistic people, whether conscious or unconscious, to 'blend in' with neurotypical peers. While initially overlooked, it is now well-known that masking behaviour can produce detrimental effects on Autistic individuals' mental health. The presence of masking behaviour has been associated with increased levels of physical and mental exhaustion, anxiety/depression, and importantly, an increased presence of EDs.

The Eating Disorder and Autism Collaborative (EDAC) used an arts-based method called Photovoice to capture the experiences of Autistic individuals with lived/living experience of an ED. Participants commented on the how an ED can serve as a means to mask or camouflage within a neurotypical world (e.g., an Autistic person may use restrictive eating or excessive exercise as a means with which to 'fit in' with their peers). Magnetic resonance imaging (MRI) research can assist in understanding which regions of the brain are associated with masking behaviour, and whether there are differences in brain function/structure in Autistic individuals with versus without an ED.

Structural magnetic resonance imaging (MRI) research reports similarities in brain structure between those with AN and Autistic individuals, reporting differential structure of the amygdala, cerebellum, insula, cingulate cortex, as well as orbitofrontal and frontal cortex in both groups. Shared differences extend to neuroanatomical parameters essential for brain development and connectivity, such as cortical thickness and surface area. Further, there are no studies investigation structural correlates with masking behaviour, or distinct aspects of social camouflage such as masking, assimilation and compensation. Further research is necessary to disentangle the complex relationship between Autistic characteristics and symptomatology associated with restrictive EDs.

The investigators believe that by further understanding the brain structure and function associated with ED symptomatology and masking behaviour in Autistic individuals can assist with the development of novel or tailored interventions for EDs in this community.

Вмешательства

• Другое Single Research Visit 3T MRI Research Scan
  Single research visit scan performed with a 3T magnetic resonance imaging scanner.
• Другое Demographic and Behavioural Questionnaires
  A series of demographic and behavioural questionnaires to be completed by participants, either online or during the single study visit. Questionnaires include the Eating Disorder Examination Questionnaire, Autism Spectrum Quotient, Monotropism Questionnaire, Camouflaging Autistic Traits Questionnaire, Hospital Anxiety and Depression Scale, Adult Attention Deficit Hyperactivity Disorder Self-Report Scale, Work and Social Adjustment Scale, International Trauma Questionnaire and Leibowitz Social An

Первичные конечные точки

• Structural and Functional Brain Differences [Срок оценки: From enrolment to single research visit (up to 30 weeks).]
• Levels of Masking [Срок оценки: From enrolment to single research visit (up to 30 weeks).]
• Associations Between Masking, Anorexic Symptoms and Brain Structure [Срок оценки: From enrolment to single research visit (up to 30 weeks).]

Критерии участия

Критерии включения

Healthy Autistic Individuals (Autistic Controls) must:

• Be aged 25-45 years
• Be Autistic (clinically diagnosed and/or have an Autism Quotient (AQ-10) score of ≥6)
• Be able to provide informed consent for the study
• Be able to read, understand and respond to questionnaires in English
• Have no history of an eating disorder
• Willing to have an MRI scan in Aberdeen

Autistic Individuals with anorexia nervosa must:

• Be aged 25-45 years
• Be Autistic (clinically diagnosed and/or have an AQ-10 score of ≥6)
• Be able to provide informed consent to the study
• Be able to read, understand and respond to questionnaires in English
• Have a diagnosis of anorexia nervosa or a body mass index of <18.5
• Willing to have an MRI scan in Aberdeen

Критерии исключения

Individuals are not eligible for the study if they:

• Are aged <25 or >45 years
• Are not Autistic or not clinically diagnosed as Autistic and have an AQ-10 score of <6
• Are diagnosed with an eating disorder other than anorexia nervosa
• Have a history of brain injury (e.g., stroke)
• Be unable to provide informed consent for the study
• Have contraindications to MRI scanning, such has implantable cardiac devices
• Are unable to read, understand and respond to questionnaires in English
• As participants will need to consent to the study and complete questionnaires by themselves, individuals with intellectual disability will be excluded from this study

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Модель наблюдения

Случай-контроль

Центры проведения

Великобритания · 2 центра

• Lilian Sutton Building — Aberdeen
• NHS Grampian Eating Disorder Services — Aberdeen

Публикации

• Hull L, Mandy W, Lai MC, Baron-Cohen S, Allison C, Smith P, Petrides KV. Development and Validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q). J Autism Dev Disord. 2019 Mar;49(3):819-833. doi: 10.1007/s10803-018-3792-6. PMID 30361940
• Leppanen J, Sedgewick F, Cardi V, Treasure J, Tchanturia K. Cortical morphometry in anorexia nervosa: An out-of-sample replication study. Eur Eat Disord Rev. 2019 Sep;27(5):507-520. doi: 10.1002/erv.2686. Epub 2019 Jun 6. PMID 31172616
• Nickel K, Joos A, Tebartz van Elst L, Matthis J, Holovics L, Endres D, Zeeck A, Hartmann A, Tuscher O, Maier S. Recovery of cortical volume and thickness after remission from acute anorexia nervosa. Int J Eat Disord. 2018 Sep;51(9):1056-1069. doi: 10.1002/eat.22918. Epub 2018 Sep 13. PMID 30212599
• Vijayakumar N, Allen NB, Youssef G, Dennison M, Yucel M, Simmons JG, Whittle S. Brain development during adolescence: A mixed-longitudinal investigation of cortical thickness, surface area, and volume. Hum Brain Mapp. 2016 Jun;37(6):2027-38. doi: 10.1002/hbm.23154. Epub 2016 Mar 4. PMID 26946457
• Sader M, Williams JHG, Waiter GD. A meta-analytic investigation of grey matter differences in anorexia nervosa and autism spectrum disorder. Eur Eat Disord Rev. 2022 Sep;30(5):560-579. doi: 10.1002/erv.2915. Epub 2022 May 7. PMID 35526083
• Alfano V, Mele G, Cotugno A, Longarzo M. Multimodal neuroimaging in anorexia nervosa. J Neurosci Res. 2020 Nov;98(11):2178-2207. doi: 10.1002/jnr.24674. Epub 2020 Aug 7. PMID 32770570
• Doyle-Thomas KA, Kushki A, Duerden EG, Taylor MJ, Lerch JP, Soorya LV, Wang AT, Fan J, Anagnostou E. The effect of diagnosis, age, and symptom severity on cortical surface area in the cingulate cortex and insula in autism spectrum disorders. J Child Neurol. 2013 Jun;28(6):732-9. doi: 10.1177/0883073812451496. Epub 2012 Jul 25. PMID 22832774
• Sydnor LM, Aldinger KA. Structure, Function, and Genetics of the Cerebellum in Autism. J Psychiatr Brain Sci. 2022;7:e220008. doi: 10.20900/jpbs.20220008. Epub 2022 Oct 25. PMID 36425354

Идентификаторы

NCT: NCT07098156 · 349220

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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