Sex differences in regional gray matter density in pre-adolescent binge eating disorder: a voxel-based morphometry study.

BACKGROUND: Binge eating disorder (BED) is a pernicious psychiatric disorder which is linked with broad medical and psychiatric morbidity, and obesity. While BED may be characterized by altered cortical morphometry, no evidence to date examined possible sex-differences in regional gray matter characteristics among those with BED. This is especially important to consider in children, where BED symptoms often emerge coincident with rapid gray matter maturation. METHODS: Pre-adolescent, 9-10-year old boys (N = 38) and girls (N = 33) with BED were extracted from the 3.0 baseline (Year 0) release of the Adolescent Brain Cognitive Development Study. We investigated sex differences in gray matter density (GMD) via voxel-based morphometry. Control sex differences were also assessed in age and body mass index and developmentally matched control children (boys N = 36; girls N = 38). Among children with BED, we additionally assessed the association between dorsolateral prefrontal (dlPFC) GMD and parent-reported behavioral approach and inhibition tendencies. RESULTS: Girls with BED uniquely demonstrate diffuse clusters of greater GMD (p < 0.05, Threshold Free Cluster Enhancement corrected) in the (i) left dlPFC (p = 0.003), (ii) bilateral dmPFC (p = 0.004), (iii) bilateral primary motor and somatosensory cortex (p = 0.0003) and (iv) bilateral precuneus (p = 0.007). Brain-behavioral associations suggest a unique negative correlation between GMD in the left dlPFC and behavioral approach tendencies among girls with BED. CONCLUSIONS: Early-onset BED may be characterized by regional sex differences in terms of its underlying gray matter morphometry.

Updates in the treatment of eating disorders in 2021: a year in review in Eating Disorders: The Journal of Treatment & Prevention.

An array of novel and important studies advancing the treatment of eating disorders (EDs) were published in Eating Disorders: The Journal of Treatment & Prevention in 2021. In an unprecedented year of challenges to the delivery of ED treatment, and the volume of patients requiring it, this review summarizes the recent contributions to the literature on the treatment of EDs. Notably, an emphasis on assessing and addressing barriers to collaborative care offers much promise in augmenting treatment delivery and patient outcomes. In keeping with recent data illustrating an elevated risk for increased symptom severity during the COVID-19 pandemic, a focus on further disseminating treatments to higher level of care settings will be critical as the field meets the challenge presented by COVID-19. In addition, we review recent findings relating to the broader assessment and treatment of comorbidities which exacerbate ED symptom severity-which offer critical insights into the development of novel treatments. These recent contributions pave the way for more nuanced approaches to treating EDs across the diagnostic spectrum.

Methamphetamine use and disordered eating: a case study of an understudied phenomenon.

PURPOSE: Little is known about co-occurring eating disorder (ED) psychopathology and methamphetamine use. Even less is known about the precise nature of how ED symptom profiles and methamphetamine use interact and influence treatment-related practices. The purpose of this study is to report a case study of a patient with co-occuring ED psychopathology and methamphetamine use. METHOD: We present the case of a White woman in her mid-30s with a long history of body image-related worries and methamphetamine use. She presented for psychiatric assessment initially for methamphetamine addiction and paranoid psychotic symptom treatment, but also reported significant weight and shape concerns. RESULTS: Over the duration of approximately 1 year of treatment, this patient experienced a reduction in her methamphetamine use, but an increased concern around how abstinence may portend weight gain. She reported that a return to methamphetamine use was underpinned by a drive to manage her weight. CONCLUSION: With increasing evidence documenting the elevated co-occurrence of methamphetamine use and ED symptomatology, this case report highlights the potential mechanisms by which these respective psychopathologies may be exacerbate the other, rendering both increased risk of relapse, and body dissatisfaction. LEVEL OF EVIDENCE: Level IV, case study.

Regional gray matter abnormalities in pre-adolescent binge eating disorder: A voxel-based morphometry study.

BACKGROUND: Binge eating disorder (BED) is a pernicious psychiatric disorder which is linked with an array of multisystemic organ morbidity, broad psychiatric morbidity, and obesity. Despite behavioral markers often developing in early childhood, the neurobiological markers of early-onset BED remain understudied, and developmental pathophysiology remains poorly understood. METHODS: 71 preadolescent children (aged 9-10-years) with BED and 74 age, BMI and developmentally matched control children were extracted from the 3.0 baseline (Year 0) release of the Adolescent Brain Cognitive Development (ABCD) Study. We investigated group differences in gray matter density (GMD) via voxel-based morphometry (VBM). We additionally performed region of interest analyses, assessing the association between GMD in nodes of the reward (orbitofrontal cortex; OFC) and inhibitory control (dorsolateral prefrontal cortex; dlPFC) networks, and parent-reported behavioral inhibition and approach tendencies. RESULTS: Diffuse elevations in cortical GMD were noted in those with BED, which spanned prefrontal, parietal, and temporal regions. No areas of reduced GMD were noted in those with BED. No alterations in subcortical GMD were noted. Brain-behavioral associations suggest a distinct and negative relationship between GMD in the OFC and dlPFC, respectively, and self-reported markers of hedonic behavioral approach tendencies. CONCLUSIONS: Early-onset BED may be characterized by diffuse morphological abnormalities in gray matter density, suggesting alterations in cortical architecture which may reflect decreased synaptic pruning and arborization, or decreased myelinated fibers and therefore inter-regional afferents.