EEG for Prediction Error in Anorexia
Trial Summary
What is the purpose of this trial?
Adolescent anorexia nervosa (AN) is an eating disorder associated with intense fear of weight gain, food refusal, and severe weight loss. AN is the third most common chronic illness among adolescent females with a mortality rate 12 times higher than expected for females 15-24 years old. Little is known about biomarkers in adolescent AN. Neuroimaging studies have repeatedly suggested altered reward processing in AN including in studies using the dopamine associated prediction error (PE) model. The brain PE response is elicited during unexpected receipt or omission of reward stimuli and thought to reflect the functionality of brain dopamine circuits. This is an important research direction as the dopamine system can be manipulated pharmacologically. In ill and recovered adult AN, unexpected or randomly applied sucrose taste stimuli evoked higher insular and striatal responses and unexpected omission or receipt of monetary or taste reward was associated with a similar response pattern in adolescent AN. PE was also inversely related to weight gain in treatment. Thus, PE brain response promises to be an important biological marker for adolescent AN with predictive value for treatment outcome. However, functional brain imaging is costly, prohibitive for instance for individuals with braces or other metal in their body and only available at certain centers. In order to study PE in AN in larger scale studies, a more practical approach and method need to be developed. In this application, we will use the exploratory/developmental R21 mechanism to develop a study protocol using electroencephalography (EEG) to study PE signals in adolescent AN. Recent studies in healthy individuals support that this is a valid approach. Our primary goal for this study is to test the feasibility of the use of EEG for prediction error and reversal learning studies in AN with the longer term goal of replacing fMRI that is costly and associated with frequent participant rule out. In Aim 1. we test the feasibility of adapting a computational taste PE reinforcement learning paradigm from fMRI to EEG in adolescents with AN and healthy controls. We expect that we will find internal consistency of taste PE brain response across fMRI and EEG in adolescents with AN as well as age-matched healthy controls, within each group. We further expect that we will find preliminary evidence that the EEG paradigm will be able to discriminate the AN group from the HC adolescents based on feedback related negativity and higher event-related potential amplitudes, which will correlate with fMRI PE brain response. In Aim 2., we test whether a monetary PE paradigm will show similar EEG brain response as taste PE in Aim 1. to establish the generalizability of EEG taste and non-taste paradigms. The development of an EEG based reward PE study paradigm will enable us in the future to conduct large-scale studies that will be less costly and independent from brain imaging centers that are only available to a small subset of adolescents with AN.
Will I have to stop taking my current medications?
The trial requires that participants with anorexia nervosa must not have used anti-psychotic or other dopamine-acting medications, including stimulants, within the past week at the time of MRI. For healthy controls, current medications other than birth control pills or IUDs are not allowed.
What data supports the effectiveness of the treatment Prediction error tasks for anorexia?
The research suggests that EEG (a test that measures brain activity) can identify differences in brain activity in people with anorexia, which might help predict how they respond to treatments. This implies that using EEG to understand prediction errors (differences between expected and actual outcomes) could potentially guide more effective treatment strategies for anorexia.12345
Is EEG safe for use in humans?
How does the EEG treatment for anorexia differ from other treatments?
The EEG treatment for anorexia is unique because it uses brain wave monitoring to understand and predict error processing in patients, which is different from traditional treatments that focus on nutrition and psychological therapy. This approach aims to address the neurological aspects of anorexia by analyzing brain activity patterns, potentially offering new insights into the condition.46789
Research Team
Guido Frank, MD
Principal Investigator
University of California, San Diego
Eligibility Criteria
This trial is for girls aged 11-17 with Anorexia Nervosa (AN), specifically the restricting type, and healthy controls within a similar age range. Participants must have a body weight below 17.5 BMI if diagnosed with AN or between 90-110% of average body weight if they are healthy controls. All participants should be right-handed as per the Edinburgh Handedness Inventory, speak English primarily, and for those with AN, be in their first weeks of treatment at specified centers.Inclusion Criteria
Exclusion Criteria
Timeline
Screening
Participants are screened for eligibility to participate in the trial
EEG Session for Taste Prediction Error
Participants undergo an EEG session to perform a taste prediction error paradigm
EEG Session for Monetary Prediction Error
Participants undergo an EEG session to perform a monetary reward prediction error paradigm
Follow-up
Participants are monitored for safety and effectiveness after EEG sessions
Treatment Details
Interventions
- Prediction error tasks
Find a Clinic Near You
Who Is Running the Clinical Trial?
University of California, San Diego
Lead Sponsor