OBJECTIVE Bulimia nervosa (BN) is characterized by excessive attention to self and specifically to body shape and weight, but the ventral attention (VAN) and default mode (DMN) networks that support attentional and self-referential processes are understudied in BN. This study assessed whether altered functional connectivity within and between these networks contributes to such excessive concerns in adolescents with BN early the course of the disorder. METHOD Resting-state functional magnetic resonance images were acquired from 33 adolescents with BN and 37 healthy control adolescents (12-21 years) group matched by age and body mass index. Region-of-interest analyses were performed to examine group differences in functional connectivity within and between the VAN and DMN. In addition associations of VAN-DMN connectivity with BN symptoms, body shape/weight concerns, and sustained attention were explored using the Continuous Performance Test (CPT). RESULTS Compared with control adolescents, those with BN showed significantly increased positive connectivity between the right ventral supramarginal gyrus and all DMN regions and between the right ventrolateral prefrontal cortex and the left lateral parietal cortex. Within-network connectivity did not differ between groups. VAN-DMN connectivity was associated with BN severity and body shape/weight concerns in the BN group. No significant group-by-CPT interactions on VAN-DMN connectivity were detected. CONCLUSION Increased positive VAN-DMN connectivity in adolescents with BN could reflect abnormal engagement of VAN-mediated attentional processes at rest, perhaps related to their excessive attention to self-referential thoughts about body shape/weight. Future studies should further investigate these circuits as targets for the development of early interventions aimed at decreasing excessive body shape/weight concerns.

中文翻译：

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青少年贪食症患者的腹侧注意力和默认模式网络之间的功能连接性增强。

目的神经性贪食症（Blimia nervosa，BN）的特征是过度关注自我，尤其是身体的形状和体重，但在BN中研究的腹侧注意力（VAN）和默认模式（DMN）网络支持注意力和自我参照过程。这项研究评估了这些网络内部和网络之间的功能连接性改变是否会导致患病早期的BN青少年过度关注。方法从年龄和体重指数匹配的33例BN青少年和37例健康对照青少年（12-21岁）中获取静止状态功能磁共振图像。进行了感兴趣区域分析，以检查VAN和DMN之间以及之间的功能连接方面的组差异。此外，VAN-DMN连通性与BN症状相关联，使用持续表现测试（CPT）探索了对身体形状/体重的关注，以及对持续关注的关注。结果与正常青少年相比，BN患儿的右上腹上回和所有DMN区域之间以及右腹外侧前额叶皮层和左侧顶叶皮质之间的正连通性显着增加。组内的网络内连接没有差异。VAN-DMN连通性与BN组的BN严重程度和身体形状/体重有关。在VAN-DMN连接上未检测到显着的按CPT分组交互。结论BN青少年中VAN-DMN阳性连接的增加可能反映了VAN介导的静息注意过程异常参与，可能与他们过分关注身体形状/体重的自我指称想法有关。未来的研究应进一步调查这些回路，将其作为开发早期干预措施的目标，以减少过多的身体形状/体重问题。