Fronto-temporal dysfunction in appetitive regulation of bulimia nervosa with affective disorders: A regional homogeneity and remote connectivity pattern analysis.

The aim of this study was to assess brain functional alterations in BN patients with affective disorders and their association with maladaptive eating behaviors. A total of 42 BN patients with affective disorders (anxiety and depression) and 47 healthy controls (HCs) were enrolled in this study. The resting-state fMRI data were analyzed for functional changes as indicated by regional homogeneity based on Kendall's coefficient of concordance (KCC-ReHo) and seed-based functional connectivity (FC). A principal component analysis (PCA) model was used to identify the commonalities within the behavioral questionnaires from the BN group. Patients in the BN group showed decreased ReHo in the bilateral middle frontal gyrus (MFG) and right supramarginal gyrus (SMG). Additionally, the BN group showed increased FC between the left MFG and the right inferior temporal gyrus (ITG); decreased FC between the right MFG and the bilateral insula and the left middle temporal gyrus (MTG); and decreased FC between the right SMG and the left superior temporal gyrus (STG) and right inferior frontal gyrus (IFG). In the FC-behavior association analysis, the second principal component (PC2) was negatively correlated with FC between the left MFG and the right ITG. Based on a brain functional analysis (ReHo and FC), this study revealed significant aberrant changes in the frontal-temporal regions of BN patients with affective disorders. These regions, which serve as fronto-temporal circuitry, are associated with restraint and emotional eating behaviors. Our findings shed new light on the neural mechanisms underlying the condition. • Anxiety and depression are the most common affective comorbidities in patients with bulimia nervosa • Little is known about the neuropathic mechanisms underlying comorbid affective disorders in bulimia nervosa • Potential disturbance in the recruitment of fronto-temporal circuitry in BN patients with comorbid affective disorders • The brain functional changes were correlated with disordered eating behaviors • Interplay between BN-specific and comorbid psychopathological effects may contribute to specific brain functional activity [ABSTRACT FROM AUTHOR]