Neural Correlates of Autistic Individuals With Anorexia Nervosa

University of Aberdeen

Status

Enrolling

Conditions

Anorexia Nervosa

Autism

Treatments

Other: Demographic and Behavioural Questionnaires

Other: Single Research Visit 3T MRI Research Scan

Study type

Observational

Funder types

Other

Identifiers

NCT07098156

349220

Details and patient eligibility

About

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

Full description

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.

Enrollment

50 estimated patients

Sex

All

Ages

25 to 45 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

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

Exclusion criteria

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