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Multimodal Longitudinal and Predictive Modelling to Understand Eating Disorder Development (ESTRA-BED)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT06050616
Recruitment Status : Recruiting
First Posted : September 22, 2023
Last Update Posted : May 9, 2024
Sponsor:
Collaborators:
Delosis Limited
NeuroSpin
Information provided by (Responsible Party):
Zuo Zhang, King's College London

Brief Summary:

The aim of this observational study is to elucidate the biopsychosocial (including neural, psychological, and social) basis of eating disorders (EDs).

The investigators will use functional and structural neuroimaging, psychological as well as environmental data to identify both shared and distinct behavioural/neural processes across ED diagnoses. The investigators will use advanced statistical methods such as machine learning based models.

The investigators will carry out analysis on the data already collected in the STRATIFY (Brain network based stratification of reinforcement-related disorders, IRAS ID 218030) and IMAGEN studies (Reinforcement-related behaviour in normal brain function and psychopathology, reference PNM/10/11-126), including participants with Anorexia Nervosa (N=60), Bulimia Nervosa (N=52), Binge eating disorder (N=27) and healthy controls. In addition, the investigators will recruit 30 new participants with a binge eating disorder using the original STRATIFY study protocol to enlarge the binge eating disorder group, so that its sample size is comparable to the other groups.

Participants will complete online questionnaires, take an online clinical interview, and undergo a research visit, including brain scans, collection of blood and urine samples, and assessment using a range of cognitive and behavioural measures.


Condition or disease Intervention/treatment
Binge-Eating Disorder Anorexia Nervosa Bulimia Nervosa Other: MRI scans Other: Psychological measures Other: Life experiences Biological: Blood and urine samples Other: Mental health symptoms

Detailed Description:

Eating disorders (EDs) are serious mental illnesses that involve a range of disturbed emotions, cognitions, and behaviours related to body shape/weight and eating. The causes of EDs are complex and involve many biological, psychological, and social factors. The investigators are interested in understanding the connections between a range of biological, psychological, social factors and eating disorders. This will help us understand the basis of diagnostic classifications, which will promote early intervention and the identification of new areas to target in treatments.

The investigators will analyse the data already collected in the STRATIFY (Brain network based stratification of reinforcement-related disorders, IRAS ID 218030) and IMAGEN studies (Reinforcement-related behaviour in normal brain function and psychopathology, reference PNM/10/11-126), including patients with Anorexia Nervosa (N=60), Bulimia Nervosa (N=52), Binge eating disorder (N=27) and healthy controls. In addition, the investigators will recruit 30 new participants with a current binge eating disorder using the original STRATIFY protocol to enlarge the binge eating disorder group, so that its sample size is comparable to the other groups. Due to funding limitations, 18 participants will take part in the full assessments, including the research visit (MRI scans, blood, and urine samples). The other 12 participants will take part in the online parts of the assessments only, without the research visit.

The investigators will use neuroimaging, cognitive, psychological and life events data to assess if behavioural/neural processes differentiate one eating disorder from another and if there are similar processes across ED diagnoses. The investigators will use advanced statistical methods such as machine learning based models.

The investigators will further test whether the identified behavioural and neurological processes can predict future disease risk, by using data from the IMAGEN study - a longitudinal population-based genetic and imaging study - that involves over 2000 participants followed up from adolescence to early adulthood.

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Study Type : Observational
Estimated Enrollment : 30 participants
Observational Model: Case-Control
Time Perspective: Cross-Sectional
Official Title: Multimodal Longitudinal and Machine Learning-based Predictive Modelling to Understand the Development of Eating Disorders
Actual Study Start Date : November 15, 2023
Estimated Primary Completion Date : December 2024
Estimated Study Completion Date : December 2024

Group/Cohort Intervention/treatment
binge eating disorder
Participants with a current binge eating disorder, as assessed by the Eating Disorder Diagnostic Screen (DSM-5 version). These participants have been recruited as part of the STRATIFY study. An additional 30 participants will be recruited in this study to enlarge the sample size, using the same study procedure and assessments in the STRATIFY study.
Other: MRI scans

Neuroimaging data will be collected with magnetic resonance imaging (MRI).

Structural neuroimaging will include T1 and T2-weighted scans, and diffusion tensor imaging (DTI).

Functional neuroimaging will include scans under the stop-signal task, monetary incentive delay task, and emotional faces task, and resting state.


Other: Psychological measures

Cognitive performance assessed by Wechsler Adult Intelligence Scale 4th Edition.

Personalities assessed by NEO Five-Factor Inventory (NEO-FFI), Substance Use Risk Profile Scale (SURPS), and Temperament and Character Inventory (TCI).

Other psychological assessments include Interpersonal Reactivity Index, Perceived Stress Scale, Kirby Monetary Choice Questionnaire, Passive Avoidance Learning Paradigm, and Stimulus-response compatibility.


Other: Life experiences
Self-report questionnaires on experiences of bullying and trauma.

Biological: Blood and urine samples
Blood and urine samples will be collected but will not undergo analysis in this study. Instead, these samples will be stored in a biobank for potential analysis in future research.

Other: Mental health symptoms

Symptoms of depression measured by the Patient Health Questionnaire -8.

Symptoms of generalised anxiety, obsessives compulsive disorder, attention deficit hyperactivity disorder, social phobia, specific phobia, agoraphobia, post-traumatic stress disorder, measured by the Development and Well-Being Assessment (DAWBA).

Harmful drinking measured by the Alcohol use disorders identification test.

Drug use measured by the European School Survey Project on Alcohol and Other Drugs (ESPAD).

Suicide risk measured by the the Mini International Neuropsychiatric Interview.


anorexia nervosa
Participants with current anorexia nervosa, as assessed by the Eating Disorder Diagnostic Screen (DSM-5 version).. These participants have been recruited as part of the STRATIFY study. Their data will be used in this study.
Other: MRI scans

Neuroimaging data will be collected with magnetic resonance imaging (MRI).

Structural neuroimaging will include T1 and T2-weighted scans, and diffusion tensor imaging (DTI).

Functional neuroimaging will include scans under the stop-signal task, monetary incentive delay task, and emotional faces task, and resting state.


Other: Psychological measures

Cognitive performance assessed by Wechsler Adult Intelligence Scale 4th Edition.

Personalities assessed by NEO Five-Factor Inventory (NEO-FFI), Substance Use Risk Profile Scale (SURPS), and Temperament and Character Inventory (TCI).

Other psychological assessments include Interpersonal Reactivity Index, Perceived Stress Scale, Kirby Monetary Choice Questionnaire, Passive Avoidance Learning Paradigm, and Stimulus-response compatibility.


Other: Life experiences
Self-report questionnaires on experiences of bullying and trauma.

Biological: Blood and urine samples
Blood and urine samples will be collected but will not undergo analysis in this study. Instead, these samples will be stored in a biobank for potential analysis in future research.

Other: Mental health symptoms

Symptoms of depression measured by the Patient Health Questionnaire -8.

Symptoms of generalised anxiety, obsessives compulsive disorder, attention deficit hyperactivity disorder, social phobia, specific phobia, agoraphobia, post-traumatic stress disorder, measured by the Development and Well-Being Assessment (DAWBA).

Harmful drinking measured by the Alcohol use disorders identification test.

Drug use measured by the European School Survey Project on Alcohol and Other Drugs (ESPAD).

Suicide risk measured by the the Mini International Neuropsychiatric Interview.


bulimia nervosa
Participants with current bulimia nervosa, as assessed by the Eating Disorder Diagnostic Screen (DSM-5 version). These participants have been recruited as part of the STRATIFY study. Their data will be used in this study.
Other: MRI scans

Neuroimaging data will be collected with magnetic resonance imaging (MRI).

Structural neuroimaging will include T1 and T2-weighted scans, and diffusion tensor imaging (DTI).

Functional neuroimaging will include scans under the stop-signal task, monetary incentive delay task, and emotional faces task, and resting state.


Other: Psychological measures

Cognitive performance assessed by Wechsler Adult Intelligence Scale 4th Edition.

Personalities assessed by NEO Five-Factor Inventory (NEO-FFI), Substance Use Risk Profile Scale (SURPS), and Temperament and Character Inventory (TCI).

Other psychological assessments include Interpersonal Reactivity Index, Perceived Stress Scale, Kirby Monetary Choice Questionnaire, Passive Avoidance Learning Paradigm, and Stimulus-response compatibility.


Other: Life experiences
Self-report questionnaires on experiences of bullying and trauma.

Biological: Blood and urine samples
Blood and urine samples will be collected but will not undergo analysis in this study. Instead, these samples will be stored in a biobank for potential analysis in future research.

Other: Mental health symptoms

Symptoms of depression measured by the Patient Health Questionnaire -8.

Symptoms of generalised anxiety, obsessives compulsive disorder, attention deficit hyperactivity disorder, social phobia, specific phobia, agoraphobia, post-traumatic stress disorder, measured by the Development and Well-Being Assessment (DAWBA).

Harmful drinking measured by the Alcohol use disorders identification test.

Drug use measured by the European School Survey Project on Alcohol and Other Drugs (ESPAD).

Suicide risk measured by the the Mini International Neuropsychiatric Interview.


healthy controls
Healthy controls are selected from the IMAGEN study at the third follow-up (~age 22 years) who do not exhibit any psychiatric disorder. Their data will be used in this study. IMAGEN and STRATIFY are sister studies that employ matched study protocols.
Other: MRI scans

Neuroimaging data will be collected with magnetic resonance imaging (MRI).

Structural neuroimaging will include T1 and T2-weighted scans, and diffusion tensor imaging (DTI).

Functional neuroimaging will include scans under the stop-signal task, monetary incentive delay task, and emotional faces task, and resting state.


Other: Psychological measures

Cognitive performance assessed by Wechsler Adult Intelligence Scale 4th Edition.

Personalities assessed by NEO Five-Factor Inventory (NEO-FFI), Substance Use Risk Profile Scale (SURPS), and Temperament and Character Inventory (TCI).

Other psychological assessments include Interpersonal Reactivity Index, Perceived Stress Scale, Kirby Monetary Choice Questionnaire, Passive Avoidance Learning Paradigm, and Stimulus-response compatibility.


Other: Life experiences
Self-report questionnaires on experiences of bullying and trauma.

Biological: Blood and urine samples
Blood and urine samples will be collected but will not undergo analysis in this study. Instead, these samples will be stored in a biobank for potential analysis in future research.

Other: Mental health symptoms

Symptoms of depression measured by the Patient Health Questionnaire -8.

Symptoms of generalised anxiety, obsessives compulsive disorder, attention deficit hyperactivity disorder, social phobia, specific phobia, agoraphobia, post-traumatic stress disorder, measured by the Development and Well-Being Assessment (DAWBA).

Harmful drinking measured by the Alcohol use disorders identification test.

Drug use measured by the European School Survey Project on Alcohol and Other Drugs (ESPAD).

Suicide risk measured by the the Mini International Neuropsychiatric Interview.





Primary Outcome Measures :
  1. Eating disorder diagnosis [ Time Frame: Administered at the screening phase and within two weeks of the other assessments. ]
    The Eating Disorder Diagnostic Scale (DSM-5 version) will be used to assess whether the participants meet the diagnostic criteria of anorexia nervosa, bulimia nervosa, or binge eating disorder.


Biospecimen Retention:   Samples With DNA
Two EDTA tubes and 2 Tempus tubes of blood will be collected. A urine sample (stored in 2 x 10ml tubes) will be collected.


Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years to 30 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Participants will be recruited via online and physical posters among people living in or near London, UK, and from eating disorder clinics in London.
Criteria

Inclusion Criteria:

  • Male and female volunteers, all ethnicities.
  • Age of 18 to 30.
  • Sufficient in English (due to validity of neuropsychological measures).
  • current DSM-5 binge eating disorder.

Exclusion Criteria:

  • People with brain injuries including stroke, tumours, epilepsy, neurodegenerative or other neurological disorders.
  • People who are deaf or have significant hearing problems or a hearing aid that cannot be removed.
  • People who are blind or have significant vision difficulties (correct near vision of 20/100 or worse in both eyes).
  • People with type I or type II diabetes.
  • People who are heavily medicated for serious illness (other than for mental illness).
  • People who are pregnant or any possibility of being pregnant.
  • People with restricted mobility, including inability to lie flat for 1.5 hours.
  • People who have a history of anorexia nervosa and have not restored their body weight in the past 6 months.
  • People who have participated in the STRATIFY, ESTRA or IMAGEN studies previously.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT06050616


Contacts
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Contact: Zuo Zhang, PhD +44 (0)20 7848 7883 zuo.zhang@kcl.ac.uk

Locations
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United Kingdom
Institute of Psychiatry, Psychology & Neuroscience, King's College London Recruiting
London, United Kingdom, SE5 8AF
Contact: Zuo Zhang, PhD         
Sponsors and Collaborators
King's College London
Delosis Limited
NeuroSpin
Investigators
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Principal Investigator: Zuo Zhang, PhD King's College London
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Responsible Party: Zuo Zhang, Principal Investigator, King's College London
ClinicalTrials.gov Identifier: NCT06050616    
Other Study ID Numbers: IRAS326571
MRF-058-0014-F-ZHAN-C0866 ( Other Grant/Funding Number: Medical Research Foundation, UK )
23/NW/0232 ( Other Identifier: NorthWest-Greater Manchester South Research Ethics Committee )
First Posted: September 22, 2023    Key Record Dates
Last Update Posted: May 9, 2024
Last Verified: May 2024
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: All collected individual participant data are to be shared. Data will be pseudonymised before sharing.
Supporting Materials: Study Protocol
Time Frame: starting 6 months after publication of the research findings
Access Criteria: A short data access application must be submitted to the principle investigator, including specific research questions, choice of variables, and plans for analysis and publication. The principle investigator will discuss with the STRATIFY Executive Committee (chaired by the Centre for Population Neuroscience and Stratified Medicine, Charité - Universitätsmedizin Berlin) about the application, and inform the applicant of the outcome.

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Zuo Zhang, King's College London:
Eating Disorders
Binge-Eating Disorder
Anorexia Nervosa
Bulimia Nervosa
Neuroimaging
Additional relevant MeSH terms:
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Anorexia
Bulimia
Feeding and Eating Disorders
Anorexia Nervosa
Binge-Eating Disorder
Bulimia Nervosa
Mental Disorders
Signs and Symptoms, Digestive
Hyperphagia