Clinical trial demonstrates reduced attention and sensorimotor connectivity in bulimia nervosa, indicating macroscopic network reconfiguration during recovery.
Key Points
To determine how macroscopic resting-state functional brain network connectivity remodels over a treatment period and relates to reductions in eating impulsivity among patients with bulimia nervosa.
Assessed 58 patients with bulimia nervosa and 58 healthy controls at baseline and follow-up using resting-state functional magnetic resonance imaging (rs-fMRI; ChiCTR2200066885).
Applied Network-Based Statistic (NBS) edgewise paired comparisons to identify longitudinal whole-brain connectivity alterations in patients with bulimia nervosa.
Evaluated the identified component across groups using a Group × Time interaction model and examined brain-behavior associations using Spearman and partial Spearman correlations.
Patients with bulimia nervosa showed significant clinical improvements in depressive symptoms and externally driven eating behavior at follow-up.
Within-group NBS analysis revealed a 23-edge component with significantly reduced functional connectivity at follow-up (p < 0.05, family-wise error corrected), concentrated in dorsal attention, ventral attention/salience, and somatomotor networks.
Mean connectivity of the identified component decreased significantly more in bulimia nervosa than in healthy controls over time (Group × Time interaction β = -0.053, p = 0.027).