Neural Correlates of Autistic Individuals With Anorexia Nervosa
NCT ID: NCT07098156
Last Updated: 2025-08-01
Study Results
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Basic Information
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RECRUITING
50 participants
OBSERVATIONAL
2025-07-31
2026-01-31
Brief Summary
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* 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
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Detailed Description
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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.
Conditions
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Study Design
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CASE_CONTROL
PROSPECTIVE
Study Groups
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Autistic Control
Autistic individuals with no history of an eating disorder
Single Research Visit 3T MRI Research Scan
Single research visit scan performed with a 3T magnetic resonance imaging scanner.
Demographic and Behavioural Questionnaires
A series of demographic and behavioural questionnaires to be completed by participants, either online or during the single study visit. Questionnaires include the Eating Disorder Examination Questionnaire, Autism Spectrum Quotient, Monotropism Questionnaire, Camouflaging Autistic Traits Questionnaire, Hospital Anxiety and Depression Scale, Adult Attention Deficit Hyperactivity Disorder Self-Report Scale, Work and Social Adjustment Scale, International Trauma Questionnaire and Leibowitz Social Anxiety Scale. These questionnaires will also include a demographic questionnaire to acquire measures such as age, BMI, co-occurring conditions, etc.
Autistic Patient
Autistic individuals acutely ill with anorexia nervosa
Single Research Visit 3T MRI Research Scan
Single research visit scan performed with a 3T magnetic resonance imaging scanner.
Demographic and Behavioural Questionnaires
A series of demographic and behavioural questionnaires to be completed by participants, either online or during the single study visit. Questionnaires include the Eating Disorder Examination Questionnaire, Autism Spectrum Quotient, Monotropism Questionnaire, Camouflaging Autistic Traits Questionnaire, Hospital Anxiety and Depression Scale, Adult Attention Deficit Hyperactivity Disorder Self-Report Scale, Work and Social Adjustment Scale, International Trauma Questionnaire and Leibowitz Social Anxiety Scale. These questionnaires will also include a demographic questionnaire to acquire measures such as age, BMI, co-occurring conditions, etc.
Interventions
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Single Research Visit 3T MRI Research Scan
Single research visit scan performed with a 3T magnetic resonance imaging scanner.
Demographic and Behavioural Questionnaires
A series of demographic and behavioural questionnaires to be completed by participants, either online or during the single study visit. Questionnaires include the Eating Disorder Examination Questionnaire, Autism Spectrum Quotient, Monotropism Questionnaire, Camouflaging Autistic Traits Questionnaire, Hospital Anxiety and Depression Scale, Adult Attention Deficit Hyperactivity Disorder Self-Report Scale, Work and Social Adjustment Scale, International Trauma Questionnaire and Leibowitz Social Anxiety Scale. These questionnaires will also include a demographic questionnaire to acquire measures such as age, BMI, co-occurring conditions, etc.
Eligibility Criteria
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Inclusion Criteria
* 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
* 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
25 Years
45 Years
ALL
No
Sponsors
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NHS Grampian
OTHER_GOV
University of Aberdeen
OTHER
Responsible Party
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Locations
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Lilian Sutton Building
Aberdeen, Aberdeen City, United Kingdom
NHS Grampian Eating Disorder Services
Aberdeen, Aberdeen City, United Kingdom
Countries
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Central Contacts
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Facility Contacts
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References
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Hull L, Mandy W, Lai MC, Baron-Cohen S, Allison C, Smith P, Petrides KV. Development and Validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q). J Autism Dev Disord. 2019 Mar;49(3):819-833. doi: 10.1007/s10803-018-3792-6.
Leppanen J, Sedgewick F, Cardi V, Treasure J, Tchanturia K. Cortical morphometry in anorexia nervosa: An out-of-sample replication study. Eur Eat Disord Rev. 2019 Sep;27(5):507-520. doi: 10.1002/erv.2686. Epub 2019 Jun 6.
Nickel K, Joos A, Tebartz van Elst L, Matthis J, Holovics L, Endres D, Zeeck A, Hartmann A, Tuscher O, Maier S. Recovery of cortical volume and thickness after remission from acute anorexia nervosa. Int J Eat Disord. 2018 Sep;51(9):1056-1069. doi: 10.1002/eat.22918. Epub 2018 Sep 13.
Vijayakumar N, Allen NB, Youssef G, Dennison M, Yucel M, Simmons JG, Whittle S. Brain development during adolescence: A mixed-longitudinal investigation of cortical thickness, surface area, and volume. Hum Brain Mapp. 2016 Jun;37(6):2027-38. doi: 10.1002/hbm.23154. Epub 2016 Mar 4.
Sader M, Williams JHG, Waiter GD. A meta-analytic investigation of grey matter differences in anorexia nervosa and autism spectrum disorder. Eur Eat Disord Rev. 2022 Sep;30(5):560-579. doi: 10.1002/erv.2915. Epub 2022 May 7.
Alfano V, Mele G, Cotugno A, Longarzo M. Multimodal neuroimaging in anorexia nervosa. J Neurosci Res. 2020 Nov;98(11):2178-2207. doi: 10.1002/jnr.24674. Epub 2020 Aug 7.
Doyle-Thomas KA, Kushki A, Duerden EG, Taylor MJ, Lerch JP, Soorya LV, Wang AT, Fan J, Anagnostou E. The effect of diagnosis, age, and symptom severity on cortical surface area in the cingulate cortex and insula in autism spectrum disorders. J Child Neurol. 2013 Jun;28(6):732-9. doi: 10.1177/0883073812451496. Epub 2012 Jul 25.
Sydnor LM, Aldinger KA. Structure, Function, and Genetics of the Cerebellum in Autism. J Psychiatr Brain Sci. 2022;7:e220008. doi: 10.20900/jpbs.20220008. Epub 2022 Oct 25.
Fonville L, Giampietro V, Williams SC, Simmons A, Tchanturia K. Alterations in brain structure in adults with anorexia nervosa and the impact of illness duration. Psychol Med. 2014 Jul;44(9):1965-75. doi: 10.1017/S0033291713002389. Epub 2013 Sep 27.
Wronski ML, Geisler D, Bernardoni F, Seidel M, Bahnsen K, Doose A, Steinhauser JL, Gronow F, Boldt LV, Plessow F, Lawson EA, King JA, Roessner V, Ehrlich S. Differential alterations of amygdala nuclei volumes in acutely ill patients with anorexia nervosa and their associations with leptin levels. Psychol Med. 2023 Oct;53(13):6288-6303. doi: 10.1017/S0033291722003609. Epub 2022 Dec 5.
Schumann CM, Bauman MD, Amaral DG. Abnormal structure or function of the amygdala is a common component of neurodevelopmental disorders. Neuropsychologia. 2011 Mar;49(4):745-59. doi: 10.1016/j.neuropsychologia.2010.09.028. Epub 2010 Oct 13.
Duffy F, Gillespie-Smith K, Sharpe H, Buchan K, Nimbley E, Maloney E, Sader M, Kettley S, Kerr-Gaffney J, Waiter G, Tchanturia K. Eating Disorder and Autism Collaborative project outline: promoting eating disorder research embedded in a neurodiversity-affirming culture. BJPsych Bull. 2025 Aug;49(4):272-277. doi: 10.1192/bjb.2024.61.
Cassidy S, Bradley L, Shaw R, Baron-Cohen S. Risk markers for suicidality in autistic adults. Mol Autism. 2018 Jul 31;9:42. doi: 10.1186/s13229-018-0226-4. eCollection 2018.
Beck JS, Lundwall RA, Gabrielsen T, Cox JC, South M. Looking good but feeling bad: "Camouflaging" behaviors and mental health in women with autistic traits. Autism. 2020 May;24(4):809-821. doi: 10.1177/1362361320912147.
Bargiela S, Steward R, Mandy W. The Experiences of Late-diagnosed Women with Autism Spectrum Conditions: An Investigation of the Female Autism Phenotype. J Autism Dev Disord. 2016 Oct;46(10):3281-94. doi: 10.1007/s10803-016-2872-8.
Leppanen J, Sedgewick F, Halls D, Tchanturia K. Autism and anorexia nervosa: Longitudinal prediction of eating disorder outcomes. Front Psychiatry. 2022 Sep 21;13:985867. doi: 10.3389/fpsyt.2022.985867. eCollection 2022.
Nickel K, Maier S, Endres D, Joos A, Maier V, Tebartz van Elst L, Zeeck A. Systematic Review: Overlap Between Eating, Autism Spectrum, and Attention-Deficit/Hyperactivity Disorder. Front Psychiatry. 2019 Oct 10;10:708. doi: 10.3389/fpsyt.2019.00708. eCollection 2019.
Westwood H, Tchanturia K. Autism Spectrum Disorder in Anorexia Nervosa: An Updated Literature Review. Curr Psychiatry Rep. 2017 Jul;19(7):41. doi: 10.1007/s11920-017-0791-9.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Publishing; 2013
Provided Documents
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Document Type: Study Protocol
Other Identifiers
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349220
Identifier Type: -
Identifier Source: org_study_id
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