Neural Correlates of Autistic Individuals With Anorexia Nervosa

NCT ID: NCT07098156

Last Updated: 2025-08-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

50 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-07-31

Study Completion Date

2026-01-31

Brief Summary

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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

Detailed Description

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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.

Conditions

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Autism Anorexia Nervosa

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

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

Intervention Type OTHER

Single research visit scan performed with a 3T magnetic resonance imaging scanner.

Demographic and Behavioural Questionnaires

Intervention Type OTHER

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

Intervention Type OTHER

Single research visit scan performed with a 3T magnetic resonance imaging scanner.

Demographic and Behavioural Questionnaires

Intervention Type OTHER

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.

Intervention Type OTHER

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.

Intervention Type OTHER

Eligibility Criteria

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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
Minimum Eligible Age

25 Years

Maximum Eligible Age

45 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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NHS Grampian

OTHER_GOV

Sponsor Role collaborator

University of Aberdeen

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Lilian Sutton Building

Aberdeen, Aberdeen City, United Kingdom

Site Status RECRUITING

NHS Grampian Eating Disorder Services

Aberdeen, Aberdeen City, United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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Michelle Sader, PhD

Role: CONTACT

+441224438365

Gordon Waiter, PhD

Role: CONTACT

+441224438365

Facility Contacts

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Michelle Sader, PhD

Role: primary

+441224438365

Samuel Aitcheson, MD

Role: primary

References

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Reference Type BACKGROUND
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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.

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Reference Type BACKGROUND
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Reference Type BACKGROUND
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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.

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Reference Type BACKGROUND

Provided Documents

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Document Type: Study Protocol

View Document

Other Identifiers

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349220

Identifier Type: -

Identifier Source: org_study_id

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