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Understanding the neural mechanisms of Lisdexamfetamine dimesylate (LDX) pharmacotherapy in Binge-Eating Disorder

Summary

While Lisdexamfetamine dimesylate (LDX) is indicated for moderate to severe binge-eating disorder (BED), the exact mode of its therapeutic action in BED remains unknown. This project involves conducting a pre-post treatment study which aims to provide a comprehensive understanding of the neural mechanisms by which LDX improves symptoms of BED.

Supervisors

Dr Kristi Griffiths, Associate Professor Michael Kohn.

Research location

Westmead - Westmead Institute for Medical Research

Program type

PHD

Synopsis

Binge Eating Disorder (BED) is an eating disorder characterized by recurrent episodes of excessive food consumption accompanied by a sense of loss of control. It is the most prevalent type of eating disorder and it affects up to 25% of obese individuals seeking weight-loss treatment. In early 2015, LDX was the first pharmacologic agent to be approved by the FDA for the treatment of moderate to severe BED in adults. LDX has demonstrated efficacy in treating BED, however there is currently little understanding of the mechanisms by which it improves binge-eating symptoms.LDX is a central nervous system stimulant which has a common side effect of decreased appetite and decreased weight. Some believe that it simply acts as an appetite suppressant by regulating neurotransmitter systems that are involved in appetite, reward and eating behaviours. Others believe that, similar to other psychostimulants, LDX likely improves impulse control via modulation of the prefrontal cortex (PFC). This part of the brain is involved in self-regulation, and it allows us to exercise inhibitory control. To date, there are no published human neuroimaging studies examining the effects of LDX in binge-eating disorder, therefore it's mechanism of action remains unclear.

By examining the effect of LDX on both clinical symptoms and objective laboratory-based measures of cognition, we can also determine if its beneficial effects extend more broadly to non-food inhibitory control and other cognitive improvements. This combination of methodologies will provide a sophisticated and comprehensive explanation of the mechanisms by which LDX improves binge-eating behaviours. This project will involve:

-Recruitment of 40 young adults with moderate-severe binge-eating disorder from our network of collaborating clinicians.
-A comprehensive assessment of clinical, cognitive and neural function at baseline and after 8 weeks of treatment with LDX.
-Collection and analysis of multi-modal neuroimaging data
-Publication of novel findings

Additional information

Candidates would gain skills in clinical trial coordination and the collection of clinical and cognitive data. Training in analysis across a range of neuroimaging modalities (DTI, T1, task-based fMRI, resting-state fMRI) will also be available. The Brain Dynamics Centre provides candidates with excellent clinical research and neuroimaging experience, with access to patient referral services and cutting-edge research facilities.
Additional Supervisor: Professor Stephen Touyz

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Opportunity ID

The opportunity ID for this research opportunity is 2318