Altered white matter functional network in female patients with bulimia nervosa

Bulimia nervosa (BN) is a serious mental illness characterized by recurrent episodes of binge eating and inappropriate compensatory behaviors. Previous studies have uncovered gray matter (GM) dysfunctions and white matter (WM) structural damage in patients with BN, but the WM functional signal and its association with GM functional networks remain unclear. A total of 118 female participants (71 BN and 47 matched healthy controls [HCs]) were enrolled in this study. We constructed 12 WM functional networks using resting-state functional magnetic resonance imaging (rs-fMRI) data for each participant according to a predefined atlas. The signal amplitudes of each WM network and the functional connectivity between the WM network and the GM network and the functional connectivity between the GM network and the GM network were calculated. Additionally, we explored the potential relationships between the aforementioned measures and clinical variables in the BN group. Compared with the HC, BN patients exhibited atypical functional connectivity between the WM and GM networks and increased functional connectivity between the GM and GM networks and enhanced amplitude fluctuations in the sensorimotor superficial WM network. The correlation analysis showed that the amplitude fluctuations in the sensorimotor superficial WM network were correlated with the drive for thinness. In summary, these findings provide neuroimaging evidence from the perspective of WM functional networks for the behavioral manifestations of body image distortion in BN patients.