ArticleJournal of psychiatry & neuroscience : JPN2017
Altered intrinsic functional brain architecture in female patients with bulimia nervosa.
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Article in Journal of psychiatry & neuroscience : JPN, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Brain networks in eating disorders: a systematic review of graph theory studies.Eating and weight disorders : EWD · 2022Pooled it
- Altered thalamo–cortical and occipital–parietal– temporal–frontal white matter connections in patients with anorexia and bulimia nervosa: a systematic review of diffusion tensor imaging studiesJournal of psychiatry & neuroscience : JPN · 2019Pooled it
- Investigating resting brain perfusion abnormalities and disease target-engagement by intranasal oxytocin in women with bulimia nervosa and binge-eating disorder and healthy controls.Translational psychiatry · 2020Trial
- Aberrant large- and mesoscale network segregation and integration in bulimia nervosa.Journal of eating disorders · 2026Article
- Shared and disorder-specific resting-state neural activity characteristics in patients with anorexia nervosa and bulimia nervosa.Journal of eating disorders · 2026Article
- Mechanism-based subtyping in binge eating: understanding neurobehavioral heterogeneity across negative emotionality, approach behavior, and executive function.Translational psychiatry · 2025Article
- Altered Self-Referential-Related Brain Regions in Depersonalization-Derealization Disorder.Brain and behavior · 2025Article
- Psilocybin-assisted psychotherapy as a potential treatment for eating disorders: a narrative review of preliminary evidence.Trends in psychiatry and psychotherapy · 2024Review
- A paraventricular thalamus to insular cortex glutamatergic projection gates "emotional" stress-induced binge eating in females.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2023Article
- Exploring the thalamus: a crucial hub for brain function and communication in patients with bulimia nervosa.Journal of eating disorders · 2023Article
- Orbitofrontal cortex functional connectivity changes in patients with binge eating disorder and bulimia nervosa.PloS one · 2022Article
- A review of the relationship between eating behavior, obesity and functional brain network organization.Social cognitive and affective neuroscience · 2020Review
- Disturbed Resting-State Whole-Brain Functional Connectivity of Striatal Subregions in Bulimia Nervosa.The international journal of neuropsychopharmacology · 2020Article
- Article
- Abnormal structural brain network and hemisphere-specific changes in bulimia nervosa.Translational psychiatry · 2019Article
- Cognitive Neuroscience of Eating Disorders.The Psychiatric clinics of North America · 2019Review
- Increased Functional Connectivity Between Ventral Attention and Default Mode Networks in Adolescents With Bulimia Nervosa.Journal of the American Academy of Child and Adolescent Psychiatry · 2019Article
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Authors and funding
15 authors at 5 institutions in 3 countries.
Li WangFrom Peking University Sixth Hospital, Institute of Mental Health, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the National Clinical Research Center for Mental Health Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the Department of Radiology, 306 Hospital of People's Liberation Army, Beijing, China (Li Ke, Zeng); the Shanxi Mental Health Center, Shanxi, China (Feng); the Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewish Health System, Glen Oaks, NY (Correll); the Hofstra Northwell School of Medicine, Hempstead, NY (Correll); the Feinstein Institute for Medical Research, Manhasset, NY (Correll); the School of Psychiatry, University of New South Wales and Black Dog Institute, Sydney, Australia (Mitchell); the CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China (Yan); the Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China (Yan); and the Department of Psychology, University of Chinese Academy of Sciences, Beijing (Yan).
Qing-Mei KongFrom Peking University Sixth Hospital, Institute of Mental Health, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the National Clinical Research Center for Mental Health Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the Department of Radiology, 306 Hospital of People's Liberation Army, Beijing, China (Li Ke, Zeng); the Shanxi Mental Health Center, Shanxi, China (Feng); the Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewish Health System, Glen Oaks, NY (Correll); the Hofstra Northwell School of Medicine, Hempstead, NY (Correll); the Feinstein Institute for Medical Research, Manhasset, NY (Correll); the School of Psychiatry, University of New South Wales and Black Dog Institute, Sydney, Australia (Mitchell); the CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China (Yan); the Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China (Yan); and the Department of Psychology, University of Chinese Academy of Sciences, Beijing (Yan).
Ke LiFrom Peking University Sixth Hospital, Institute of Mental Health, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the National Clinical Research Center for Mental Health Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the Department of Radiology, 306 Hospital of People's Liberation Army, Beijing, China (Li Ke, Zeng); the Shanxi Mental Health Center, Shanxi, China (Feng); the Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewish Health System, Glen Oaks, NY (Correll); the Hofstra Northwell School of Medicine, Hempstead, NY (Correll); the Feinstein Institute for Medical Research, Manhasset, NY (Correll); the School of Psychiatry, University of New South Wales and Black Dog Institute, Sydney, Australia (Mitchell); the CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China (Yan); the Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China (Yan); and the Department of Psychology, University of Chinese Academy of Sciences, Beijing (Yan).
Xue-Ni LiFrom Peking University Sixth Hospital, Institute of Mental Health, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the National Clinical Research Center for Mental Health Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the Department of Radiology, 306 Hospital of People's Liberation Army, Beijing, China (Li Ke, Zeng); the Shanxi Mental Health Center, Shanxi, China (Feng); the Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewish Health System, Glen Oaks, NY (Correll); the Hofstra Northwell School of Medicine, Hempstead, NY (Correll); the Feinstein Institute for Medical Research, Manhasset, NY (Correll); the School of Psychiatry, University of New South Wales and Black Dog Institute, Sydney, Australia (Mitchell); the CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China (Yan); the Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China (Yan); and the Department of Psychology, University of Chinese Academy of Sciences, Beijing (Yan).
Ya-Wei ZengFrom Peking University Sixth Hospital, Institute of Mental Health, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the National Clinical Research Center for Mental Health Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the Department of Radiology, 306 Hospital of People's Liberation Army, Beijing, China (Li Ke, Zeng); the Shanxi Mental Health Center, Shanxi, China (Feng); the Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewish Health System, Glen Oaks, NY (Correll); the Hofstra Northwell School of Medicine, Hempstead, NY (Correll); the Feinstein Institute for Medical Research, Manhasset, NY (Correll); the School of Psychiatry, University of New South Wales and Black Dog Institute, Sydney, Australia (Mitchell); the CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China (Yan); the Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China (Yan); and the Department of Psychology, University of Chinese Academy of Sciences, Beijing (Yan).
Chao ChenFrom Peking University Sixth Hospital, Institute of Mental Health, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the National Clinical Research Center for Mental Health Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the Department of Radiology, 306 Hospital of People's Liberation Army, Beijing, China (Li Ke, Zeng); the Shanxi Mental Health Center, Shanxi, China (Feng); the Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewish Health System, Glen Oaks, NY (Correll); the Hofstra Northwell School of Medicine, Hempstead, NY (Correll); the Feinstein Institute for Medical Research, Manhasset, NY (Correll); the School of Psychiatry, University of New South Wales and Black Dog Institute, Sydney, Australia (Mitchell); the CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China (Yan); the Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China (Yan); and the Department of Psychology, University of Chinese Academy of Sciences, Beijing (Yan).
Ying QianFrom Peking University Sixth Hospital, Institute of Mental Health, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the National Clinical Research Center for Mental Health Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the Department of Radiology, 306 Hospital of People's Liberation Army, Beijing, China (Li Ke, Zeng); the Shanxi Mental Health Center, Shanxi, China (Feng); the Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewish Health System, Glen Oaks, NY (Correll); the Hofstra Northwell School of Medicine, Hempstead, NY (Correll); the Feinstein Institute for Medical Research, Manhasset, NY (Correll); the School of Psychiatry, University of New South Wales and Black Dog Institute, Sydney, Australia (Mitchell); the CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China (Yan); the Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China (Yan); and the Department of Psychology, University of Chinese Academy of Sciences, Beijing (Yan).
Shi-Jie FengFrom Peking University Sixth Hospital, Institute of Mental Health, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the National Clinical Research Center for Mental Health Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the Department of Radiology, 306 Hospital of People's Liberation Army, Beijing, China (Li Ke, Zeng); the Shanxi Mental Health Center, Shanxi, China (Feng); the Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewish Health System, Glen Oaks, NY (Correll); the Hofstra Northwell School of Medicine, Hempstead, NY (Correll); the Feinstein Institute for Medical Research, Manhasset, NY (Correll); the School of Psychiatry, University of New South Wales and Black Dog Institute, Sydney, Australia (Mitchell); the CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China (Yan); the Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China (Yan); and the Department of Psychology, University of Chinese Academy of Sciences, Beijing (Yan).
Ji-Tao LiFrom Peking University Sixth Hospital, Institute of Mental Health, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the National Clinical Research Center for Mental Health Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the Department of Radiology, 306 Hospital of People's Liberation Army, Beijing, China (Li Ke, Zeng); the Shanxi Mental Health Center, Shanxi, China (Feng); the Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewish Health System, Glen Oaks, NY (Correll); the Hofstra Northwell School of Medicine, Hempstead, NY (Correll); the Feinstein Institute for Medical Research, Manhasset, NY (Correll); the School of Psychiatry, University of New South Wales and Black Dog Institute, Sydney, Australia (Mitchell); the CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China (Yan); the Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China (Yan); and the Department of Psychology, University of Chinese Academy of Sciences, Beijing (Yan).
Yun'Ai SuFrom Peking University Sixth Hospital, Institute of Mental Health, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the National Clinical Research Center for Mental Health Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the Department of Radiology, 306 Hospital of People's Liberation Army, Beijing, China (Li Ke, Zeng); the Shanxi Mental Health Center, Shanxi, China (Feng); the Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewish Health System, Glen Oaks, NY (Correll); the Hofstra Northwell School of Medicine, Hempstead, NY (Correll); the Feinstein Institute for Medical Research, Manhasset, NY (Correll); the School of Psychiatry, University of New South Wales and Black Dog Institute, Sydney, Australia (Mitchell); the CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China (Yan); the Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China (Yan); and the Department of Psychology, University of Chinese Academy of Sciences, Beijing (Yan).
Christoph U CorrellFrom Peking University Sixth Hospital, Institute of Mental Health, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the National Clinical Research Center for Mental Health Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the Department of Radiology, 306 Hospital of People's Liberation Army, Beijing, China (Li Ke, Zeng); the Shanxi Mental Health Center, Shanxi, China (Feng); the Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewish Health System, Glen Oaks, NY (Correll); the Hofstra Northwell School of Medicine, Hempstead, NY (Correll); the Feinstein Institute for Medical Research, Manhasset, NY (Correll); the School of Psychiatry, University of New South Wales and Black Dog Institute, Sydney, Australia (Mitchell); the CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China (Yan); the Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China (Yan); and the Department of Psychology, University of Chinese Academy of Sciences, Beijing (Yan).
Philip B MitchellFrom Peking University Sixth Hospital, Institute of Mental Health, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the National Clinical Research Center for Mental Health Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the Department of Radiology, 306 Hospital of People's Liberation Army, Beijing, China (Li Ke, Zeng); the Shanxi Mental Health Center, Shanxi, China (Feng); the Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewish Health System, Glen Oaks, NY (Correll); the Hofstra Northwell School of Medicine, Hempstead, NY (Correll); the Feinstein Institute for Medical Research, Manhasset, NY (Correll); the School of Psychiatry, University of New South Wales and Black Dog Institute, Sydney, Australia (Mitchell); the CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China (Yan); the Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China (Yan); and the Department of Psychology, University of Chinese Academy of Sciences, Beijing (Yan).
Chao-Gan YanFrom Peking University Sixth Hospital, Institute of Mental Health, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the National Clinical Research Center for Mental Health Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the Department of Radiology, 306 Hospital of People's Liberation Army, Beijing, China (Li Ke, Zeng); the Shanxi Mental Health Center, Shanxi, China (Feng); the Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewish Health System, Glen Oaks, NY (Correll); the Hofstra Northwell School of Medicine, Hempstead, NY (Correll); the Feinstein Institute for Medical Research, Manhasset, NY (Correll); the School of Psychiatry, University of New South Wales and Black Dog Institute, Sydney, Australia (Mitchell); the CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China (Yan); the Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China (Yan); and the Department of Psychology, University of Chinese Academy of Sciences, Beijing (Yan).
Da-Rong ZhangFrom Peking University Sixth Hospital, Institute of Mental Health, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the National Clinical Research Center for Mental Health Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the Department of Radiology, 306 Hospital of People's Liberation Army, Beijing, China (Li Ke, Zeng); the Shanxi Mental Health Center, Shanxi, China (Feng); the Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewish Health System, Glen Oaks, NY (Correll); the Hofstra Northwell School of Medicine, Hempstead, NY (Correll); the Feinstein Institute for Medical Research, Manhasset, NY (Correll); the School of Psychiatry, University of New South Wales and Black Dog Institute, Sydney, Australia (Mitchell); the CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China (Yan); the Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China (Yan); and the Department of Psychology, University of Chinese Academy of Sciences, Beijing (Yan).
Tian-Mei SiFrom Peking University Sixth Hospital, Institute of Mental Health, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the National Clinical Research Center for Mental Health Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China (Wang, Kong, Li Xue-Ni, Chen, Qian, Li Ji-Tao, Su, Zhang, Si); the Department of Radiology, 306 Hospital of People's Liberation Army, Beijing, China (Li Ke, Zeng); the Shanxi Mental Health Center, Shanxi, China (Feng); the Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewish Health System, Glen Oaks, NY (Correll); the Hofstra Northwell School of Medicine, Hempstead, NY (Correll); the Feinstein Institute for Medical Research, Manhasset, NY (Correll); the School of Psychiatry, University of New South Wales and Black Dog Institute, Sydney, Australia (Mitchell); the CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China (Yan); the Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China (Yan); and the Department of Psychology, University of Chinese Academy of Sciences, Beijing (Yan).
Black Dog Institute · AUInstitute of Psychology, Chinese Academy of Sciences · CNPeking University · CNPeking University Sixth Hospital · CNShantou University Mental Health Center · CN
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBulimia nervosa is a severe psychiatric syndrome with uncertain pathogenesis. Neural systems involved in sensorimotor and visual processing, reward and impulsive control may contribute to the binge eating and purging behaviours characterizing bulimia nervosa. However, little is known about the alterations of functional organization of whole brain networks in individuals with this disorder.
methodsWe used resting-state functional MRI and graph theory to characterize functional brain networks of unmedicated women with bulimia nervosa and healthy women.
resultsWe included 44 unmedicated women with bulimia nervosa and 44 healthy women in our analyses. Women with bulimia nervosa showed increased clustering coefficient and path length compared with control women. The nodal strength in patients with the disorder was higher in the sensorimotor and visual regions as well as the precuneus, but lower in several subcortical regions, such as the hippocampus, parahippocampal gyrus and orbitofrontal cortex. Patients also showed hyperconnectivity primarily involving sensorimotor and unimodal visual association regions, but hypoconnectivity involving subcortical (striatum, thalamus), limbic (amygdala, hippocampus) and paralimbic (orbitofrontal cortex, parahippocampal gyrus) regions. The topological aberrations correlated significantly with scores of bulimia and drive for thinness and with body mass index. LIMITATIONS: We reruited patients with only acute bulimia nervosa, so it is unclear whether the topological abnormalities comprise vulnerability markers for the disorder developing or the changes associated with illness state.
conclusionOur findings show altered intrinsic functional brain architecture, specifically abnormal global and local efficiency, as well as nodal- and network-level connectivity across sensorimotor, visual, subcortical and limbic systems in women with bulimia nervosa, suggesting that it is a disorder of dysfunctional integration among large-scale distributed brain regions. These abnormalities contribute to more comprehensive understanding of the neural mechanism underlying pathological eating and body perception in women with bulimia nervosa.
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BrainBulimia NervosaConnectomeFemaleHumansMagnetic Resonance ImagingNeural PathwaysPsychiatric Status Rating ScalesReproducibility of ResultsRestYoung Adult
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