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Xie L, Zhao J, Li Y, Bai J. PET brain imaging in neurological disorders. Phys Life Rev 2024; 49:100-111. [PMID: 38574584 DOI: 10.1016/j.plrev.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 03/20/2024] [Indexed: 04/06/2024]
Abstract
Brain disorders are a series of conditions with damage or loss of neurons, such as Parkinson's disease (PD), Alzheimer's disease (AD), or drug dependence. These individuals have gradual deterioration of cognitive, motor, and other central nervous system functions affected. This degenerative trajectory is intricately associated with dysregulations in neurotransmitter systems. Positron Emission Tomography (PET) imaging, employing radiopharmaceuticals and molecular imaging techniques, emerges as a crucial tool for detecting brain biomarkers. It offers invaluable insights for early diagnosis and distinguishing brain disorders. This article comprehensively reviews the application and progress of conventional and novel PET imaging agents in diagnosing brain disorders. Furthermore, it conducts a thorough analysis on merits and limitations. The article also provides a forward-looking perspective in the future development directions of PET imaging agents for diagnosing brain disorders and proposes potential innovative strategies. It aims to furnish clinicians and researchers with an all-encompassing overview of the latest advancements and forthcoming trends in the utilization of PET imaging for diagnosing brain disorders.
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Affiliation(s)
- Lijun Xie
- Faculty of Life science and Technology, Kunming University of Science and Technology, Kunming 650500, PR China; Laboratory of Molecular Neurobiology, Medical school, Kunming University of Science and Technology, Kunming 650500, PR China; Department of Nuclear Medicine, First Affiliated Hospital of Kunming Medical University, Kunming 650032, PR China
| | - Jihua Zhao
- Department of Nuclear Medicine, First Affiliated Hospital of Kunming Medical University, Kunming 650032, PR China
| | - Ye Li
- Laboratory of Molecular Neurobiology, Medical school, Kunming University of Science and Technology, Kunming 650500, PR China.
| | - Jie Bai
- Laboratory of Molecular Neurobiology, Medical school, Kunming University of Science and Technology, Kunming 650500, PR China.
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Conn K, Huang K, Gorrell S, Foldi CJ. A transdiagnostic and translational framework for delineating the neuronal mechanisms of compulsive exercise in anorexia nervosa. Int J Eat Disord 2024; 57:1406-1417. [PMID: 38174745 PMCID: PMC11222308 DOI: 10.1002/eat.24130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/21/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVE The development of novel treatments for anorexia nervosa (AN) requires a detailed understanding of the biological underpinnings of specific, commonly occurring symptoms, including compulsive exercise. There is considerable bio-behavioral overlap between AN and obsessive-compulsive disorder (OCD), therefore it is plausible that similar mechanisms underlie compulsive behavior in both populations. While the association between these conditions is widely acknowledged, defining the shared mechanisms for compulsive behavior in AN and OCD requires a novel approach. METHODS We present an argument that a better understanding of the neurobiological mechanisms that underpin compulsive exercise in AN can be achieved in two critical ways. First, by applying a framework of the neuronal control of OCD to exercise behavior in AN, and second, by taking better advantage of the activity-based anorexia (ABA) rodent model to directly test this framework in the context of feeding pathology. RESULTS A cross-disciplinary approach that spans preclinical, neuroimaging, and clinical research as well as compulsive neurocircuitry and behavior can advance our understanding of when, why, and how compulsive exercise develops in the context of AN and provide targets for novel treatment strategies. DISCUSSION In this article, we (i) link the expression of compulsive behavior in AN and OCD via a transition between goal-directed and habitual behavior, (ii) present disrupted cortico-striatal circuitry as a key substrate for the development of compulsive behavior in both conditions, and (iii) highlight the utility of the ABA rodent model to better understand the mechanisms of compulsive behavior relevant to AN. PUBLIC SIGNIFICANCE Individuals with AN who exercise compulsively are at risk of worse health outcomes and have poorer responses to standard treatments. However, when, why, and how compulsive exercise develops in AN remains inadequately understood. Identifying whether the neural circuitry underlying compulsive behavior in OCD also controls hyperactivity in the activity-based anorexia model will aid in the development of novel eating disorder treatment strategies for this high-risk population.
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Affiliation(s)
- K Conn
- Monash University, Department of Physiology, 26 Innovation Walk, 3800, Clayton, Australia
- Monash Biomedicine Discovery Institute, 23 Innovation Walk, 3800, Clayton, Australia
| | - K Huang
- Monash University, Department of Physiology, 26 Innovation Walk, 3800, Clayton, Australia
- Monash Biomedicine Discovery Institute, 23 Innovation Walk, 3800, Clayton, Australia
| | - S Gorrell
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18th street, San Francisco, CA 94143, USA
| | - CJ Foldi
- Monash University, Department of Physiology, 26 Innovation Walk, 3800, Clayton, Australia
- Monash Biomedicine Discovery Institute, 23 Innovation Walk, 3800, Clayton, Australia
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Kooij KL, Andreani NA, van der Gun LL, Keller L, Trinh S, van der Vijgh B, Luijendijk M, Dempfle A, Herpertz-Dahlmann B, Seitz J, van Elburg A, Danner UN, Baines J, Adan RAH. Fecal microbiota transplantation of patients with anorexia nervosa did not alter flexible behavior in rats. Int J Eat Disord 2024. [PMID: 38934721 DOI: 10.1002/eat.24231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 04/11/2024] [Accepted: 04/30/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE Patients with anorexia nervosa (AN) are often anxious, display inflexible behavior and disrupted reward processing. Emerging evidence suggests that gut dysbiosis in patients contributes to the disease phenotype and progression. METHODS In a preclinical study, we explored whether AN-derived microbiota impacts cognitive flexibility, anxiety, and dopamine signaling using fecal microbiota transplantation (FMT) in tyrosine hydroxylase-cre rats. We performed probabilistic reversal learning task (PRLT) at the baseline, after antibiotic treatment, and following FMT from patients with AN and controls. We assessed flexible behavior, task engagement, and ventral tegmental area (VTA) dopamine signaling during and in the absence of reward. Furthermore, anxiety-like behavior was evaluated with open field (OF) and elevated plus maze (EPM) tests. RESULTS Neither antibiotic-induced dysbiosis nor AN FMT led to significant alterations in the number of reversals or lever press strategies after reinforced or nonreinforced lever presses (win and lose-stay) in the PRLT. However, the number of initiated trials decreased after antibiotic treatment while remaining unchanged after FMT. No significant differences were observed in VTA dopamine activity, anxiety measures in the OF and EPM tests. Microbiome analysis revealed limited overlap between the microbiota of the donors and recipients. DISCUSSION No evidence was found that the microbiota of patients compared to controls, nor a depleted microbiome impacts cognitive flexibility. Nonetheless, antibiotic-induced dysbiosis resulted in reduced task engagement during the PRLT. The relatively low efficiency of the FMT is a limitation of our study and highlights the need for improved protocols to draw robust conclusions in future studies. PUBLIC SIGNIFICANCE While our study did not reveal direct impacts of AN-associated gut microbiota on cognitive flexibility or anxiety behaviors in our preclinical model, we observed a decrease in task engagement after antibiotic-induced dysbiosis, underscoring that the presence of a gut microbiome matters. Our findings underscore the need for further refinement in FMT protocols to better elucidate the complex interplay between gut microbiota and behaviors characteristic of anorexia nervosa.
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Affiliation(s)
- Karlijn L Kooij
- UMC Brain Center, Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Altrecht Eating Disorders Rintveld, Zeist, The Netherlands
| | - Nadia Andrea Andreani
- Section Evolutionary Medicine, Max Planck Institute for Evolutionary Biology, Plön, Germany
- Section Evolutionary Medicine, Institute for Experimental Medicine, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Luna L van der Gun
- UMC Brain Center, Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Lara Keller
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH Aachen, Aachen, Germany
| | - Stefanie Trinh
- Institute of Neuroanatomy, RWTH Aachen University, Aachen, Germany
| | | | - Mieneke Luijendijk
- UMC Brain Center, Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Astrid Dempfle
- Institute of Medical Informatics and Statistics, Kiel University, Kiel, Germany
| | | | - Jochen Seitz
- Institute of Neuroanatomy, RWTH Aachen University, Aachen, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LVR University Hospital Essen, Essen, Germany
| | - Annemarie van Elburg
- Altrecht Eating Disorders Rintveld, Zeist, The Netherlands
- Faculty of Social Sciences, Utrecht University, Utrecht, The Netherlands
| | - Unna N Danner
- Altrecht Eating Disorders Rintveld, Zeist, The Netherlands
| | - John Baines
- Section Evolutionary Medicine, Max Planck Institute for Evolutionary Biology, Plön, Germany
- Section Evolutionary Medicine, Institute for Experimental Medicine, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Roger A H Adan
- UMC Brain Center, Department of Translational Neuroscience, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Altrecht Eating Disorders Rintveld, Zeist, The Netherlands
- Department of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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Song Y, Guo SH, Davies-Jenkins CW, Guarda A, Edden RA, Smith KR. Myo-inositol Levels in the Dorsal Anterior Cingulate Cortex Predicts Anxiety-to-Eat in Anorexia Nervosa. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.29.596476. [PMID: 38854088 PMCID: PMC11160692 DOI: 10.1101/2024.05.29.596476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Background Anorexia nervosa (AN) is a mental and behavioral health condition characterized by an intense fear of weight or fat gain, severe restriction of food intake resulting in low body weight, and distorted self-perception of body shape or weight. While substantial research has focused on general anxiety in AN, less is known about eating-related anxiety and its underlying neural mechanisms. Therefore, we sought to characterize anxiety-to-eat in AN and examine the neurometabolic profile within the dorsal anterior cingulate cortex (dACC), a brain region putatively involved in magnifying the threat response. Methods Women seeking inpatient treatment for AN and women of healthy weight without a lifetime history of an eating disorder (healthy controls; HC) completed a computer-based behavioral task assessing anxiety-to-eat in response to images of higher (HED) and lower (LED) energy density foods. Participants also underwent magnetic resonance spectroscopy of the dACC in a 3 Tesla scanner. Results The AN group reported greater anxiety to eat HED and LED foods relative to the HC group. Both groups reported greater anxiety to eat HED foods relative to LED foods. The neurometabolite myo-inositol (mI) was lower in the dACC in AN relative to HC, and mI levels negatively predicted anxiety to eat HED but not LED foods in the AN group only. mI levels in the dACC were independent of body weight, body mass, and general anxiety. Conclusions These findings provide critical new insight into the clinically challenging feature and underlying neural mechanisms of eating-related anxiety and indicate mI levels in the dACC could serve as a novel biomarker of illness severity that is independent of body weight to identify individuals vulnerable to disordered eating or eating pathology as well as a potential therapeutic target.
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Affiliation(s)
- Yulu Song
- The Russel H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, United States
| | - Sarah H. Guo
- Department of Psychiatry and Behavioral Science, Johns Hopkins School of Medicine, Baltimore, MD USA
| | - Christopher W. Davies-Jenkins
- The Russel H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, United States
| | - Angela Guarda
- Department of Psychiatry and Behavioral Science, Johns Hopkins School of Medicine, Baltimore, MD USA
| | - Richard A.E. Edden
- The Russel H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, United States
| | - Kimberly R. Smith
- Department of Psychiatry and Behavioral Science, Johns Hopkins School of Medicine, Baltimore, MD USA
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Murray SB, Diaz‐Fong JP, Mak VWT, Feusner JD. Assessing midbrain neuromelanin and its relationship to reward learning in anorexia nervosa: Stage 1 of a registered report. Brain Behav 2024; 14:e3573. [PMID: 38898625 PMCID: PMC11186843 DOI: 10.1002/brb3.3573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 05/06/2024] [Indexed: 06/21/2024] Open
Abstract
INTRODUCTION Anorexia nervosa (AN) is a debilitating and potentially chronic eating disorder, characterized by low hedonic drive toward food, which has been linked with perturbations in both reward processing and dopaminergic activity. Neuromelanin-sensitive magnetic resonance imaging (MRI) is an emerging method to index midbrain neuromelanin-a by-product of dopaminergic synthesis. The assessment of midbrain neuromelanin, and its association with AN psychopathology and reward-related processes, may provide critical insights into reward circuit function in AN. METHODS This study will incorporate neuromelanin-sensitive MRI into an existing study of appetitive conditioning in those with AN. Specifically, those with acute and underweight AN (N = 30), those with weight-restored AN (N = 30), and age-matched healthy controls (N = 30) will undergo clinical assessment of current and previous psychopathology, in addition to structural neuromelanin-sensitive MRI, diffusion MRI, and functional MRI (fMRI) during appetitive conditioning. CONCLUSION This study will be among the first to interrogate midbrain neuromelanin in AN-a disorder characterized by altered dopaminergic activity. Results will help establish whether abnormalities in the midbrain synthesis of dopamine are evident in those with AN and are associated with symptomatic behavior and reduced ability to experience pleasure and reward.
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Affiliation(s)
- Stuart B. Murray
- Department of Psychiatry & Behavioral SciencesUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Joel P. Diaz‐Fong
- Centre for Addiction and Mental HealthTorontoOntarioCanada
- Institute of Medical Science, Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- Semel Institute for Neuroscience & Human Behavior, Department of Psychiatry & Biobehavioral ScienceUniversity of California, Los AngelesLos AngelesCaliforniaUSA
| | | | - Jamie D. Feusner
- Centre for Addiction and Mental HealthTorontoOntarioCanada
- Institute of Medical Science, Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- Semel Institute for Neuroscience & Human Behavior, Department of Psychiatry & Biobehavioral ScienceUniversity of California, Los AngelesLos AngelesCaliforniaUSA
- Department of Psychiatry, Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- Department of Women's and Children's HealthKarolinska InstitutetStockholmSweden
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Senol E, Mohammad H. Current perspectives on brain circuits involved in food addiction-like behaviors. J Neural Transm (Vienna) 2024; 131:475-485. [PMID: 38216705 DOI: 10.1007/s00702-023-02732-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/17/2023] [Indexed: 01/14/2024]
Abstract
There is an emerging view that the increased availability of energy-dense foods in our society is contributing to excessive food consumption which could lead to food addiction-like behavior. Particularly, compulsive eating patterns are predominant in people suffering from eating disorders (binge-eating disorder, bulimia and anorexia nervosa) and obesity. Phenotypically, the behavioral pattern exhibits a close resemblance to individuals suffering from other forms of addiction (drug, sex, gambling). Growing body of evidence in neuroscience research is showing that excessive consumption of energy-dense foods alters the brain circuits implicated in reward, decision-making, control, habit formation, and emotions that are central to drug addiction. Here, we review the current understanding of the circuits of food addiction-like behaviors and highlight the future possibility of exploring those circuits to combat obesity and eating disorders.
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Affiliation(s)
- Esra Senol
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Hasan Mohammad
- Centre de Recherche en Biomédicine de Strasbourg (CRBS), L'Institut National de La Santé Et de La Recherche Médicale (Inserm) U1114, University of Strasbourg, Strasbourg, France.
- Department of Biological Sciences, Indian Institute of Science Education and Research, Mohali, Punjab, 140306, India.
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Brooks SJ, Dahl K, Dudley-Jones R, Schiöth HB. A neuroinflammatory compulsivity model of anorexia nervosa (NICAN). Neurosci Biobehav Rev 2024; 159:105580. [PMID: 38417395 DOI: 10.1016/j.neubiorev.2024.105580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/31/2024] [Accepted: 02/09/2024] [Indexed: 03/01/2024]
Affiliation(s)
- S J Brooks
- Department of Surgical Sciences, Uppsala University, Sweden; School of Psychology, Liverpool John Moores University, UK; Neuroscience Research Laboratory (NeuRL), Department of Psychology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa.
| | - K Dahl
- Department of Surgical Sciences, Uppsala University, Sweden
| | - R Dudley-Jones
- School of Psychology, Liverpool John Moores University, UK
| | - H B Schiöth
- Department of Surgical Sciences, Uppsala University, Sweden
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Foldi CJ. Taking better advantage of the activity-based anorexia model. Trends Mol Med 2024; 30:330-338. [PMID: 38103992 DOI: 10.1016/j.molmed.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 11/02/2023] [Accepted: 11/17/2023] [Indexed: 12/19/2023]
Abstract
The lack of specific treatments for anorexia nervosa (AN) is partly driven by an inadequate understanding of the neurobiological drivers of the condition. The activity-based anorexia (ABA) model recapitulates key characteristics of AN in rats and mice, and can be used to understand factors that predispose, maintain, and rescue anorectic behaviour. With the rapidly evolving suite of technologies to manipulate and record neural activity during the development of ABA, we are better placed than ever before to take advantage of this unique biobehavioural model in order to develop and refine novel treatments for AN. This will require a collective effort to bridge research disciplines in order to capitalise on knowledge gains from genetics, neurobiology, metabolism, and cognition.
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Affiliation(s)
- Claire J Foldi
- Monash University, Department of Physiology, 26 Innovation Walk, Clayton, VIC 3800, Australia; Monash Biomedicine Discovery Institute, 23 Innovation Walk, Clayton, VIC 3800, Australia.
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Maussion G, Rocha C, Ramoz N. iPSC-derived models for anorexia nervosa research. Trends Mol Med 2024; 30:339-349. [PMID: 38472034 DOI: 10.1016/j.molmed.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 03/14/2024]
Abstract
Anorexia nervosa (AN) is a complex neuropsychiatric disorder with genetic and epigenetic components that results in reduced food intake combined with alterations in the reward-processing network. While studies of patient cohorts and mouse models have uncovered genes and epigenetic changes associated with the disease, neuronal networks and brain areas preferentially activated and metabolic changes associated with reduced food intake, the underlying molecular and cellular mechanisms remain unknown. The use of both 2D in vitro cultures and 3D models, namely organoids and spheroids, derived from either human embryonic stem cells (ESCs) or induced pluripotent stem cells (iPSCs), would allow identification of cell type-specific changes associated with AN and comorbid diseases, to study preferential connections between brain areas and organs, and the development of therapeutic strategies.
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Affiliation(s)
- Gilles Maussion
- The Neuro's Early Drug Discovery Unit (EDDU), McGill University, Montreal, Quebec H3A 2B4, Canada.
| | - Cecilia Rocha
- The Neuro's Early Drug Discovery Unit (EDDU), McGill University, Montreal, Quebec H3A 2B4, Canada
| | - Nicolas Ramoz
- Université Paris Cité, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Paris 75014, France; GHU Paris Psychiatrie et Neurosciences, CMME, Hôpital Sainte-Anne, Paris F-75014, France
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Castell L, Le Gall V, Cutando L, Petit CP, Puighermanal E, Makrini-Maleville L, Kim HR, Jercog D, Tarot P, Tassou A, Harrus AG, Rubinstein M, Nouvian R, Rivat C, Besnard A, Trifilieff P, Gangarossa G, Janak PH, Herry C, Valjent E. Dopamine D2 receptors in WFS1-neurons regulate food-seeking and avoidance behaviors. Prog Neuropsychopharmacol Biol Psychiatry 2024; 129:110883. [PMID: 37858736 DOI: 10.1016/j.pnpbp.2023.110883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/09/2023] [Accepted: 10/16/2023] [Indexed: 10/21/2023]
Abstract
The selection and optimization of appropriate adaptive responses depends on interoceptive and exteroceptive stimuli as well as on the animal's ability to switch from one behavioral strategy to another. Although growing evidence indicate that dopamine D2R-mediated signaling events ensure the selection of the appropriate strategy for each specific situation, the underlying neural circuits through which they mediate these effects are poorly characterized. Here, we investigated the role of D2R signaling in a mesolimbic neuronal subpopulation expressing the Wolfram syndrome 1 (Wfs1) gene. This subpopulation is located within the nucleus accumbens, the central amygdala, the bed nucleus of the stria terminalis, and the tail of the striatum, all brain regions critical for the regulation of emotions and motivated behaviors. Using a mouse model carrying a temporally controlled deletion of D2R in WFS1-neurons, we demonstrate that intact D2R signaling in this neuronal population is necessary to regulate homeostasis-dependent food-seeking behaviors in both male and female mice. In addition, we found that reduced D2R signaling in WFS1-neurons impaired active avoidance learning and innate escape responses. Collectively, these findings identify a yet undocumented role for D2R signaling in WFS1-neurons as a novel effector through which dopamine optimizes appetitive behaviors and regulates defensive behaviors.
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Affiliation(s)
- Laia Castell
- IGF, Université, Montpellier, CNRS, Inserm, Montpellier F-34094, France; Department of Psychological and Brain Sciences, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD 21218, USA.
| | - Valentine Le Gall
- Université, Bordeaux, Neurocentre Magendie, U1215, Bordeaux F-33077, France
| | - Laura Cutando
- IGF, Université, Montpellier, CNRS, Inserm, Montpellier F-34094, France
| | - Chloé P Petit
- INM, Université, Montpellier, Inserm, Montpellier F-34000, France
| | - Emma Puighermanal
- IGF, Université, Montpellier, CNRS, Inserm, Montpellier F-34094, France
| | | | - Ha-Rang Kim
- Université, Bordeaux, Neurocentre Magendie, U1215, Bordeaux F-33077, France
| | - Daniel Jercog
- Université, Bordeaux, Neurocentre Magendie, U1215, Bordeaux F-33077, France
| | - Pauline Tarot
- IGF, Université, Montpellier, CNRS, Inserm, Montpellier F-34094, France
| | - Adrien Tassou
- INM, Université, Montpellier, Inserm, Montpellier F-34000, France
| | | | - Marcelo Rubinstein
- Instituto de Investigaciones en Ingeniería Genética y Biología Molecular, CONICET; FCEN, Universidad de Buenos Aires, Buenos Aires, Argentina; Department of Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Régis Nouvian
- INM, Université, Montpellier, Inserm, Montpellier F-34000, France
| | - Cyril Rivat
- INM, Université, Montpellier, Inserm, Montpellier F-34000, France
| | - Antoine Besnard
- IGF, Université, Montpellier, CNRS, Inserm, Montpellier F-34094, France
| | - Pierre Trifilieff
- Université, Bordeaux, INRAE, Bordeaux INP, NutriNeuro, Bordeaux F-33000, France
| | - Giuseppe Gangarossa
- Université Paris Cité, CNRS, Unité de Biologie Fonctionnelle et Adaptative, Paris F-75013, France; Institut Universitaire de France, France
| | - Patricia H Janak
- Department of Psychological and Brain Sciences, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD 21218, USA; The Solomon H. Snyder Department of Neuroscience, Johns Hopkins University, Baltimore, MD 21205, USA; Kavli Neuroscience Discovery Institute, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Cyril Herry
- Université, Bordeaux, Neurocentre Magendie, U1215, Bordeaux F-33077, France
| | - Emmanuel Valjent
- IGF, Université, Montpellier, CNRS, Inserm, Montpellier F-34094, France.
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Chmiel J, Gladka A, Leszek J. The Effect of Transcranial Direct Current Stimulation (tDCS) on Anorexia Nervosa: A Narrative Review. Nutrients 2023; 15:4455. [PMID: 37892530 PMCID: PMC10610104 DOI: 10.3390/nu15204455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023] Open
Abstract
(1) Introduction: Anorexia nervosa (AN) is a severe, debilitating disease with high incidence and high mortality. The methods of treatment used so far are moderately effective. Evidence from neuroimaging studies helps to design modern methods of therapy. One of them is transcranial direct current stimulation (tDCS), a non-invasive brain neuromodulation technique. (2) Methods: The purpose of this narrative review is to bring together all studies investigating the use of tDCS in the treatment of AN and to evaluate its effect and efficiency. Searches were conducted in the Pubmed/Medline, Research Gate, and Cochrane databases. (3) Results: The literature search resulted in five articles. These studies provide preliminary evidence that tDCS has the potential to alter eating behaviour, body weight, and food intake. Additionally, tDCS reduced symptoms of depression. Throughout all trials, stimulation targeted the left dorsolateral prefrontal cortex (DLPFC). Although the number of studies included is limited, attempts were made to elucidate the potential mechanisms underlying tDCS action in individuals with AN. Recommendations for future tDCS research in AN were issued. (4) Conclusions: The included studies have shown that tDCS stimulation of the left DLPFC has a positive effect on AN clinical symptoms and may improve them, as measured by various assessment measures. It is important to conduct more in-depth research on the potential benefits of using tDCS for treating AN. This should entail well-designed studies incorporating advanced neuroimaging techniques, such as fMRI. The aim is to gain a better understanding of how tDCS works in AN.
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Affiliation(s)
- James Chmiel
- Institute of Neurofeedback and tDCS Poland, 70-393 Szczecin, Poland
| | - Anna Gladka
- Department and Clinic of Psychiatry, Wrocław Medical University, 54-235 Wrocław, Poland
| | - Jerzy Leszek
- Department and Clinic of Psychiatry, Wrocław Medical University, 54-235 Wrocław, Poland
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Seiger R, Reggente N, Majid DSA, Ly R, Tadayonnejad R, Strober M, Feusner JD. Neural representations of anxiety in adolescents with anorexia nervosa: a multivariate approach. Transl Psychiatry 2023; 13:283. [PMID: 37582758 PMCID: PMC10427677 DOI: 10.1038/s41398-023-02581-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/17/2023] Open
Abstract
Anorexia nervosa (AN) is characterized by low body weight, fear of gaining weight, and distorted body image. Anxiety may play a role in the formation and course of the illness, especially related to situations involving food, eating, weight, and body image. To understand distributed patterns and consistency of neural responses related to anxiety, we enrolled 25 female adolescents with AN and 22 non-clinical female adolescents with mild anxiety who underwent two fMRI sessions in which they saw personalized anxiety-provoking word stimuli and neutral words. Consistency in brain response patterns across trials was determined using a multivariate representational similarity analysis (RSA) approach within anxiety circuits and in a whole-brain voxel-wise searchlight analysis. In the AN group there was higher representational similarity for anxiety-provoking compared with neutral stimuli predominantly in prefrontal regions including the frontal pole, medial prefrontal cortex, dorsolateral prefrontal cortex, and medial orbitofrontal cortex, although no significant group differences. Severity of anxiety correlated with consistency of brain responses within anxiety circuits and in cortical and subcortical regions including the frontal pole, middle frontal gyrus, orbitofrontal cortex, thalamus, lateral occipital cortex, middle temporal gyrus, and cerebellum. Higher consistency of activation in those with more severe anxiety symptoms suggests the possibility of a greater degree of conditioned brain responses evoked by personally-relevant emotional stimuli. Anxiety elicited by disorder-related stimuli may activate stereotyped, previously-learned neural responses within- and outside of classical anxiety circuits. Results have implications for understanding consistent and automatic responding to environmental stimuli that may play a role in maintenance of AN.
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Affiliation(s)
- René Seiger
- General Adult Psychiatry and Health Systems, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Nicco Reggente
- Institute for Advanced Consciousness Studies, Santa Monica, CA, USA
| | - D S-Adnan Majid
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Ronald Ly
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Reza Tadayonnejad
- Division of Neuromodulation, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Division of Humanities and Social Sciences, California Institute of Technology, Pasadena, CA, USA
| | - Michael Strober
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Jamie D Feusner
- General Adult Psychiatry and Health Systems, Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.
- Department of Women's and Children's Health, Karolinska Hospital, Karolinska Institutet, Stockholm, Sweden.
- Department of Psychiatry, University of Toronto, Toronto, Canada.
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13
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Giunti E, Collu R, Dedoni S, Castelli MP, Fratta W, Scherma M, Fadda P. Food restriction and hyperactivity induce changes in corticolimbic brain dopamine and serotonin levels in female rats. Behav Brain Res 2023; 444:114374. [PMID: 36863461 DOI: 10.1016/j.bbr.2023.114374] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/27/2023] [Accepted: 02/27/2023] [Indexed: 03/04/2023]
Abstract
Compelling data support altered dopamine (DA) and serotonin (5-HT) signaling in anorexia nervosa (AN). However, their exact role in the etiopathogenesis of AN has yet to be elucidated. Here, we evaluated the corticolimbic brain levels of DA and 5-HT in the induction and recovery phases of the activity-based anorexia (ABA) model of AN. We exposed female rats to the ABA paradigm and measured the levels of DA, 5-HT, the metabolites 3,4-dihydroxyphenylacetic acid (DOPAC), homovanillic acid (HVA), 5-hydroxyindoleacetic acid (5-HIAA), and the dopaminergic type 2 (D2) receptors density in feeding- and reward-implicated brain regions (i.e., cerebral cortex, Cx; prefrontal cortex, PFC; caudate putamen, CPu; nucleus accumbens, NAcc; amygdala, Amy; hypothalamus, Hyp; hippocampus, Hipp). DA levels were significantly increased in the Cx, PFC and NAcc, while 5-HT was significantly enhanced in the NAcc and Hipp of ABA rats. Following recovery, DA was still elevated in the NAcc, while 5-HT was increased in the Hyp of recovered ABA rats. DA and 5-HT turnover were impaired at both ABA induction and recovery. D2 receptors density was increased in the NAcc shell. These results provide further proof of the impairment of the dopaminergic and serotoninergic systems in the brain of ABA rats and support the knowledge of the involvement of these two important neurotransmitter systems in the development and progression of AN. Thus, providing new insights on the corticolimbic regions involved in the monoamine dysregulations in the ABA model of AN.
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Affiliation(s)
- Elisa Giunti
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Roberto Collu
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Simona Dedoni
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - M Paola Castelli
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | | | - Maria Scherma
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy.
| | - Paola Fadda
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy; CNR Institute of Neuroscience, Cagliari, National Research Council, Cagliari, Italy
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14
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Valente EEL, Klotz JL, Egert-McLean AM, Costa GW, May JB, Harmon DL. Influence of intra-abomasal administration of L-DOPA on circulating catecholamines and feed intake in cattle. FRONTIERS IN ANIMAL SCIENCE 2023. [DOI: 10.3389/fanim.2023.1127575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
Dopamine has multiple physiological functions including feed intake control in which it can act as an anorectic or orexigenic agent. This study had the objective to evaluate intra-abomasal administration of L-DOPA (levodopa; L-3,4-dihydroxyphenylalanine) from -Mucuna pruriens on circulating catecholamines, indicators of energy metabolism and feed intake in cattle. Eight Holstein steers (340 ± 20 kg) fitted with ruminal cannula were used in a replicated 4 x 4 Latin Square design experiment. Intra-abomasal infusion of L-DOPA at 0, 0.5, 1 and 2 mg/kg BW was carried out for seven days and blood samples were collected at 0, 30, 60, 120, 240 and 480 min from L-DOPA infusion on day 7. The area under the curve (AUC) of plasma L-DOPA and free dopamine increased quadratically with the administration of L-DOPA. However, the AUC of plasma total dopamine had a positive linear response with the increase of L-DOPA. Conversely, the serum 5-hydroxytriptophan (5-HTP), plasma serotonin, serum serotonin, serum tyrosine, plasma glucose and plasma free fatty acids were not affected by the intra-abomasal infusion of L-DOPA. The circulating concentration of the epinephrine, norepinephrine, serotonin, glucose and free fatty acids did not change with L-DOPA infusion. It can be concluded that intra-abomasal L-DOPA administration produced a strong increase in circulating dopamine with no change in energy metabolites and feed intake in cattle.
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15
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Zhu R, Tian P, Zhang H, Wang G, Chen W. Gut microbiome-brain interactions in anorexia nervosa: Potential mechanisms and regulatory strategies. Neuropharmacology 2023; 224:109315. [PMID: 36356938 DOI: 10.1016/j.neuropharm.2022.109315] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 09/29/2022] [Accepted: 10/30/2022] [Indexed: 11/09/2022]
Abstract
Anorexia nervosa (AN) is a psychiatric disorder characterised by malnutrition, fear of weight gain, and body image disturbances. The aetiology of AN is complex, and may involve environmental factors, genetic factors, and biochemical factors, with the latter meaning that AN may be closely associated with neurons, neurotransmitters, and hormones related to appetite and emotional regulation. In addition, an increasing number of studies have shown there is a link between the intestinal microbiota and psychiatric disorders, such as depression. However, few studies and reviews have focused on AN and gut microbes. Accordingly, in this review, we examine the potential pathogenesis of AN in terms of changes in the gut microbiota and its metabolites, and their effects on AN. The neurobiological function of the nervous system in relation to AN are also been mentioned. Furthermore, we suggest future research directions for this field, and note that probiotics may be developed for use as dietary supplements to help alleviate AN in patients.
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Affiliation(s)
- Ran Zhu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, 214122, PR China; School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, 214122, China
| | - Peijun Tian
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, 214122, PR China; School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, 214122, China
| | - Hao Zhang
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, 214122, PR China; School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, 214122, China; National Engineering Research Center for Functional Food, Jiangnan University, Wuxi, Jiangsu, 214122, China; (Yangzhou) Institute of Food Biotechnology, Jiangnan University, Yangzhou, 225004, China; Wuxi Translational Medicine Research Center and Jiangsu Translational Medicine Research Institute Wuxi Branch, Wuxi, Jiangsu, 214122, China
| | - Gang Wang
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, 214122, PR China; School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, 214122, China; National Engineering Research Center for Functional Food, Jiangnan University, Wuxi, Jiangsu, 214122, China; (Yangzhou) Institute of Food Biotechnology, Jiangnan University, Yangzhou, 225004, China.
| | - Wei Chen
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, 214122, PR China; School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, 214122, China; Wuxi Translational Medicine Research Center and Jiangsu Translational Medicine Research Institute Wuxi Branch, Wuxi, Jiangsu, 214122, China
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16
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Frank GKW, Shott ME, Pryor T, Swindle S, Stoddard J. Brain reward response in adolescents and young adults with anorexia nervosa is moderated by changes in body weight and sweetness perception. Int J Eat Disord 2022; 55:1799-1810. [PMID: 36135728 DOI: 10.1002/eat.23814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/30/2022] [Accepted: 09/07/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Anorexia nervosa (AN) is a severe psychiatric illness with complex etiology. Recently, we found elevated striatal brain response to sweet taste stimuli in adolescents and young adults with AN. Here, we tested the hypothesis that nutritional rehabilitation normalizes prediction error activation, a measure for dopamine-related reward circuit response, to salient caloric taste stimuli in AN. METHODS A total of 28 individuals with AN (age = 16 ± 2 years; body mass index [BMI] = 16 ± 1) who previously underwent brain imaging while performing a taste prediction error task using sucrose as salient caloric stimulus, participated in a second brain imaging scan (BMI = 18 ± 1) after intensive specialized eating disorder treatment (41 ± 15 days). A total of 31 healthy controls (age = 16 ± 3 years; BMI = 21 ± 2) were also studied on two occasions. RESULTS At baseline, individuals with AN demonstrated an elevated salience response in bilateral caudate head and nucleus accumbens, and right ventral striatum. At the second scan, elevated response was only found in the right nucleus accumbens. A moderator analysis indicated that greater increase in BMI and greater decrease in sweetness perception predicted lesser prediction error response at the second scan in AN. CONCLUSION Consistent with the previously reported monetary stimulus-response, elevated taste prediction error response in AN was largely absent after weight restoration. This study indicates that changes in BMI and sweet taste perception are independent moderators of change of brain salience response in adolescents and young adults with AN. The study points toward dynamic changes in the brain reward circuitry in AN and highlights the importance of nutrition and weight restoration in that process. PUBLIC SIGNIFICANCE STATEMENT AN is a severe psychiatric illness. Biological factors that integrate neurobiology and behavior could become important targets to improve treatment outcome. This study highlights the importance of weight normalization and taste perception the normalization of brain function, and food type or taste-specific interventions could help in the recovery process. Furthermore, the study suggests that food-related and nonfood-related reward processing adapts to illness state in AN.
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Affiliation(s)
- Guido K W Frank
- Department of Psychiatry, University of California San Diego, San Diego, California, USA.,Rady Children's Hospital San Diego, Medical Behavior Unit, San Diego, California, USA
| | - Megan E Shott
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | | | - Skylar Swindle
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Joel Stoddard
- Department of Psychiatry, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
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17
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A Framework for Developing Translationally Relevant Animal Models of Stress-Induced Changes in Eating Behavior. Biol Psychiatry 2022; 91:888-897. [PMID: 34433512 PMCID: PMC8720907 DOI: 10.1016/j.biopsych.2021.06.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 06/22/2021] [Accepted: 06/24/2021] [Indexed: 02/08/2023]
Abstract
Stress often affects eating behaviors, leading to increased eating in some individuals and decreased eating in others. Identifying physiological and psychological factors that determine the direction of eating responses to stress has been a major goal of epidemiological and clinical studies. However, challenges of standardizing the stress exposure in humans hinder efforts to uncover the underlying mechanisms. The issue of what determines the direction of stress-induced feeding responses has not been directly addressed in animal models, but assays that combine stress with a feeding-related task are commonly used as readouts of other behaviors, such as anxiety. Sex, estrous cyclicity, circadian cyclicity, caloric restriction, palatable diets, elevated body weight, and properties of the stressors similarly influence feeding behavior in humans and rodent models. Yet, most rodent studies do not use conditions that are most relevant for studying feeding behavior in humans. This review proposes a conceptual framework for incorporating these influences to develop reproducible and translationally relevant assays to study effects of stress on food intake. Such paradigms have the potential to uncover links between emotional eating and obesity as well as to the etiology of eating disorders.
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18
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Murray SB, Zbozinek TD, Craske M, Tadayonnejad R, Strober M, Bari AA, O'Doherty JP, Feusner JD. Neural, physiological, and psychological markers of appetitive conditioning in anorexia nervosa: a study protocol. J Eat Disord 2022; 10:68. [PMID: 35538507 PMCID: PMC9092702 DOI: 10.1186/s40337-022-00546-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 01/31/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anorexia nervosa (AN) is a chronic and disabling psychiatric condition characterized by low hedonic drive towards food, and is thought to be inclusive of altered dimensions of reward processing. Whether there exists a fundamental aberrancy in the capacity to acquire and maintain de novo hedonic associations-a critical component of hedonic responding-has never been studied in AN. METHODS This multi-modal study will employ a 2-day Pavlovian appetitive conditioning paradigm to interrogate the (1) acquisition, (2) extinction, (3) spontaneous recovery and (4) reinstatement of appetitive learning in adolescents and young adults with AN. Participants will be 30 currently ill, underweight individuals with AN; 30 weight-restored individuals with AN; and 30 age-matched healthy controls, all aged 12-22 years. All subjects will undergo clinical assessment, followed by the 2-day appetitive conditioning task during which fMRI, pupillometry, heart rate deceleration, and subjective ratings will be acquired. DISCUSSION This study will be the first to interrogate appetitive conditioning in AN-a disorder characterized by altered hedonic responding to food. Results will help establish objective biomarkers of appetitive conditioning in AN and lay the groundwork for developing novel lines of treatment for AN and other psychiatric disorders involving diminished ability to experience pleasure and reward. TRIAL REGISTRATION Pending. INTENDED REGISTRY Clinicaltrials.gov.
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Affiliation(s)
- Stuart B Murray
- Department of Psychiatry and Behavioral Sciences, University of Southern California, 2250 Alcazar Street, Los Angeles, CA, 90033, USA.
| | - Tomislav D Zbozinek
- Division of Humanities and Social Sciences, California Institute of Technology, Pasadena, CA, USA
| | - Michelle Craske
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Reza Tadayonnejad
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA.,Computation and Neural Systems Program, California Institute of Technology, Pasadena, CA, USA
| | - Michael Strober
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Ausaf A Bari
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA
| | - John P O'Doherty
- Division of Humanities and Social Sciences, California Institute of Technology, Pasadena, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jamie D Feusner
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA.,Centre for Addiction and Mental Health, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
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19
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How Can Animal Models Inform the Understanding of Cognitive Inflexibility in Patients with Anorexia Nervosa? J Clin Med 2022; 11:jcm11092594. [PMID: 35566718 PMCID: PMC9105411 DOI: 10.3390/jcm11092594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/27/2022] [Accepted: 04/30/2022] [Indexed: 02/04/2023] Open
Abstract
Deficits in cognitive flexibility are consistently seen in patients with anorexia nervosa (AN). This type of cognitive impairment is thought to be associated with the persistence of AN because it leads to deeply ingrained patterns of thought and behaviour that are highly resistant to change. Neurobiological drivers of cognitive inflexibility have some commonalities with the abnormal brain functional outcomes described in patients with AN, including disrupted prefrontal cortical function, and dysregulated dopamine and serotonin neurotransmitter systems. The activity-based anorexia (ABA) model recapitulates the key features of AN in human patients, including rapid weight loss caused by self-starvation and hyperactivity, supporting its application in investigating the cognitive and neurobiological causes of pathological weight loss. The aim of this review is to describe the relationship between AN, neural function and cognitive flexibility in human patients, and to highlight how new techniques in behavioural neuroscience can improve the utility of animal models of AN to inform the development of novel therapeutics.
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20
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Kawakami I, Iritani S, Riku Y, Umeda K, Takase M, Ikeda K, Niizato K, Arai T, Yoshida M, Oshima K, Hasegawa M. Neuropathological investigation of patients with prolonged anorexia nervosa. Psychiatry Clin Neurosci 2022; 76:187-194. [PMID: 35167165 PMCID: PMC9314851 DOI: 10.1111/pcn.13340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 01/21/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Recent neuroimaging studies have indicated that the mesolimbic pathway, known to work as reward neuronal circuitry, regulates cognitive-behavioral flexibility in prolonged anorexia nervosa (AN). Although AN is associated with the highest mortality rate among psychiatric disorders, there have been few neuropathological studies on this topic. This study aims to identify alterations of the reward circuitry regions, especially in the nucleus accumbens (NAcc), using AN brain tissues. METHODS The neuronal networks in AN cases and controls were examined by immunohistochemistry directed at tyrosine hydroxylase (TH; dopaminergic neuron marker) and glial fibrillary acidic protein (GFAP; astrocyte marker). We also immunochemically analyzed frozen samples presenting astrogliosis, especially in the NAcc and striatum. RESULTS Histologically, neuronal deformation with cytoplasmic shrinkage was seen in reward-related brain regions, such as the orbitofrontal cortex/anterior cingulate cortex. The NAcc showed massive GFAP-positive astrocytes and dot-like protrusions of astrocytes in the shell compartment. In the shell, TH and GFAP immunoreactivities revealed prominent astrogliosis within striosomes, which receive projection from the ventral tegmental area (VTA). The numbers of GFAP-positive astrocytes in the NAcc (P = 0.0079) and VTA (P = 0.0025) of AN cases were significantly higher than those of controls. Strongly immunoreactive 18 to 25 kDa bands, which might represent degradation products, were detected only in the NAcc of AN cases. Clinically, all cases presented cognitive rigidity, which might reflect a deficit of the reward pathway. CONCLUSION Our findings suggest impaired dopaminergic innervation between the NAcc and VTA in AN. Functional dysconnectivity in the reward-related network might induce neuropsychiatric symptoms associated with AN.
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Affiliation(s)
- Ito Kawakami
- Dementia Research Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.,Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Shuji Iritani
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuichi Riku
- Institute for Medical Science of Aging, Aichi Medical University, Nagakute, Japan.,Department of Neurology, Nagoya University, Nagoya, Japan
| | - Kentaro Umeda
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan.,Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mina Takase
- Dementia Research Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kenji Ikeda
- Dementia Research Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kazuhiro Niizato
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Tomio Arai
- Department of Pathology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Mari Yoshida
- Institute for Medical Science of Aging, Aichi Medical University, Nagakute, Japan
| | - Kenichi Oshima
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Masato Hasegawa
- Dementia Research Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
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21
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Gupta A, Bhatt RR, Rivera-Cancel A, Makkar R, Kragel PA, Rodriguez T, Graner JL, Alaverdyan A, Hamadani K, Vora P, Naliboff B, Labus JS, LaBar KS, Mayer EA, Zucker N. Complex functional brain network properties in anorexia nervosa. J Eat Disord 2022; 10:13. [PMID: 35123579 PMCID: PMC8817538 DOI: 10.1186/s40337-022-00534-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anorexia nervosa (AN) is a disorder characterized by an incapacitating fear of weight gain and by a disturbance in the way the body is experienced, facets that motivate dangerous weight loss behaviors. Multimodal neuroimaging studies highlight atypical neural activity in brain networks involved in interoceptive awareness and reward processing. METHODS The current study used resting-state neuroimaging to model the architecture of large-scale functional brain networks and characterize network properties of individual brain regions to clinical measures. Resting-state neuroimaging was conducted in 62 adolescents, 22 (21 female) with a history of AN and 40 (39 female) healthy controls (HCs). Sensorimotor and basal ganglia regions, as part of a 165-region whole-brain network, were investigated. Subject-specific functional brain networks were computed to index centrality. A contrast analysis within the general linear model covarying for age was performed. Correlations between network properties and behavioral measures were conducted (significance q < .05). RESULTS Compared to HCs, AN had lower connectivity from sensorimotor regions, and greater connectivity from the left caudate nucleus to the right postcentral gyrus. AN demonstrated lower sensorimotor centrality, but higher basal ganglia centrality. Sensorimotor connectivity dyads and centrality exhibited negative correlations with body dissatisfaction and drive for thinness, two essential features of AN. CONCLUSIONS These findings suggest that AN is associated with greater communication from the basal ganglia, and lower information propagation in sensorimotor cortices. This is consistent with the clinical presentation of AN, where individuals exhibit patterns of rigid habitual behavior that is not responsive to bodily needs, and seem "disconnected" from their bodies.
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Affiliation(s)
- Arpana Gupta
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA. .,David Geffen School of Medicine, UCLA, Los Angeles, CA, 90095, USA. .,Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA, Los Angeles, CA, 90095, USA.
| | - Ravi R Bhatt
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA.,Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine at USC, University of Southern California, Los Angeles, USA
| | | | - Rishi Makkar
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA
| | | | - Thomas Rodriguez
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA
| | - John L Graner
- Department of Psychology and Neuroscience, Duke University, Durham, USA
| | - Anita Alaverdyan
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA
| | - Kareem Hamadani
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA
| | - Priten Vora
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA
| | - Bruce Naliboff
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA.,David Geffen School of Medicine, UCLA, Los Angeles, CA, 90095, USA.,Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA, Los Angeles, CA, 90095, USA
| | - Jennifer S Labus
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA.,David Geffen School of Medicine, UCLA, Los Angeles, CA, 90095, USA.,Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA, Los Angeles, CA, 90095, USA
| | - Kevin S LaBar
- Department of Psychology and Neuroscience, Duke University, Durham, USA
| | - Emeran A Mayer
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA.,David Geffen School of Medicine, UCLA, Los Angeles, CA, 90095, USA.,Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA, Los Angeles, CA, 90095, USA.,Ahmanson-Lovelace Brain Mapping Center, UCLA, Los Angeles, CA, 90095, USA
| | - Nancy Zucker
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, USA.,Department of Psychology and Neuroscience, Duke University, Durham, USA
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22
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Roger C, Lasbleiz A, Guye M, Dutour A, Gaborit B, Ranjeva JP. The Role of the Human Hypothalamus in Food Intake Networks: An MRI Perspective. Front Nutr 2022; 8:760914. [PMID: 35047539 PMCID: PMC8762294 DOI: 10.3389/fnut.2021.760914] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 12/07/2021] [Indexed: 12/12/2022] Open
Abstract
Hypothalamus (HT), this small structure often perceived through the prism of neuroimaging as morphologically and functionally homogeneous, plays a key role in the primitive act of feeding. The current paper aims at reviewing the contribution of magnetic resonance imaging (MRI) in the study of the role of the HT in food intake regulation. It focuses on the different MRI techniques that have been used to describe structurally and functionally the Human HT. The latest advances in HT parcellation as well as perspectives in this field are presented. The value of MRI in the study of eating disorders such as anorexia nervosa (AN) and obesity are also highlighted.
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Affiliation(s)
- Coleen Roger
- Centre de Résonance Magnétique Biologique et Médicale (CRMBM), Centre National de la Recherche Scientifique (CNRS), Université Aix-Marseille, Marseille, France.,Centre d'Exploration Métabolique par Résonance Magnétique (CEMEREM), Assistance Publique-Hôpitaux de Marseille (AP-HM), Hôpital Universitaire de la Timone, Marseille, France
| | - Adèle Lasbleiz
- Centre d'Exploration Métabolique par Résonance Magnétique (CEMEREM), Assistance Publique-Hôpitaux de Marseille (AP-HM), Hôpital Universitaire de la Timone, Marseille, France.,Département d'Endocrinologie, Assistance Publique-Hôpitaux de Marseille (AP-HM), Hôpital de la Conception, Marseille, France
| | - Maxime Guye
- Centre de Résonance Magnétique Biologique et Médicale (CRMBM), Centre National de la Recherche Scientifique (CNRS), Université Aix-Marseille, Marseille, France.,Centre d'Exploration Métabolique par Résonance Magnétique (CEMEREM), Assistance Publique-Hôpitaux de Marseille (AP-HM), Hôpital Universitaire de la Timone, Marseille, France
| | - Anne Dutour
- Département d'Endocrinologie, Assistance Publique-Hôpitaux de Marseille (AP-HM), Hôpital de la Conception, Marseille, France
| | - Bénédicte Gaborit
- Département d'Endocrinologie, Assistance Publique-Hôpitaux de Marseille (AP-HM), Hôpital de la Conception, Marseille, France
| | - Jean-Philippe Ranjeva
- Centre de Résonance Magnétique Biologique et Médicale (CRMBM), Centre National de la Recherche Scientifique (CNRS), Université Aix-Marseille, Marseille, France.,Centre d'Exploration Métabolique par Résonance Magnétique (CEMEREM), Assistance Publique-Hôpitaux de Marseille (AP-HM), Hôpital Universitaire de la Timone, Marseille, France
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23
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Beeler JA, Burghardt NS. The Rise and Fall of Dopamine: A Two-Stage Model of the Development and Entrenchment of Anorexia Nervosa. Front Psychiatry 2022; 12:799548. [PMID: 35087433 PMCID: PMC8787068 DOI: 10.3389/fpsyt.2021.799548] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/14/2021] [Indexed: 12/03/2022] Open
Abstract
Dopamine has long been implicated as a critical neural substrate mediating anorexia nervosa (AN). Despite nearly 50 years of research, the putative direction of change in dopamine function remains unclear and no consensus on the mechanistic role of dopamine in AN has been achieved. We hypothesize two stages in AN- corresponding to initial development and entrenchment- characterized by opposite changes in dopamine. First, caloric restriction, particularly when combined with exercise, triggers an escalating spiral of increasing dopamine that facilitates the behavioral plasticity necessary to establish and reinforce weight-loss behaviors. Second, chronic self-starvation reverses this escalation to reduce or impair dopamine which, in turn, confers behavioral inflexibility and entrenchment of now established AN behaviors. This pattern of enhanced, followed by impaired dopamine might be a common path to many behavioral disorders characterized by reinforcement learning and subsequent behavioral inflexibility. If correct, our hypothesis has significant clinical and research implications for AN and other disorders, such as addiction and obesity.
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Affiliation(s)
- Jeff A. Beeler
- Department of Psychology, Queens College, City University of New York, Flushing, NY, United States
- Psychology Program, The Graduate Center, CUNY, New York, NY, United States
- Biology Program, The Graduate Center, City University of New York, New York, NY, United States
| | - Nesha S. Burghardt
- Psychology Program, The Graduate Center, CUNY, New York, NY, United States
- Department of Psychology, Hunter College, CUNY, New York, NY, United States
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24
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Oudijn M, Linders J, Mocking R, Lok A, van Elburg A, Denys D. Psychopathological and Neurobiological Overlap Between Anorexia Nervosa and Self-Injurious Behavior: A Narrative Review and Conceptual Hypotheses. Front Psychiatry 2022; 13:756238. [PMID: 35633779 PMCID: PMC9130491 DOI: 10.3389/fpsyt.2022.756238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 04/25/2022] [Indexed: 11/29/2022] Open
Abstract
Empirical evidence and clinical observations suggest a strong -yet under acknowledged-link between anorexia nervosa (AN) and non-suicidal self-injurious behavior (NSSI). By reviewing the literature on the psychopathology and neurobiology of AN and NSSI, we shed light on their relationship. Both AN and NSSI are characterized by disturbances in affect regulation, dysregulation of the reward circuitry and the opioid system. By formulating a reward-centered hypothesis, we explain the overlap between AN and NSSI. We propose three approaches understanding the relationship between AN and NSSI, which integrate psychopathology and neurobiology from the perspective of self-destructiveness: (1) a nosographical approach, (2) a research domain (RDoC) approach and (3) a network analysis approach. These approaches will enhance our knowledge of the underlying neurobiological substrates and may provide groundwork for the development of new treatment options for disorders of self-destructiveness, like AN and NSSI. In conclusion, we hypothesize that self-destructiveness is a new, DSM-5-transcending concept or psychopathological entity that is reward-driven, and that both AN and NSSI could be conceptualized as disorders of self-destructiveness.
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Affiliation(s)
- Marloes Oudijn
- Department of Psychiatry, Amsterdam University Medical Centers (Amsterdam UMC), Academic Medical Center (AMC), University of Amsterdam, Amsterdam, Netherlands
| | - Jara Linders
- Department of Psychiatry, Amsterdam University Medical Centers (Amsterdam UMC), Academic Medical Center (AMC), University of Amsterdam, Amsterdam, Netherlands
| | - Roel Mocking
- Department of Psychiatry, Amsterdam University Medical Centers (Amsterdam UMC), Academic Medical Center (AMC), University of Amsterdam, Amsterdam, Netherlands
| | - Anja Lok
- Department of Psychiatry, Amsterdam University Medical Centers (Amsterdam UMC), Academic Medical Center (AMC), University of Amsterdam, Amsterdam, Netherlands
| | | | - D Denys
- Department of Psychiatry, Amsterdam University Medical Centers (Amsterdam UMC), Academic Medical Center (AMC), University of Amsterdam, Amsterdam, Netherlands
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25
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Murray SB, Strober M, Tadayonnejad R, Bari AA, Feusner JD. Neurosurgery and neuromodulation for anorexia nervosa in the 21st century: a systematic review of treatment outcomes. Eat Disord 2022; 30:26-53. [PMID: 32991247 PMCID: PMC8386186 DOI: 10.1080/10640266.2020.1790270] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
As current psychosocial and pharmacological interventions show limited efficacy in the treatment of anorexia nervosa (AN), interest in the potential value of neurosurgical intervention and neuromodulation in managing severe and enduring illness has grown. We conducted a systematic review of 20 trials of neurosurgical and neuromodulatory treatments for AN, including neurosurgical ablation, deep brain stimulation (DBS), repetitive transcranial magnetic stimulation (rTMS), and transcranial direct current stimulation (tDCS). Overall, there is evidence to support the role of stereotactic ablation and DBS in the treatment of AN. In contrast, results for rTMS and tDCS have been modest and generally more mixed. Neurosurgical treatment may offer important new avenues for the treatment of AN. Additional randomized clinical trials with comparable patient populations will be needed, in which change in affective, cognitive, and perceptual symptom phenomena, and interrogation of targeted circuits, pre- and post-intervention, are carefully documented.
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Affiliation(s)
- Stuart B Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Michael Strober
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, USA
| | - Reza Tadayonnejad
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, USA
| | - Ausaf A Bari
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jamie D Feusner
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, USA
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26
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Abstract
PURPOSE OF REVIEW The goal of this review is to describe how emerging technological developments in pre-clinical animal research can be harnessed to accelerate research in anorexia nervosa (AN). RECENT FINDINGS The activity-based anorexia (ABA) paradigm, the best characterized animal model of AN, combines restricted feeding, excessive exercise, and weight loss. A growing body of evidence supports the idea that pathophysiological weight loss in this model is due to cognitive inflexibility, a clinical feature of AN. Targeted manipulations that recapitulate brain changes reported in AN - hyperdopaminergia or hyperactivity of cortical inputs to the nucleus accumbens - exacerbate weight loss in the ABA paradigm, providing the first evidence of causality. The power of preclinical research lies in the ability to assess the consequences of targeted manipulations of neuronal circuits that have been implicated in clinical research. Additional paradigms are needed to capture other features of AN that are not seen in ABA.
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Abstract
Anhedonia is frequently observed among individuals with eating disorders (ED), though its relevance to ED pathology and clinical outcomes remain poorly understood. This chapter will present the latest findings regarding anhedonia in ED, with the majority of data available for anorexia nervosa (AN) and bulimia nervosa (BN). We consider anhedonia from the mechanistic lens of altered reward processing, with attention given to subjective experience, neurotransmitter function, neural correlates, and cognitive performance corresponding to distinct components of reward (i.e., liking, wanting, and learning). Findings from animal models are also highlighted. The chapter concludes with a discussion of implications for treatment and future directions aimed at better understanding anhedonia in ED.
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Affiliation(s)
- Susan M Murray
- Department of Psychiatry, University of California San Diego, UCSD Eating Disorders Center for Treatment and Research, San Diego, CA, USA
| | - Carina S Brown
- Department of Psychiatry, University of California San Diego, UCSD Eating Disorders Center for Treatment and Research, San Diego, CA, USA
| | - Walter H Kaye
- Department of Psychiatry, University of California San Diego, UCSD Eating Disorders Center for Treatment and Research, San Diego, CA, USA
| | - Christina E Wierenga
- Department of Psychiatry, University of California San Diego, UCSD Eating Disorders Center for Treatment and Research, San Diego, CA, USA.
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28
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Beeler JA, Mourra D, Zanca RM, Kalmbach A, Gellman C, Klein BY, Ravenelle R, Serrano P, Moore H, Rayport S, Mingote S, Burghardt NS. Vulnerable and Resilient Phenotypes in a Mouse Model of Anorexia Nervosa. Biol Psychiatry 2021; 90:829-842. [PMID: 32950210 PMCID: PMC7855473 DOI: 10.1016/j.biopsych.2020.06.030] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 06/26/2020] [Accepted: 06/30/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Increased physical activity is a common feature of anorexia nervosa (AN). Although high activity levels are associated with greater risk of developing AN, particularly when combined with dieting, most individuals who diet and exercise maintain a healthy body weight. It is unclear why some individuals develop AN while most do not. A rodent model of resilience and vulnerability to AN would be valuable to research. Dopamine, which is believed to play a crucial role in AN, regulates both reward and activity and may modulate vulnerability. METHODS Adolescent and young adult female C57BL/6N mice were tested in the activity-based anorexia (ABA) model, with an extended period of food restriction in adult mice. ABA was also tested in dopamine transporter knockdown mice and wild-type littermates. Mice that adapted to conditions and maintained a stable body weight were characterized as resilient. RESULTS In adults, vulnerable and resilient phenotypes emerged in both the ABA and food-restricted mice without wheels. Vulnerable mice exhibited a pronounced increase in running throughout the light cycle, which dramatically peaked prior to requiring removal from the experiment. Resilient mice exhibited an adaptive decrease in total running, appropriate food anticipatory activity, and increased consumption, thereby achieving stable body weight. Hyperdopaminergia accelerated progression of the vulnerable phenotype. CONCLUSIONS Our demonstration of distinct resilient and vulnerable phenotypes in mouse ABA significantly advances the utility of the model for identifying genes and neural substrates mediating AN risk and resilience. Modulation of dopamine may play a central role in the underlying circuit.
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Affiliation(s)
- Jeff A. Beeler
- Dept. of Psychology, Queens College and The Graduate Center, CUNY, Flushing, NY, 11367 USA
| | - Devry Mourra
- Dept. of Psychology, Queens College and The Graduate Center, CUNY, Flushing, NY, 11367 USA
| | - Roseanna M. Zanca
- Dept. of Psychology, Hunter College and The Graduate Center, CUNY, New York, NY, 10065 USA
| | - Abigail Kalmbach
- Dept. of Psychiatry, Columbia University, New York, NY, 10032 USA
| | - Celia Gellman
- Dept. of Psychiatry, Columbia University, New York, NY, 10032 USA,Dept. of Molecular Therapeutics, NYS Psychiatric Institute, New York, NY 10032 USA
| | - Benjamin Y. Klein
- Dept. of Psychiatry, Columbia University, New York, NY, 10032 USA,Dept. of Developmental Neuroscience, NYS Psychiatric Institute, New York, NY 10031 USA,Dept. of Microbiology and Molecular Genetics, Hebrew University, Jerusalem, Israel
| | | | - Peter Serrano
- Dept. of Psychology, Hunter College and The Graduate Center, CUNY, New York, NY, 10065 USA
| | - Holly Moore
- Dept. of Psychiatry, Columbia University, New York, NY, 10032 USA,Dept. of Systems Neuroscience, NYS Psychiatric Institute, New York, NY 10032 USA,National Institute on Drug Abuse, Bethesda, MD
| | - Stephen Rayport
- Dept. of Psychiatry, Columbia University, New York, NY, 10032 USA,Dept. of Molecular Therapeutics, NYS Psychiatric Institute, New York, NY 10032 USA
| | - Susana Mingote
- Dept. of Psychiatry, Columbia University, New York, NY, 10032 USA,Dept. of Molecular Therapeutics, NYS Psychiatric Institute, New York, NY 10032 USA,Advanced Science Research Center, The Graduate Center, CUNY, New York, NY 10031 USA
| | - Nesha S. Burghardt
- Dept. of Psychology, Hunter College and The Graduate Center, CUNY, New York, NY, 10065 USA,Dept. of Psychiatry, Columbia University, New York, NY, 10032 USA
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29
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Spadini S, Ferro M, Lamanna J, Malgaroli A. Activity-based anorexia animal model: a review of the main neurobiological findings. J Eat Disord 2021; 9:123. [PMID: 34600568 PMCID: PMC8487535 DOI: 10.1186/s40337-021-00481-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/15/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The genesis of anorexia nervosa (AN), a severe eating disorder with a pervasive effect on many brain functions such as attention, emotions, reward processing, cognition and motor control, has not yet been understood. Since our current knowledge of the genetic aspects of AN is limited, we are left with a large and diversified number of biological, psychological and environmental risk factors, called into question as potential triggers of this chronic condition with a high relapse rate. One of the most valid and used animal models for AN is the activity-based anorexia (ABA), which recapitulates important features of the human condition. This model is generated from naïve rodents by a self-motivated caloric restriction, where a fixed schedule food delivery induces spontaneous increased physical activity. AIM In this review, we sought to provide a summary of the experimental research conducted using the ABA model in the pursuit of potential neurobiological mechanism(s) underlying AN. METHOD The experimental work presented here includes evidence for neuroanatomical and neurophysiological changes in several brain regions as well as for the dysregulation of specific neurochemical synaptic and neurohormonal pathways. RESULTS The most likely hypothesis for the mechanism behind the development of the ABA phenotype relates to an imbalance of the neural circuitry that mediates reward processing. Evidence collected here suggests that ABA animals show a large set of alterations, involving regions whose functions extend way beyond the control of reward mechanisms and eating habits. Hence, we cannot exclude a primary role of these alterations from a mechanistic theory of ABA induction. CONCLUSIONS These findings are not sufficient to solve such a major enigma in neuroscience, still they could be used to design ad hoc further experimental investigation. The prospect is that, since treatment of AN is still challenging, the ABA model could be more effectively used to shed light on the complex AN neurobiological framework, thus supporting the future development of therapeutic strategies but also the identification of biomarkers and diagnostic tools. Anorexia Nervosa (AN) is a severe eating disorder with a dramatic effect on many functions of our brain, such as attention, emotions, cognition and motion control. Since our current knowledge of the genetic aspects behind the development of AN is still limited, many biological, psychological and environmental factors must be taken into account as potential triggers of this condition. One of the most valid animal models for studying AN is the activity-based anorexia (ABA). In this model, rodents spontaneously limit food intake and start performing increased physical activity on a running wheel, a result of the imposition of a fixed time schedule for food delivery. In this review, we provide a detailed summary of the experimental research conducted using the ABA model, which includes extended evidence for changes in the anatomy and function of the brain of ABA rodents. The hope is that such integrated view will support the design of future experiments that will shed light on the complex brain mechanisms behind AN. Such advanced knowledge is crucial to find new, effective strategies for both the early diagnosis of AN and for its treatment.
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Affiliation(s)
- Sara Spadini
- Center for Behavioral Neuroscience and Communication (BNC), Vita-Salute San Raffaele University, Via Olgettina 58, 20132, Milan, Italy
| | - Mattia Ferro
- Center for Behavioral Neuroscience and Communication (BNC), Vita-Salute San Raffaele University, Via Olgettina 58, 20132, Milan, Italy
- Department of Psychology, Sigmund Freud University, Milan, Italy
| | - Jacopo Lamanna
- Center for Behavioral Neuroscience and Communication (BNC), Vita-Salute San Raffaele University, Via Olgettina 58, 20132, Milan, Italy
- Faculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy
| | - Antonio Malgaroli
- Center for Behavioral Neuroscience and Communication (BNC), Vita-Salute San Raffaele University, Via Olgettina 58, 20132, Milan, Italy.
- Faculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy.
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30
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Kogel AK, Herpertz S, Steins-Loeber S, Diers M. Disorder specific rewarding stimuli in anorexia nervosa. Int J Eat Disord 2021; 54:1477-1485. [PMID: 33955563 DOI: 10.1002/eat.23526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 04/09/2021] [Accepted: 04/10/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To enhance our understanding of reward stimuli in anorexia nervosa (AN) and to provide a basis for future research on reward processes, disorder specific reward stimuli as well as primary and secondary reinforcers were investigated. METHOD We developed a set of pictures with "disorder specific reward" stimuli, with the six subcategories "sport," "losing weight," "healthy food," "discipline," "thin bodies," "appreciation of others," and evaluated reward ratings of these "disorder specific reward" stimuli as well as "erotic," "high caloric," and "neutral" stimuli in 25 patients with AN and 25 participants in the comparison group (CG). RESULTS We found a significant main effect for picture category and a significant interaction. The reward ratings were higher in patients with AN compared with CG for the "disorder specific reward" stimuli. In the reward subcategories, patients with AN had higher reward ratings compared with CG in all categories except of healthy food. The "disorder specific reward" stimuli of the categories "sport," "losing weight," and "healthy food" showed higher reward ratings compared with the categories "discipline," "thin bodies," and "appreciation of others" in patients with AN. DISCUSSION The previously used category "thin bodies" used to investigate the reward system might be less effective compared with stimuli from the categories "sport," "losing weight," and "healthy food."
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Affiliation(s)
- Ann-Kathrin Kogel
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Sabine Steins-Loeber
- Department of Clinical Psychology and Psychotherapy, Otto-Friedrich-University of Bamberg, Bamberg, Germany
| | - Martin Diers
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
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31
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Dopamine D2 receptor overexpression in the nucleus accumbens core induces robust weight loss during scheduled fasting selectively in female mice. Mol Psychiatry 2021; 26:3765-3777. [PMID: 31863019 PMCID: PMC7305037 DOI: 10.1038/s41380-019-0633-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 11/26/2019] [Accepted: 12/11/2019] [Indexed: 01/22/2023]
Abstract
Anorexia nervosa (AN) is an eating disorder observed predominantly in women and girls that is characterized by a low body-mass index, hypophagia, and hyperactivity. Activity-based anorexia (ABA), which refers to the weight loss, hypophagia, and hyperactivity exhibited by rodents exposed to both running wheels and scheduled fasting, provides a model for aspects of AN. Increased dopamine D2/D3 receptor binding in the anteroventral striatum has been reported in AN patients. We virally overexpressed D2Rs on nucleus accumbens core (D2R-OENAc) neurons that endogenously express D2Rs, and tested mice of both sexes in the open field test, ABA paradigm, and intraperitoneal glucose tolerance test (IGTT). D2R-OENAc did not alter baseline body weight, but increased locomotor activity in the open field across both sexes. During constant access to food and running wheels, D2R-OENAc mice of both sexes increased food intake and ran more than controls. However, when food was available only 7 h a day, only female D2R-OENAc mice rapidly lost 25% of their initial body weight, reduced food intake, and substantially increased wheel running. Surprisingly, female D2R-OENAc mice also rapidly lost 25% of their initial body weight during scheduled fasting without wheel access and showed no changes in food intake. In contrast, male D2R-OENAc mice maintained body weight during scheduled fasting. D2R-OENAc mice of both sexes also showed glucose intolerance in the IGTT. In conclusion, D2R-OENAc alters glucose metabolism in both sexes but drives robust weight loss only in females during scheduled fasting, implicating metabolic mechanisms in this sexually dimorphic effect.
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32
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Atomoxetine Reduced Binge/Purge Symptoms in a Case of Anorexia Nervosa Binge/Purge Type. Clin Neuropharmacol 2021; 44:68-70. [PMID: 33538518 DOI: 10.1097/wnf.0000000000000438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Psychopharmacologic treatments for eating disorders (EDs) remain unclear, particularly for anorexia nervosa. As in attention-deficit hyperactivity disorder, a dopaminergic mechanism has been implicated in EDs, prompting our use of atomoxetine in an 18-year-old woman with anorexia nervosa, binge/purge type. Atomoxetine is a highly selective norepinephrine reuptake inhibitor with nonaddictive properties and limited effects of appetite suppression. Doses followed those used in a previous trial of atomoxetine in the treatment of binge ED, and response was assessed over 4 months, with significant improvement in ED behaviors and mood. Larger-scale, randomized studies that assess the efficacy of atomoxetine in the treatment of anorexia nervosa, binge/purge type are warranted.
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33
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Umeda K, Kawakami I, Ikeda K, Tanei ZI, Matsubara T, Murayama S, Murahashi Y, Niizato K, Oshima K, Iritani S. Case report of anorexia nervosa showing periventricular gliosis at autopsy. Neuropathology 2021; 41:127-132. [PMID: 33474800 DOI: 10.1111/neup.12711] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/08/2020] [Accepted: 09/11/2020] [Indexed: 01/14/2023]
Abstract
Anorexia nervosa (AN) is a serious eating disorder characterized by self-starvation and extreme weight loss. It has the highest mortality rate among all psychiatric disorders. Recent research indicates that malnutrition in AN patients induces various kinds of functional brain damage, but the pathophysiology of AN remains unclear. We report here the neuropathological findings of a 31-year-old Japanese woman. At age 24, she had a fear of gaining weight and reduced her dietary intake; she had extremely low body weight associated with overeating then self-induced vomiting. She was clinically diagnosed as having AN and was admitted to a psychiatric hospital with severe depression and suicidal thoughts. At age 31, she died despite intensive physical care and psychotherapy. Neuropathological examination revealed increased capillary blood vessels and slight fibrillary gliosis in the mammillary bodies, with similarities to Wernicke encephalopathy. The brainstem exhibited the characteristic features of central pontine myelinolysis, characterized by a sharply demarcated region of myelin pallor and relative sparing of axons. Senile changes, including neurofibrillary tangles/senile plaques, were not significant. Severe fibrillary gliosis was prominent around periventricular regions, including the caudate nucleus and nucleus accumbens, which are associated with cognition, emotion, and emotional behaviors via the dopaminergic pathways. These findings indicate that prolonged malnutrition in AN patients may induce brain damage, leading to dysfunction of the reward-related dopaminergic pathways. Furthermore, they represent the first pathological evidence that dysfunction of the cortico-limbic-striatal circuitry is involved in the pathophysiology of psychiatric symptoms in AN patients.
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Affiliation(s)
- Kentaro Umeda
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan.,Department of Psychiatry, Nagoya University, Nagoya, Japan
| | - Ito Kawakami
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan.,Department of Neuropathology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan.,Dementia Research Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kenji Ikeda
- Dementia Research Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Zen-Ichi Tanei
- Department of Neuropathology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Tomoyasu Matsubara
- Department of Neuropathology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Shigeo Murayama
- Department of Neuropathology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | - Yuki Murahashi
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Kazuhiro Niizato
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Kenichi Oshima
- Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - Shuji Iritani
- Department of Psychiatry, Nagoya University, Nagoya, Japan
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34
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Zhang J, Dulawa SC. The Utility of Animal Models for Studying the Metabo-Psychiatric Origins of Anorexia Nervosa. Front Psychiatry 2021; 12:711181. [PMID: 34721100 PMCID: PMC8551379 DOI: 10.3389/fpsyt.2021.711181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 09/17/2021] [Indexed: 11/15/2022] Open
Abstract
Anorexia nervosa (AN) is a severe eating disorder that primarily affects young women and girls, and is characterized by abnormal restrictive feeding and a dangerously low body-mass index. AN has one of the highest mortality rates of any psychiatric disorder, and no approved pharmacological treatments exist. Current psychological and behavioral treatments are largely ineffective, and relapse is common. Relatively little basic research has examined biological mechanisms that underlie AN compared to other major neuropsychiatric disorders. A recent large-scale genome-wide association study (GWAS) revealed that the genetic architecture of AN has strong metabolic as well as psychiatric origins, suggesting that AN should be reconceptualized as a metabo-psychiatric disorder. Therefore, identifying the metabo-psychiatric mechanisms that contribute to AN may be essential for developing effective treatments. This review focuses on animal models for studying the metabo-psychiatric mechanisms that may contribute to AN, with a focus on the activity-based anorexia (ABA) paradigm. We also highlight recent work using modern circuit-dissecting neuroscience techniques to uncover metabolic mechanisms that regulate ABA, and encourage further work to ultimately identify novel treatment strategies for AN.
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Affiliation(s)
- Jie Zhang
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Stephanie C Dulawa
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
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Exploring the Eating Disorder Examination Questionnaire, Clinical Impairment Assessment, and Autism Quotient to Identify Eating Disorder Vulnerability: A Cluster Analysis. MACHINE LEARNING AND KNOWLEDGE EXTRACTION 2020. [DOI: 10.3390/make2030019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Eating disorders are very complicated and many factors play a role in their manifestation. Furthermore, due to the variability in diagnosis and symptoms, treatment for an eating disorder is unique to the individual. As a result, there are numerous assessment tools available, which range from brief survey questionnaires to in-depth interviews conducted by a professional. One of the many benefits to using machine learning is that it offers new insight into datasets that researchers may not previously have, particularly when compared to traditional statistical methods. The aim of this paper was to employ k-means clustering to explore the Eating Disorder Examination Questionnaire, Clinical Impairment Assessment, and Autism Quotient scores. The goal is to identify prevalent cluster topologies in the data, using the truth data as a means to validate identified groupings. Our results show that a model with k = 2 performs the best and clustered the dataset in the most appropriate way. This matches our truth data group labels, and we calculated our model’s accuracy at 78.125%, so we know that our model is working well. We see that the Eating Disorder Examination Questionnaire (EDE-Q) and Clinical Impairment Assessment (CIA) scores are, in fact, important discriminators of eating disorder behavior.
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Frank GKW, Kalina C, DeGuzman MC, Shott ME. Eye blink and reward prediction error response in anorexia nervosa. Int J Eat Disord 2020; 53:1544-1549. [PMID: 32567716 DOI: 10.1002/eat.23332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 06/07/2020] [Accepted: 06/08/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Functional brain imaging has been used to study brain reward function and behavioral traits in anorexia nervosa (AN). Here we tested whether eye blink relates to behavior and brain imaging response as a method that is less costly and more accessible. METHOD We recruited 26 women with AN and 50 healthy matched controls. All underwent a reward-learning prediction error task during functional magnetic resonance imaging. In addition, eye blink was measured for spontaneous blink rate, baseline blink amplitude, and startle response to an auditory stimulus. RESULTS Baseline blink rate, amplitude and startle response were similar between groups. In AN, there were significant positive correlations between spontaneous blink rate and bulimia symptoms, and baseline blink amplitude and prediction error response in right-sided caudate, insula, and nucleus accumbens. Correlations between eye blink measures and body dissatisfaction or harm avoidance were no longer significant after multiple comparison adjustments. DISCUSSION This study provides evidence that measures of eye blink response can be related to brain prediction error response and eating disorder behavior in AN. The catecholamine dopamine contributes to both eye blink and prediction error response providing indirect evidence that it could be a neurobiological correlate that contributes to behaviors relevant to AN.
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Affiliation(s)
- Guido K W Frank
- Department of Psychiatry, University of California at San Diego, San Diego, California, USA
| | | | | | - Megan E Shott
- Department of Psychiatry, University of California at San Diego, San Diego, California, USA
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Backstage of Eating Disorder-About the Biological Mechanisms behind the Symptoms of Anorexia Nervosa. Nutrients 2020; 12:nu12092604. [PMID: 32867089 PMCID: PMC7551451 DOI: 10.3390/nu12092604] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/23/2020] [Accepted: 08/25/2020] [Indexed: 12/12/2022] Open
Abstract
Anorexia nervosa (AN) represents a disorder with the highest mortality rate among all psychiatric diseases, yet our understanding of its pathophysiological components continues to be fragmentary. This article reviews the current concepts regarding AN pathomechanisms that focus on the main biological aspects involving central and peripheral neurohormonal pathways, endocrine function, as well as the microbiome–gut–brain axis. It emerged from the unique complexity of constantly accumulating new discoveries, which hamper the ability to look at the disease in a more comprehensive way. The emphasis is placed on the mechanisms underlying the main symptoms and potential new directions that require further investigation in clinical settings.
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Galusca B, Traverse B, Costes N, Massoubre C, Le Bars D, Estour B, Germain N, Redouté J. Decreased cerebral opioid receptors availability related to hormonal and psychometric profile in restrictive-type anorexia nervosa. Psychoneuroendocrinology 2020; 118:104711. [PMID: 32460196 DOI: 10.1016/j.psyneuen.2020.104711] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 04/27/2020] [Accepted: 05/05/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The opioid system role in anorexia nervosa (AN) pathophysiology is still unclear since conflicting results were reported on peripheral and cerebrospinal fluid opioids levels. The study main aim was to evaluate cerebral AN opiate receptor availability by using [11C] diprenorphine, a ligand with non-selective binding. METHODS In vivo [11C]diprenorphine cerebral non-displaceable binding potential (BPND) evaluated by PET imaging was compared between three groups : 17 undernourished restrictive-type AN patients (LeanAN), 15 AN patients having regained normal weight (RecAN) and 15 controls. A lower BPND may account for an increased opioid tone and vice versa. Serum hormones and endogenous opioids levels, eating-related and unspecific psychological traits were also evaluated. RESULTS Compared to controls, LeanAN and RecAN patients had decreased [11C]diprenorphine BPND in middle frontal gyrus, temporo-parietal cortices, anterior cingulate cortex and in left accumbens nucleus. Hypothalamo-pituitary (H-P), left amygdala and insula BPND was found decreased only in LeanAN and that of putamen only in RecAN. LeanAN presented higher dynorphin A and enkephalin serum levels than in controls or RecAN. Inverse correlations were found in total group between : 24 h mean serum cortisol levels and anterior cingulate gyrus or insula BPND; eating concern score and left amygdala BPND. Positive correlation were found between leptin and hypothamus BPND; LH and pituitary BPND. CONCLUSIONS Low opiate receptor availability may be interpreted as an increased opioid tone in areas associated with both reward/aversive system in both AN groups. The relationship between the opioid receptors activity and hypercorticism or specific psychometric scores in some of these regions suggests adaptive mechanisms facing anxiety but also may play a role in the disease perpetuation.
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Affiliation(s)
- Bogdan Galusca
- Endocrinology Department, CHU Saint Etienne, 42055 Saint Etienne Cedex 2, France; TAPE Reaserch Unit, EA 7423, Jean Monnet University, Saint Etienne, France.
| | - Bastien Traverse
- Endocrinology Department, CHU Saint Etienne, 42055 Saint Etienne Cedex 2, France; TAPE Reaserch Unit, EA 7423, Jean Monnet University, Saint Etienne, France
| | | | - Catherine Massoubre
- Psychiatry Department, CHU Saint Etienne Saint Etienne, France; TAPE Reaserch Unit, EA 7423, Jean Monnet University, Saint Etienne, France
| | | | - Bruno Estour
- Endocrinology Department, CHU Saint Etienne, 42055 Saint Etienne Cedex 2, France; TAPE Reaserch Unit, EA 7423, Jean Monnet University, Saint Etienne, France
| | - Natacha Germain
- Endocrinology Department, CHU Saint Etienne, 42055 Saint Etienne Cedex 2, France; TAPE Reaserch Unit, EA 7423, Jean Monnet University, Saint Etienne, France
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Increased anticipatory brain response to pleasant touch in women remitted from bulimia nervosa. Transl Psychiatry 2020; 10:236. [PMID: 32669557 PMCID: PMC7363900 DOI: 10.1038/s41398-020-00916-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 06/22/2020] [Accepted: 06/30/2020] [Indexed: 01/24/2023] Open
Abstract
Bulimia nervosa (BN) is characterized by affective instability and dysregulated behaviors (binge eating, fasting, self-induced vomiting) that disrupt bodily homeostasis. Mechanisms underlying dysregulation in BN are unclear, although altered reward responsivity, anticipatory processing of environmental cues, and interoception (detection and integration of body-state signals to regulate behavior) have been implicated in BN pathophysiology. We aimed to determine whether BN is associated with ineffectively predicting body state or integrating predicted experience with actual experience by examining neural response to anticipation and experience of affective touch, a pleasant interoceptive stimulus that acts on sensory and emotional systems to guide behavior. During fMRI, we administered soft strokes to the palm and forearm in women remitted from BN (RBN; N = 23) and control women (CW; N = 25). A Group (RBN/CW) × Condition (anticipation/touch) interaction was found in the right dorsal caudate; both CW and RBN had increased activation during touch compared with anticipation, with RBN demonstrating marginally greater anticipatory response than CW. For RBN, those individuals who showed greater anticipatory response in the dorsal caudate also reported higher levels of harm avoidance. RBN individuals relative to CW showed greater activation in left putamen and insula during the anticipation but not when experiencing an affective touch. This increase during anticipation rather than the actual experience of the affective touch is consistent with a top-down preparatory process which is associated with harm avoidance and is similar to what has been observed in anxious individuals. This aberrant signal integration could disrupt feedback processing, serving to maintain disordered behavior.
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Kaye WH, Wierenga CE, Bischoff-Grethe A, Berner LA, Ely AV, Bailer UF, Paulus MP, Fudge JL. Neural Insensitivity to the Effects of Hunger in Women Remitted From Anorexia Nervosa. Am J Psychiatry 2020; 177:601-610. [PMID: 32160766 PMCID: PMC7332383 DOI: 10.1176/appi.ajp.2019.19030261] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Anorexia nervosa has the highest mortality rate of any psychiatric condition, yet the pathophysiology of this disorder and its primary symptom, extreme dietary restriction, remains poorly understood. In states of hunger relative to satiety, the rewarding value of food stimuli normally increases to promote eating, yet individuals with anorexia nervosa avoid food despite emaciation. This study's aim was to examine potential neural insensitivity to these effects of hunger in anorexia nervosa. METHODS At two scanning sessions scheduled 24 hours apart, one after a 16-hour fast and one after a standardized meal, 26 women who were in remission from anorexia nervosa (to avoid the confounding effects of malnutrition) and 22 matched control women received tastes of sucrose solution or ionic water while functional MRI data were acquired. Within a network of interest responsible for food valuation and transforming taste signals into motivation to eat, the authors compared groups across conditions on blood-oxygen-level-dependent (BOLD) signal and task-based functional connectivity. RESULTS Participants in the two groups had similar BOLD responses to sucrose and water tastants. A group-by-condition interaction in the ventral caudal putamen indicated that hunger had opposite effects on tastant response in the control group and the remitted anorexia nervosa group, with an increase and a decrease, respectively, in BOLD response when hungry. Hunger had a similar opposite effect on insula-to-ventral caudal putamen functional connectivity in the remitted anorexia nervosa group compared with the control group. Exploratory analyses indicated that lower caudate response to tastants when hungry was associated with higher scores on harm avoidance among participants in the remitted anorexia nervosa group. CONCLUSIONS Reduced recruitment of neural circuitry that translates taste stimulation to motivated eating behavior when hungry may facilitate food avoidance and prolonged periods of extremely restricted food intake in anorexia nervosa.
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Affiliation(s)
- Walter H Kaye
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - Christina E Wierenga
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | | | - Laura A Berner
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alice V Ely
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - Ursula F Bailer
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA,Medical University of Vienna, Department of Psychiatry and Psychotherapy, Division of General Psychiatry, Vienna, Austria
| | - Martin P Paulus
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA,Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Julie L Fudge
- Departments of Neuroscience and Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
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Gianni AD, De Donatis D, Valente S, De Ronchi D, Atti AR. Eating disorders: Do PET and SPECT have a role? A systematic review of the literature. Psychiatry Res Neuroimaging 2020; 300:111065. [PMID: 32234640 DOI: 10.1016/j.pscychresns.2020.111065] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 03/04/2020] [Accepted: 03/06/2020] [Indexed: 02/08/2023]
Abstract
A systematic review was implemented according to PRISMA guidelines on Pubmed, Psychinfo, Medline, Embase to fill the existing literature gap on the effectiveness of using Positron Emission Tomography (PET) and Single Photon Emission Computed Tomography (SPECT) in Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Binge Eating Disorder (BED). Twenty-two articles were included. Four studies reported an increased density in 5-hydroxytryptamine receptor (5-HT1A) in fronto-temporo-parietal regions in both affected and recovered AN as well as in BN. The 5-HT transporter (5-HTT) binding was increased or diminished in different specific cortical areas and in relation to Eating Disorder (ED) subtypes. Some evidences of blunted Dopamine (DA) release in the putamen in BN patients suggest that their DA function might be impaired as in addictive behaviours. Studies estimating the regional Cerebral Blood Flow (rCBF) with SPECT demonstrated that temporal areas seem to play a key role in ED corroborating the hypothesis of a cingulate-temporal cortical dysfunction in AN. In addition, alterations of both parietal and prefrontal cortex provide a possible common neural substrate in AN. Studies included in this review are heterogeneous preventing robust conclusions, however, our findings add knowledge on some of the neurotransmitters involved in ED.
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Affiliation(s)
- Angela Di Gianni
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy.
| | - Domenico De Donatis
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy.
| | - Stefano Valente
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy.
| | - Diana De Ronchi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy.
| | - Anna Rita Atti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy.
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Çöpür S, Çöpür M. Olanzapine in the treatment of anorexia nervosa: a systematic review. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020. [DOI: 10.1186/s41983-020-00195-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
AbstractAnorexia nervosa, with the highest mortality rate among psychiatric diseases, is characterized by low body mass index, fear of weight gain, and disturbed body image. Even though multiple drugs have been proposed for the treatment of anorexia nervosa, current treatment modalities include nutritional support and psychotherapy. In this study, our aim is to analyze the efficiency and possible adverse effects of olanzapine, an atypical anti-psychotic drug, in the treatment of anorexia nervosa. The studies investigating the efficiency and possible adverse effects of olanzapine in anorexia nervosa have been searched by using 3 databases (Embase, PubMed, and Cochrane Library). DerSimonian-Laird random effects meta-analyses have been used in the statistical analysis. Effect of olanzapine treatment in accordance with the duration and dosage of drug have been analyzed by the determination of 95% confidence intervals (p value < 0.05 is considered as statistically significant). Despite the presence of some contradictory studies, olanzapine treatment has been found beneficial in anorexia nervosa. In addition, analysis reveals that statistically significant beneficial effect of olanzapine treatment is used at high doses and for short duration. Possible side effects include neuroleptic malignant syndrome, hypoglycemia, and heart block in patients suffering from anorexia nervosa. Even though there is obvious need for more comprehensive further studies, current literature favors olanzapine treatment. The efficiency of olanzapine is considered to be related to changes in dopaminergic and serotonergic system in anorexic patients both in terms of neurotransmitter levels and receptor activity.
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Haynos AF, Lavender JM, Nelson J, Crow SJ, Peterson CB. Moving towards specificity: A systematic review of cue features associated with reward and punishment in anorexia nervosa. Clin Psychol Rev 2020; 79:101872. [PMID: 32521390 DOI: 10.1016/j.cpr.2020.101872] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 03/16/2020] [Accepted: 05/24/2020] [Indexed: 12/13/2022]
Abstract
Models of anorexia nervosa (AN) posit that symptoms are maintained through deficient reward and enhanced punishment processing. However, theoretical and empirical inconsistencies highlight the need for a more nuanced conceptualization of this literature. Our goal was to comprehensively review the research on reward and punishment responding in AN from a cue-specific lens to determine which stimuli evoke or discourage reward and punishment responses in this population, and, ultimately, what properties these rewarding and punishing cues might share. A systematic review interrogating reward and punishment responses to specific cues yielded articles (n = 92) that examined responses to disorder relevant (e.g., food) and irrelevant (e.g., money) stimuli across self-report, behavioral, and biological indices. Overall, in most studies individuals with AN exhibited aversive responses to cues signaling higher body weights, social contexts, and monetary losses, and appetitive responses to cues for weight loss behaviors and thinness. Findings were more mixed on responses to palatable food and monetary gains. Results highlight that reward and punishment responding in AN are context specific and may be affected by varied stimulus qualities (e.g., predictability, controllability, delay, effort). Increasing specificity in future research on reward and punishment mechanisms in AN will better inform development of precisely-targeted interventions.
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Affiliation(s)
- Ann F Haynos
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States of America.
| | - Jason M Lavender
- Military Cardiovascular Outcomes Research (MiCOR) Program, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, United States of America; The Metis Foundation, San Antonio, TX, United States of America
| | - Jillian Nelson
- Department of Psychology, George Mason University, Fairfax, VA, United States of America
| | - Scott J Crow
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States of America; The Emily Program, St. Paul, MN, United States of America
| | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States of America; The Emily Program, St. Paul, MN, United States of America
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Pietrini F, Castellini G, Ricca V, Polito C, Pupi A, Faravelli C. Functional neuroimaging in anorexia nervosa: A clinical approach. Eur Psychiatry 2020; 26:176-82. [PMID: 20934859 DOI: 10.1016/j.eurpsy.2010.07.011] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2010] [Revised: 07/20/2010] [Accepted: 07/21/2010] [Indexed: 11/18/2022] Open
Abstract
AbstractAimsTo provide a review of the available literature about the functional neuroimaging of anorexia nervosa, and to summarize the possible role of neurobiological factors in its pathogenesis.MethodsA systematic review of the literature was performed using PubMed and Medline electronic database (1950–September 2009). Eligible studies were restricted to those involving the main parameters of cerebral activity and functional neuroimaging techniques. Findings of the reviewed studies have been grouped on a diagnostic subtype basis, and their comparison has been interpreted in terms of concordance.ResultsWe found a high level of concordance among available studies with regard to the presence of frontal, parietal and cingulate functional disturbances in both anorexia nervosa restricting and binge/purging subtypes. Concordance among studies conducted regardless of the anorexia nervosa subtypes suggests an alteration in temporal and parietal functions and striatal metabolism.ConclusionsThe most consistent alterations in anorexia nervosa cerebral activity seem to involve the dorsolateral prefrontal cortex, the inferior parietal lobule, the anterior cingulate cortex and the caudate nucleus. They may affect different neural systems such as the frontal visual system, the attention network, the arousal and emotional processing systems, the reward processing network, and the network for the body schema.
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Affiliation(s)
- F Pietrini
- Psychiatric Unit, Department of Neuropsychiatric Sciences, Florence University School of Medicine, Viale Morgagni 85, Florence, Italy
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Gorrell S, Collins AG, Le Grange D, Yang TT. Dopaminergic activity and exercise behavior in anorexia nervosa. OBM NEUROBIOLOGY 2020; 4:10.21926/obm.neurobiol.2001053. [PMID: 33569542 PMCID: PMC7872149 DOI: 10.21926/obm.neurobiol.2001053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Driven exercise (i.e., the tendency to exercise in excess to influence weight/shape or regulate emotion) is difficult to manage in the context of anorexia nervosa, and is associated with poorer treatment outcomes, and psychological and medical severity. Driven exercise is observed in a considerable number of those diagnosed with anorexia nervosa; however, to date, this hallmark symptom remains poorly understood. Dopamine signaling is implicated in motivating and maintaining appetitive behavior among patients with eating disorders; but, much less is known about the role of dopamine signaling specific to the symptom of driven exercise. An improved understanding of this biobehavioral mechanism may inform the etiology of driven exercise in anorexia nervosa, with the potential to impact future research and treatment efforts. This review describes the role that dopamine serves in maintaining symptoms in the context of anorexia nervosa, and synthesizes current relevant evidence on exercise in AN and related dopaminergic activity. Throughout, theoretical implications are discussed, along with critical directions for future research.
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Affiliation(s)
- Sasha Gorrell
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Anne G.E. Collins
- Department of Psychology and Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA
| | - Daniel Le Grange
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Psychiatry & Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA (Emeritus)
| | - Tony T. Yang
- Department of Psychiatry, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
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Babbs RK, Beierle JA, Yao EJ, Kelliher JC, Medeiros AR, Anandakumar J, Shah AA, Chen MM, Johnson WE, Bryant CD. The effect of the demyelinating agent cuprizone on binge-like eating of sweetened palatable food in female and male C57BL/6 substrains. Appetite 2020; 150:104678. [PMID: 32209386 DOI: 10.1016/j.appet.2020.104678] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 02/26/2020] [Accepted: 03/18/2020] [Indexed: 12/16/2022]
Abstract
Binge eating is a heritable symptom of eating disorders with an unknown genetic etiology. Rodent models for binge-like eating (BLE) of palatable food permit the study of genetic and biological mechanisms. We previously genetically mapped a coding mutation in Cyfip2 associated with increased BLE of sweetened palatable food in the C57BL/6NJ versus C57BL/6J substrain. The increase in BLE in C57BL/6NJ mice was associated with a decrease in transcription of genes enriched for myelination in the striatum. Here, we tested the hypothesis that decreasing myelin levels with the demyelinating agent cuprizone would enhance BLE. Mice were treated with a 0.3% cuprizone home cage diet for two weeks. Cuprizone induced similar weight loss in both substrains and sexes that recovered within 48 h after removal of cuprizone. Following a three-week recovery period, mice were trained for BLE in an intermittent, limited access procedure. Surprisingly, cuprizone significantly reduced BLE in male but not female C57BL/6NJ mice while having no effect in C57BL/6J mice. Cuprizone also reduced myelin basic protein (MBP) at seven weeks post-cuprizone removal while having no effect on myelin-associated glycoprotein at this time point. C57BL/6NJ mice also showed less MBP than C57BL/6J mice. There were no statistical interactions of Treatment with Sex on MBP levels, indicating that differences in MBP reduction are unlikely to account for sex differences in BLE. To summarize, cuprizone induced an unexpected, significant reduction in BLE in C57BL/6NJ males, which could indicate genotype-dependent sex differences in the biological mechanisms of BLE.
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Affiliation(s)
- Richard K Babbs
- Laboratory of Addiction Genetics, Department of Pharmacology and Experimental Therapeutics and Psychiatry, Boston University School of Medicine, 72 E. Concord St., L-606C, Boston, MA, 02118, USA
| | - Jacob A Beierle
- Laboratory of Addiction Genetics, Department of Pharmacology and Experimental Therapeutics and Psychiatry, Boston University School of Medicine, 72 E. Concord St., L-606C, Boston, MA, 02118, USA; Biomolecular Pharmacology Ph.D. Program, Boston University School of Medicine, USA; Boston University's Transformative Training Program in Addiction Science (TTPAS), Biomedical Genetics, Boston University School of Medicine, 72 E. Concord St., E-200, Boston, MA, 02118, USA
| | - Emily J Yao
- Laboratory of Addiction Genetics, Department of Pharmacology and Experimental Therapeutics and Psychiatry, Boston University School of Medicine, 72 E. Concord St., L-606C, Boston, MA, 02118, USA
| | - Julia C Kelliher
- Laboratory of Addiction Genetics, Department of Pharmacology and Experimental Therapeutics and Psychiatry, Boston University School of Medicine, 72 E. Concord St., L-606C, Boston, MA, 02118, USA
| | - Arthurine R Medeiros
- Laboratory of Addiction Genetics, Department of Pharmacology and Experimental Therapeutics and Psychiatry, Boston University School of Medicine, 72 E. Concord St., L-606C, Boston, MA, 02118, USA; National Institute on Drug Abuse Diversity Scholars Program, 6001 Executive Boulevard, Room 3105, MSC 9567, Bethesda, MD, USA, 20892-9567
| | - Jeya Anandakumar
- Laboratory of Addiction Genetics, Department of Pharmacology and Experimental Therapeutics and Psychiatry, Boston University School of Medicine, 72 E. Concord St., L-606C, Boston, MA, 02118, USA; National Institute on Drug Abuse Diversity Scholars Program, 6001 Executive Boulevard, Room 3105, MSC 9567, Bethesda, MD, USA, 20892-9567
| | - Anyaa A Shah
- Laboratory of Addiction Genetics, Department of Pharmacology and Experimental Therapeutics and Psychiatry, Boston University School of Medicine, 72 E. Concord St., L-606C, Boston, MA, 02118, USA
| | - Melanie M Chen
- Laboratory of Addiction Genetics, Department of Pharmacology and Experimental Therapeutics and Psychiatry, Boston University School of Medicine, 72 E. Concord St., L-606C, Boston, MA, 02118, USA
| | - William E Johnson
- Department of Medicine, Division of Computational Biomedicine, Boston University, 72 E. Concord St., E-609, Boston, MA, 02118, USA
| | - Camron D Bryant
- Laboratory of Addiction Genetics, Department of Pharmacology and Experimental Therapeutics and Psychiatry, Boston University School of Medicine, 72 E. Concord St., L-606C, Boston, MA, 02118, USA.
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Gilman TL, Owens WA, George CM, Metzel L, Vitela M, Ferreira L, Bowman MA, Gould GG, Toney GM, Daws LC. Age- and Sex-Specific Plasticity in Dopamine Transporter Function Revealed by Food Restriction and Exercise in a Rat Activity-Based Anorexia Paradigm. J Pharmacol Exp Ther 2019; 371:268-277. [PMID: 31481515 PMCID: PMC6795746 DOI: 10.1124/jpet.119.260794] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 08/21/2019] [Indexed: 01/06/2023] Open
Abstract
Eating disorders such as anorexia typically emerge during adolescence, are characterized by engagement in compulsive and detrimental behaviors, and are often comorbid with neuropsychiatric disorders and drug abuse. No effective treatments exist. Moreover, anorexia lacks adolescent animal models, contributing to a poor understanding of underlying age-specific neurophysiological disruptions. To evaluate the contribution of dopaminergic signaling to the emergence of anorexia-related behaviors during the vulnerable adolescent period, we applied an established adult activity-based anorexia (ABA) paradigm (food restriction plus unlimited exercise access for 4 to 5 days) to adult and adolescent rats of both sexes. At the end of the paradigm, measures of plasma volume, blood hormone levels, dopamine transporter (DAT) expression and function, acute cocaine-induced locomotion, and brain water weight were taken. Adolescents were dramatically more affected by the ABA paradigm than adults in all measures. In vivo chronoamperometry and cocaine locomotor responses revealed sex-specific changes in adolescent DAT function after ABA that were independent of DAT expression differences. Hematocrit, insulin, ghrelin, and corticosterone levels did not resemble shifts typically observed in patients with anorexia, though decreases in leptin levels aligned with human reports. These findings are the first to suggest that food restriction in conjunction with excessive exercise sex-dependently and age-specifically modulate DAT functional plasticity during adolescence. The adolescent vulnerability to this relatively short manipulation, combined with blood measures, evidence need for an optimized age-appropriate ABA paradigm with greater face and predictive validity for the study of the pathophysiology and treatment of anorexia. SIGNIFICANCE STATEMENT: Adolescent rats exhibit a distinctive, sex-specific plasticity in dopamine transporter function and cocaine response after food restriction and exercise access; this plasticity is both absent in adults and not attributable to changes in dopamine transporter expression levels. These novel findings may help explain sex differences in vulnerability to eating disorders and drug abuse during adolescence.
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Affiliation(s)
- T Lee Gilman
- Department of Cellular and Integrative Physiology (T.L.G., W.A.O., C.M.G., L.M., M.V., L.F., M.A.B., G.G.G., G.M.T., L.C.D.), Addiction Research, Treatment & Training Center of Excellence (T.L.G., L.C.D.), Center for Biomedical Neuroscience (G.M.T., L.C.D.), and Department of Pharmacology (L.C.D.), University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - W Anthony Owens
- Department of Cellular and Integrative Physiology (T.L.G., W.A.O., C.M.G., L.M., M.V., L.F., M.A.B., G.G.G., G.M.T., L.C.D.), Addiction Research, Treatment & Training Center of Excellence (T.L.G., L.C.D.), Center for Biomedical Neuroscience (G.M.T., L.C.D.), and Department of Pharmacology (L.C.D.), University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Christina M George
- Department of Cellular and Integrative Physiology (T.L.G., W.A.O., C.M.G., L.M., M.V., L.F., M.A.B., G.G.G., G.M.T., L.C.D.), Addiction Research, Treatment & Training Center of Excellence (T.L.G., L.C.D.), Center for Biomedical Neuroscience (G.M.T., L.C.D.), and Department of Pharmacology (L.C.D.), University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Lauren Metzel
- Department of Cellular and Integrative Physiology (T.L.G., W.A.O., C.M.G., L.M., M.V., L.F., M.A.B., G.G.G., G.M.T., L.C.D.), Addiction Research, Treatment & Training Center of Excellence (T.L.G., L.C.D.), Center for Biomedical Neuroscience (G.M.T., L.C.D.), and Department of Pharmacology (L.C.D.), University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Melissa Vitela
- Department of Cellular and Integrative Physiology (T.L.G., W.A.O., C.M.G., L.M., M.V., L.F., M.A.B., G.G.G., G.M.T., L.C.D.), Addiction Research, Treatment & Training Center of Excellence (T.L.G., L.C.D.), Center for Biomedical Neuroscience (G.M.T., L.C.D.), and Department of Pharmacology (L.C.D.), University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Livia Ferreira
- Department of Cellular and Integrative Physiology (T.L.G., W.A.O., C.M.G., L.M., M.V., L.F., M.A.B., G.G.G., G.M.T., L.C.D.), Addiction Research, Treatment & Training Center of Excellence (T.L.G., L.C.D.), Center for Biomedical Neuroscience (G.M.T., L.C.D.), and Department of Pharmacology (L.C.D.), University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Melodi A Bowman
- Department of Cellular and Integrative Physiology (T.L.G., W.A.O., C.M.G., L.M., M.V., L.F., M.A.B., G.G.G., G.M.T., L.C.D.), Addiction Research, Treatment & Training Center of Excellence (T.L.G., L.C.D.), Center for Biomedical Neuroscience (G.M.T., L.C.D.), and Department of Pharmacology (L.C.D.), University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Georgianna G Gould
- Department of Cellular and Integrative Physiology (T.L.G., W.A.O., C.M.G., L.M., M.V., L.F., M.A.B., G.G.G., G.M.T., L.C.D.), Addiction Research, Treatment & Training Center of Excellence (T.L.G., L.C.D.), Center for Biomedical Neuroscience (G.M.T., L.C.D.), and Department of Pharmacology (L.C.D.), University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Glenn M Toney
- Department of Cellular and Integrative Physiology (T.L.G., W.A.O., C.M.G., L.M., M.V., L.F., M.A.B., G.G.G., G.M.T., L.C.D.), Addiction Research, Treatment & Training Center of Excellence (T.L.G., L.C.D.), Center for Biomedical Neuroscience (G.M.T., L.C.D.), and Department of Pharmacology (L.C.D.), University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Lynette C Daws
- Department of Cellular and Integrative Physiology (T.L.G., W.A.O., C.M.G., L.M., M.V., L.F., M.A.B., G.G.G., G.M.T., L.C.D.), Addiction Research, Treatment & Training Center of Excellence (T.L.G., L.C.D.), Center for Biomedical Neuroscience (G.M.T., L.C.D.), and Department of Pharmacology (L.C.D.), University of Texas Health Science Center at San Antonio, San Antonio, Texas
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Maussion G, Demirova I, Gorwood P, Ramoz N. Induced Pluripotent Stem Cells; New Tools for Investigating Molecular Mechanisms in Anorexia Nervosa. Front Nutr 2019; 6:118. [PMID: 31457016 PMCID: PMC6700384 DOI: 10.3389/fnut.2019.00118] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 07/17/2019] [Indexed: 12/11/2022] Open
Abstract
Anorexia nervosa (AN) is a dramatic psychiatric disorder characterized by dysregulations in food intake and reward processing, involving molecular and cellular changes in several peripheral cell types and central neuronal networks. Genomic and epigenomic analyses have allowed the identification of multiple genetic and epigenetic modifications highlighting the complex pathophysiology of AN. Behavioral and genetic rodent models have been used to recapitulate and investigate, with some limitations, the cellular and molecular changes that potentially underlie eating disorders. In the last 5 years, the use of induced pluripotent stem cells (IPSCs), combined with CRISPR-Cas9 technology, has led to the generation of specific neuronal cell subtypes engineered from human somatic samples, representing a powerful tool to complement observations made in human samples and data collected from animal models. Systems biology using IPSCs has indeed proved to be a valuable approach for the study of metabolic disorders, in addition to neurodevelopmental and psychiatric disorders. The manuscript, while reviewing the main findings related to the genetic, epigenetic, and cellular bases of AN, will present how new studies published, or to be performed, in the field of IPSC-derived cells should improve our current understanding of the pathophysiology of AN and provide potential therapeutic strategies addressing specific endophenotypes.
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Affiliation(s)
- Gilles Maussion
- Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Iveta Demirova
- Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Philip Gorwood
- INSERM U1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France.,Hôpital Sainte-Anne (CMME), University Paris-Descartes, Paris, France
| | - Nicolas Ramoz
- INSERM U1266, Institute of Psychiatry and Neuroscience of Paris, Paris, France
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Himmerich H, Bentley J, Lichtblau N, Brennan C, Au K. Facets of shared decision-making on drug treatment for adults with an eating disorder. Int Rev Psychiatry 2019; 31:332-346. [PMID: 30870048 DOI: 10.1080/09540261.2019.1571995] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Shared decision-making (SDM) means that clinicians and the patient make decisions about the treatment together. Regarding drug treatment in eating disorders (EDs), such decisions may include psychopharmacological treatment for the ED itself, medications for potential co-morbid psychiatric disorders, pharmacological strategies to alleviate the health consequences of an ED, or 'pro re nata' (PRN) medication which is given in acute care when required. Decisions regarding drug treatment in EDs should be specific in terms of the active pharmacological substance, its dose, its route of administration, and the duration of treatment. Decisions should be made with regard to the specific health risks of patients with EDs and the entire treatment approach, and should take alternative measures, additional therapies, and specific combinations of therapies into account. The differences in the expectations of patients, carers, and clinicians towards drug treatment, the lack of specific suggestions in clinical practice guidelines, and the lack of approved psychopharmacological treatment options make SDM necessary, but also a challenge. However, SDM may be limited due to the patient's impaired insight or limited capacity due to the ED. Thus, the legal framework must be taken into consideration.
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Affiliation(s)
- Hubertus Himmerich
- a South London and Maudsley NHS Foundation Trust , Bethlem Royal Hospital , London , UK.,b Department of Psychological Medicine , IoPPN, King's College London , London , UK
| | - Jessica Bentley
- b Department of Psychological Medicine , IoPPN, King's College London , London , UK
| | | | - Clare Brennan
- a South London and Maudsley NHS Foundation Trust , Bethlem Royal Hospital , London , UK
| | - Katie Au
- a South London and Maudsley NHS Foundation Trust , Bethlem Royal Hospital , London , UK
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Attia E, Steinglass JE, Walsh BT, Wang Y, Wu P, Schreyer C, Wildes J, Yilmaz Z, Guarda A, Kaplan A, Marcus MD. Olanzapine Versus Placebo in Adult Outpatients With Anorexia Nervosa: A Randomized Clinical Trial. Am J Psychiatry 2019; 176:449-456. [PMID: 30654643 PMCID: PMC7015155 DOI: 10.1176/appi.ajp.2018.18101125] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study evaluated the benefits of olanzapine compared with placebo for adult outpatients with anorexia nervosa. METHODS This randomized double-blind placebo-controlled trial of adult outpatients with anorexia nervosa (N=152, 96% of whom were women; the sample's mean body mass index [BMI] was 16.7) was conducted at five sites in North America. Participants were randomly assigned in a 1:1 ratio to receive olanzapine or placebo and were seen weekly for 16 weeks. The primary outcome measures were rate of change in body weight and rate of change in obsessionality, assessed with the Yale-Brown Obsessive Compulsive Scale (YBOCS). RESULTS Seventy-five participants were assigned to receive olanzapine and 77 to receive placebo. A statistically significant treatment-by-time interaction was observed, indicating that the increase in BMI over time was greater in the olanzapine group (0.259 [SD=0.051] compared with 0.095 [SD=0.053] per month). There was no significant difference between treatment groups in change in the YBOCS obsessions subscale score over time (-0.325 compared with -0.017 points per month) and there were no significant differences between groups in the frequency of abnormalities on blood tests assessing potential metabolic disturbances. CONCLUSIONS This study documented a modest therapeutic effect of olanzapine compared with placebo on weight in adult outpatients with anorexia nervosa, but no significant benefit for psychological symptoms. Nevertheless, the finding on weight is notable, as achieving change in weight is notoriously challenging in this disorder.
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Affiliation(s)
- Evelyn Attia
- Columbia University Irving Medical Center;,New York State Psychiatric Institute;,Weill Cornell Medical College
| | - Joanna E. Steinglass
- Columbia University Irving Medical Center;,New York State Psychiatric Institute
| | - B Timothy Walsh
- Columbia University Irving Medical Center;,New York State Psychiatric Institute
| | | | - Peng Wu
- Columbia University Irving Medical Center
| | | | - Jennifer Wildes
- University of Pittsburgh Medical Center;,University of Chicago
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