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Nagamitsu S, Sakurai R, Matsuoka M, Chiba H, Ozono S, Tanigawa H, Yamashita Y, Kaida H, Ishibashi M, Kakuma T, Croarkin PE, Matsuishi T. Altered SPECT (123)I-iomazenil Binding in the Cingulate Cortex of Children with Anorexia Nervosa. Front Psychiatry 2016; 7:16. [PMID: 26909048 PMCID: PMC4754452 DOI: 10.3389/fpsyt.2016.00016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 02/01/2016] [Indexed: 11/13/2022] Open
Abstract
Several lines of evidence suggest that anxiety plays a key role in the development and maintenance of anorexia nervosa (AN) in children. The purpose of this study was to examine cortical GABA(A)-benzodiazepine receptor binding before and after treatment in children beginning intensive AN treatment. Brain single-photon emission computed tomography (SPECT) measurements using (123)I-iomazenil, which binds to GABA(A)-benzodiazepine receptors, was performed in 26 participants with AN who were enrolled in a multimodal treatment program. Sixteen of the 26 participants underwent a repeat SPECT scan immediately before discharge at conclusion of the intensive treatment program. Eating behavior and mood disturbances were assessed using Eating Attitudes Test with 26 items (EAT-26) and the short form of the Profile of Mood States (POMS). Clinical outcome scores were evaluated after a 1-year period. We examined association between relative iomazenil-binding activity in cortical regions of interest and psychometric profiles and determined which psychometric profiles show interaction effects with brain regions. Further, we determined if binding activity could predict clinical outcome and treatment changes. Higher EAT-26 scores were significantly associated with lower iomazenil-binding activity in the anterior and posterior cingulate cortex. Higher POMS subscale scores were significantly associated with lower iomazenil-binding activity in the left frontal, parietal cortex, and posterior cingulate cortex (PCC). "Depression-Dejection" and "Confusion" POMS subscale scores, and total POMS score showed interaction effects with brain regions in iomazenil-binding activity. Decreased binding in the anterior cingulate cortex and left parietal cortex was associated with poor clinical outcomes. Relative binding increases throughout the PCC and occipital gyrus were observed after weight gain in children with AN. These findings suggest that cortical GABAergic receptor binding is altered in children with AN. This may be a state-related change, which could be used to monitor and guide the treatment of eating disorders.
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Affiliation(s)
- Shinichiro Nagamitsu
- Department of Pediatrics and Child Health, Kurume University School of Medicine , Fukuoka , Japan
| | - Rieko Sakurai
- Graduate School of Medicine, Kurume University , Fukuoka , Japan
| | - Michiko Matsuoka
- Department of Psychiatry, Kurume University School of Medicine , Fukuoka , Japan
| | - Hiromi Chiba
- Department of Psychiatry, Kurume University School of Medicine , Fukuoka , Japan
| | - Shuichi Ozono
- Department of Pediatrics and Child Health, Kurume University School of Medicine , Fukuoka , Japan
| | - Hitoshi Tanigawa
- Center of Diaginostic Imaging, Kurume University Hospital , Fukuoka , Japan
| | - Yushiro Yamashita
- Department of Pediatrics and Child Health, Kurume University School of Medicine , Fukuoka , Japan
| | - Hayato Kaida
- Department of Radiology, Kinki University Faculty of Medicine , Osakasayama , Japan
| | - Masatoshi Ishibashi
- Department of Radiology, Kurume University School of Medicine , Fukuoka , Japan
| | - Tatsuki Kakuma
- Biostatistics Center, Kurume University School of Medicine , Fukuoka , Japan
| | - Paul E Croarkin
- Department of Psychiatry and Psychology, Mayo Clinic , Rochester, MN , USA
| | - Toyojiro Matsuishi
- Department of Pediatrics and Child Health, Kurume University School of Medicine , Fukuoka , Japan
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Nagamitsu S, Yamashita Y, Tanigawa H, Chiba H, Kaida H, Ishibashi M, Kakuma T, Croarkin PE, Matsuishi T. Upregulated GABA Inhibitory Function in ADHD Children with Child Behavior Checklist-Dysregulation Profile: 123I-Iomazenil SPECT Study. Front Psychiatry 2015; 6:84. [PMID: 26082729 PMCID: PMC4451796 DOI: 10.3389/fpsyt.2015.00084] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 05/18/2015] [Indexed: 11/23/2022] Open
Abstract
The child behavior checklist-dysregulation profile (CBCL-DP) refers to a pattern of elevated scores on the attention problems, aggression, and anxiety/depression subscales of the child behavior checklist. The aim of the present study was to investigate the potential role of GABA inhibitory neurons in children with attention deficit/hyperactivity disorder (ADHD) and dysregulation assessed with a dimensional measure. Brain single photon emission computed tomography (SPECT) was performed in 35 children with ADHD using 123I-iomazenil, which binds with high affinity to benzodiazepine receptors. Iomazenil binding activities were assessed with respect to the presence or absence of a threshold CBCL-DP (a score ≥210 for the sum of the three subscales: Attention Problems, Aggression, and Anxiety/Depression). We then attempted to identify which CBCL-DP subscale explained the most variance with respect to SPECT data, using "age," "sex," and "history of maltreatment" as covariates. Significantly higher iomazenil binding activity was seen in the posterior cingulate cortex (PCC) of ADHD children with a significant CBCL-DP. The Anxiety/Depression subscale on the CBCL had significant effects on higher iomazenil binding activity in the left superior frontal, middle frontal, and temporal regions, as well as in the PCC. The present brain SPECT findings suggest that GABAergic inhibitory neurons may play an important role in the neurobiology of the CBCL-DP, in children with ADHD.
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Affiliation(s)
- Shinichiro Nagamitsu
- Department of Pediatrics and Child Health, Kurume University School of Medicine , Fukuoka , Japan
| | - Yushiro Yamashita
- Department of Pediatrics and Child Health, Kurume University School of Medicine , Fukuoka , Japan
| | - Hitoshi Tanigawa
- Department of Radiology, Kurume University School of Medicine , Fukuoka , Japan
| | - Hiromi Chiba
- Department of Psychiatry, Kurume University School of Medicine , Fukuoka , Japan
| | - Hayato Kaida
- Department of Radiology, Kurume University School of Medicine , Fukuoka , Japan
| | - Masatoshi Ishibashi
- Department of Radiology, Kurume University School of Medicine , Fukuoka , Japan
| | - Tatsuyuki Kakuma
- Biostatistics Center, Kurume University School of Medicine , Fukuoka , Japan
| | - Paul E Croarkin
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester , MN , USA
| | - Toyojiro Matsuishi
- Department of Pediatrics and Child Health, Kurume University School of Medicine , Fukuoka , Japan
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