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Osorio Acuña LC, Franco Zuluaga A. Behavioural and emotional symptoms of adolescents consulting a specialised eating disorders programme. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2022; 51:318-325. [PMID: 36446704 DOI: 10.1016/j.rcpeng.2020.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/25/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Eating disorders (EDs) are complex conditions of multifactorial origin. Their main characteristic is excessive concern about body weight and shape, which causes great discomfort and physical problems and leads to a decrease in quality of life and alterations in the patient's functionality social environment. The objective of this study is to describe the emotional and behavioural symptoms of adolescents who consult a specialised ED programme in the city of Bogota. METHODS Observational, descriptive, cross-sectional study, for which patients between 11 and 19 years old with an ED diagnosis were recruited. RESULTS Forty patients with an ED diagnosis were included, of which 92% were female. The mean age of the patients was 16.6±1.9 years; 57% of patients live in a two-parent home and 30% in a single-parent home; 72% of the sample had excellent academic performance; 50% were moderately ill; 60% received pharmacological management with SSRIs; 65% of patients met clinical criteria for anxiety disorder, 30% for depressive disorder; 22.5% had aggression problems; 17.5% criminal behaviour; 72.5% of the sample met clinical criteria for internalising symptoms and 42.5% for externalising symptoms, the majority being patients with a diagnosis of bulimia nervosa. CONCLUSIONS Patients with bulimia nervosa obtained higher scores in the different emotional and behavioural symptoms than those with other eating disorders. This condition is associated with greater psychopathology, which must be examined rigorously at the time of clinical care, seeking to reduce the functional impact that these symptoms generate on the individual.
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Affiliation(s)
- Lucia Carolina Osorio Acuña
- Especialista en psiquiatría infantil y del adolescente, Docente del Departamento de Psiquiatría, Universidad ICESI, Fundación Valle del Lili, Cali, Colombia.
| | - Alvaro Franco Zuluaga
- Especialista en psiquiatría infantil y del adolescente, Docente de psiquiatría de la Universidad El Bosque, Bogotá, Colombia
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Osorio Acuña LC, Franco Zuluaga A. Behavioural and Emotional Symptoms of Adolescents Consulting a Specialised Eating Disorders Programme. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2021; 51:S0034-7450(21)00044-5. [PMID: 33962787 DOI: 10.1016/j.rcp.2020.11.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/13/2020] [Accepted: 11/25/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Eating disorders (EDs) are complex conditions of multifactorial origin. Their main characteristic is excessive concern about body weight and shape, which causes great discomfort and physical problems and leads to a decrease in quality of life and alterations in the patient's functionality social environment. The objective of this study is to describe the emotional and behavioural symptoms of adolescents who consult a specialised ED programme in the city of Bogota. METHODS Observational, descriptive, cross-sectional study, for which patients between 11 and 19 years old with an ED diagnosis were recruited. RESULTS Forty patients with an ED diagnosis were included, of which 92% were female. The mean age of the patients was 16.6±1.9 years; 57% of patients live in a two-parent home and 30% in a single-parent home; 72% of the sample had excellent academic performance; 50% were moderately ill; 60% received pharmacological management with SSRIs; 65% of patients met clinical criteria for anxiety disorder, 30% for depressive disorder; 22.5% had aggression problems; 17.5% criminal behaviour; 72.5% of the sample met clinical criteria for internalising symptoms and 42.5% for externalising symptoms, the majority being patients with a diagnosis of bulimia nervosa. CONCLUSIONS Patients with bulimia nervosa obtained higher scores in the different emotional and behavioural symptoms than those with other eating disorders. This condition is associated with greater psychopathology, which must be examined rigorously at the time of clinical care, seeking to reduce the functional impact that these symptoms generate on the individual.
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Affiliation(s)
- Lucia Carolina Osorio Acuña
- Especialista en psiquiatría infantil y del adolescente, Docente del Departamento de Psiquiatría, Universidad ICESI, Fundación Valle del Lili, Cali, Colombia.
| | - Alvaro Franco Zuluaga
- Especialista en psiquiatría infantil y del adolescente, Docente de psiquiatría de la Universidad El Bosque, Bogotá, Colombia
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3
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Marzola E, Cavallo F, Panero M, Porliod A, Amodeo L, Abbate-Daga G. The role of prenatal and perinatal factors in eating disorders: a systematic review. Arch Womens Ment Health 2021; 24:185-204. [PMID: 32767123 PMCID: PMC7979621 DOI: 10.1007/s00737-020-01057-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 07/20/2020] [Indexed: 12/30/2022]
Abstract
Numerous studies showed that factors influencing fetal development and neonatal period could lead to lasting alterations in the brain of the offspring, in turn increasing the risk for eating disorders (EDs). This work aims to systematically and critically review the literature on the association of prenatal and perinatal factors with the onset of EDs in the offspring, updating previous findings and focusing on anorexia nervosa (AN) and bulimia nervosa (BN). A systematic literature search was performed on Pubmed, PsycINFO, and Scopus. The drafting of this systematic review was conducted following the PRISMA statement criteria and the methodological quality of each study was assessed by the MMAT 2018. A total of 37 studies were included in this review. The factors that showed a more robust association with AN were higher maternal age, preeclampsia and eclampsia, multiparity, hypoxic complications, prematurity, or being born preterm (< 32 weeks) and small for gestational age or lower birth size. BN was only associated with maternal stress during pregnancy. Many methodological flaws emerged in the considered studies, so further research is needed to clarify these inconsistencies. Altogether, data are suggestive of an association between prenatal and perinatal factors and the onset of EDs in the offspring. Nevertheless, given the methodological quality of the available literature, firm conclusions cannot be drawn and whether this vulnerability is specific to EDs or mental disorders remains to be defined. Also, a strong need for longitudinal and well-designed studies on this topic emerged.
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Affiliation(s)
- Enrica Marzola
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, via Cherasco 15, 10126 Turin, Italy
| | - Fabio Cavallo
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, via Cherasco 15, 10126 Turin, Italy
| | - Matteo Panero
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, via Cherasco 15, 10126 Turin, Italy
| | - Alain Porliod
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, via Cherasco 15, 10126 Turin, Italy
| | - Laura Amodeo
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, via Cherasco 15, 10126 Turin, Italy
| | - Giovanni Abbate-Daga
- Department of Neuroscience “Rita Levi Montalcini”, University of Turin, via Cherasco 15, 10126 Turin, Italy
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Ogata K, Koyama KI, Fukumoto T, Kawazu S, Kawamoto M, Yamaguchi E, Fuku Y, Amitani M, Amitani H, Sagiyama KI, Inui A, Asakawa A. The relationship between premorbid intelligence and symptoms of severe anorexia nervosa restricting type. Int J Med Sci 2021; 18:1566-1569. [PMID: 33746572 PMCID: PMC7976560 DOI: 10.7150/ijms.53907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/05/2021] [Indexed: 11/23/2022] Open
Abstract
The purposes of this study were as follows: to compare premorbid IQ with present IQ in patients with more severe anorexia nervosa restricting type (AN-R) and to investigate the relationship between decreasing IQ and symptoms in patients with severe AN-R. Twenty-two participants were recruited (12 were AN-R patients; 10 were healthy controls). The average BMI in AN-R patients and healthy controls was 12.65 and 19.82, respectively. We assessed the outcomes using the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III), the Japanese Adult Reading Test, The Eating Disorders Inventory-2 (EDI-2), Beck Depression Scale-2 (BDI-2) and State-Trait Anxiety Index. In two-way ANOVA, there were significant interactions for the FIQ and PIQ. Only in the AN-R group, a significant single main effect of time was evidenced for the FIQ and PIQ. In the AN-R group, a significantly high positive correlation was found between changes in the PIQ and the body dissatisfaction subscale of the EDI-2. These findings raise the possibility that in patients with severe AN-R, an excessive decrease in body weight induces decreased PIQ; as a result, they have worse dissatisfaction with their body shape.
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Affiliation(s)
- Keizaburo Ogata
- Division of Clinical Psychology, Kitasato University Hospital, Kanagawa, Japan.,Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Ken Ichiro Koyama
- Faculty of Integrated Human Studies and Social Sciences, Fukuoka Prefectural University Graduate School of Human and Social Sciences, Fukuoka, Japan
| | - Takamasa Fukumoto
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Suguru Kawazu
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Mihoko Kawamoto
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Eriko Yamaguchi
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yuuki Fuku
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Marie Amitani
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.,Education Center for Doctors in Remote Islands and Rural Areas, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Haruka Amitani
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Ken Ichiro Sagiyama
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Akio Inui
- Pharmacological Department of Herbal Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Akihiro Asakawa
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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Lao-Kaim NP, Giampietro VP, Williams SCR, Simmons A, Tchanturia K. Functional MRI investigation of verbal working memory in adults with anorexia nervosa. Eur Psychiatry 2020; 29:211-8. [PMID: 23849992 DOI: 10.1016/j.eurpsy.2013.05.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Revised: 05/10/2013] [Accepted: 05/22/2013] [Indexed: 11/28/2022] Open
Abstract
AbstractLiterature regarding verbal working memory (vWM) in anorexia nervosa (AN) has been inconsistent due to a misunderstanding of the key components of vWM and introduction of confounding stimuli. Furthermore, there are no studies looking at how brain function in people with AN relates to vWM performance. The present study used functional magnetic resonance imaging (fMRI) with a letter n-back paradigm to study the effect of increasing vWM task difficulty on cortical functioning in the largest AN sample to date (n = 31). Although the AN group had low BMI and higher anxious and depressive symptomology compared to age-matched controls (HC), there were no between-group differences in accuracy and speed at any task difficulty. fMRI data revealed no regions exhibiting significant differences in activation when groups were compared at each difficulty separately and no regions showing group x condition interaction. Although there was a trend towards lower accuracy as duration of illness increased, this was not correlated with activity in regions associated with vWM. These findings indicate that vWM in AN is as efficient and performed using the same cognitive strategy as HC, and that there may not be a need for therapies to pursue remediation of this particular neurocognitive faculty.
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Affiliation(s)
- N P Lao-Kaim
- King's College London, Institute of Psychiatry, Department of Psychological Medicine, London, United Kingdom
| | - V P Giampietro
- King's College London, Institute of Psychiatry, Department of Neuroimaging, SE5 8AF London, United Kingdom
| | - S C R Williams
- King's College London, Institute of Psychiatry, Department of Neuroimaging, SE5 8AF London, United Kingdom; NIHR Biomedical Research Centre for Mental Health at South London, Maudsley NHS Foundation Trust, Institute of Psychiatry, King's College London, London, United Kingdom
| | - A Simmons
- King's College London, Institute of Psychiatry, Department of Neuroimaging, SE5 8AF London, United Kingdom; NIHR Biomedical Research Centre for Mental Health at South London, Maudsley NHS Foundation Trust, Institute of Psychiatry, King's College London, London, United Kingdom
| | - K Tchanturia
- King's College London, Institute of Psychiatry, Department of Psychological Medicine, London, United Kingdom.
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Paslakis G, Agüera Z, Granero R, Sánchez I, Riesco N, Jiménez-Murcia S, Fernández-García JC, Garrido-Sánchez L, Tinahones FJ, Casanueva FF, Baños RM, Botella C, Crujeiras AB, Torre RDL, Fernández-Real JM, Frühbeck G, Ortega FJ, Rodríguez A, Serra-Majem L, Fitó M, Menchón JM, Fernández-Aranda F. Associations between neuropsychological performance and appetite-regulating hormones in anorexia nervosa and healthy controls: Ghrelin's putative role as a mediator of decision-making. Mol Cell Endocrinol 2019; 497:110441. [PMID: 31121263 DOI: 10.1016/j.mce.2019.04.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 04/25/2019] [Accepted: 04/29/2019] [Indexed: 12/28/2022]
Abstract
Anorexia nervosa (AN) is a severe eating disorder accompanied by alterations in endocrinological circuits and deficits in neuropsychological performance. In this study, a series of appetite-regulating hormones (ghrelin, leptin, cholecystokinin, PYY, adiponectin, and visfatin) were measured under fasting conditions in female patients with AN and female healthy controls. All of the participants also underwent a battery of neuropsychological assessment [namely the Iowa Gambling Task (IGT), the Wisconsin Card Sorting Test (WCST), and the Stroop Color and Word Test (SCWT)]. As the main finding, we found that higher ghrelin levels predict better performance in the IGT. Ghrelin may be a putative mediator of decision-making, a finding that has not been described so far. The role of ghrelin in decision-making can only be described as speculative, as there are hardly any additional evidence-based data published up to date. Further studies are warranted.
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Affiliation(s)
- Georgios Paslakis
- Toronto General Hospital, University Health Network, Toronto, Ontario, M5G 2C4, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, M5T 1R8, Canada; Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Zaida Agüera
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Psychobiology and Methodology of Health Science, Autonomous University of Barcelona, Barcelona, Spain
| | - Isabel Sánchez
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Nadine Riesco
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Jose C Fernández-García
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Diabetes, Endocrinology and Nutrition, Hospital Clínico Universitario Virgen de Victoria, Málaga, Spain
| | - Lourdes Garrido-Sánchez
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Diabetes, Endocrinology and Nutrition, Hospital Clínico Universitario Virgen de Victoria, Málaga, Spain
| | - Francisco J Tinahones
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Diabetes, Endocrinology and Nutrition, Hospital Clínico Universitario Virgen de Victoria, Málaga, Spain
| | - Felipe F Casanueva
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Medicine, Endocrinology Division, Santiago de Compostela University, Complejo Hospitalario Universitario, Santiago de Compostela, Spain
| | - Rosa M Baños
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Psychological, Personality, Evaluation and Treatment of the University of Valencia, Valencia, Spain
| | - Cristina Botella
- Department of Psychological, Personality, Evaluation and Treatment of the University of Valencia, Valencia, Spain
| | - Ana B Crujeiras
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Medicine, Endocrinology Division, Santiago de Compostela University, Complejo Hospitalario Universitario, Santiago de Compostela, Spain
| | - Rafael de la Torre
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Integrated Pharmacology and Systems Neurosciences Research Group, Neuroscience Research Program Organization IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Health and Experimental Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Jose M Fernández-Real
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Diabetes, Endocrinology and Nutrition, Institu d'Investigació, Biomèdica de Girona (IdIBGi), Hospital Dr Josep Trueta, Girona, Spain
| | - Gema Frühbeck
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Metabolic Research Laboratory, Clínica Universidad de Navarra, University of Navarra-IdiSNA, Pamplona, Spain
| | - Francisco J Ortega
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Diabetes, Endocrinology and Nutrition, Institu d'Investigació, Biomèdica de Girona (IdIBGi), Hospital Dr Josep Trueta, Girona, Spain
| | - Amaia Rodríguez
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Metabolic Research Laboratory, Clínica Universidad de Navarra, University of Navarra-IdiSNA, Pamplona, Spain
| | - Luís Serra-Majem
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Clinical Sciences, Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Spain
| | - Montserrat Fitó
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Cardiovascular Risk and Nutrition Research Group, Inflammatory and Cardiovascular Disorders Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - José M Menchón
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; CIBER Salud Mental (CIBERSAM), Instituto Salud Carlos III, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
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Dichtel LE, Lawson EA, Schorr M, Meenaghan E, Paskal ML, Eddy KT, Pinna G, Nelson M, Rasmusson AM, Klibanski A, Miller KK. Neuroactive Steroids and Affective Symptoms in Women Across the Weight Spectrum. Neuropsychopharmacology 2018; 43:1436-1444. [PMID: 29090684 PMCID: PMC5916351 DOI: 10.1038/npp.2017.269] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 08/24/2017] [Accepted: 10/27/2017] [Indexed: 11/09/2022]
Abstract
3α-5α-Tetrahydroprogesterone, a progesterone metabolite also known as allopregnanolone, and 5α-androstane-3α,17β-diol, a testosterone metabolite also known as 3α-androstanediol, are neuroactive steroids and positive GABAA receptor allosteric modulators. Both anorexia nervosa (AN) and obesity are complicated by affective comorbidities and hypothalamic-pituitary-gonadal dysregulation. However, it is not known whether neuroactive steroid levels are abnormal at the extremes of the weight spectrum. We hypothesized that serum allopregnanolone and 3α-androstanediol levels would be decreased in AN compared with healthy controls (HC) and negatively associated with affective symptoms throughout the weight spectrum, independent of body mass index (BMI). Thirty-six women were 1 : 1 age-matched across three groups: AN, HC, and overweight/obese (OW/OB). AN were amenorrheic; HC and OW/OB were studied in the follicular phase. Fasting serum neuroactive steroids were measured by gas chromatography/mass spectrometry. Mean Hamilton depression and anxiety scores were highest in AN (p<0.0001). Mean serum allopregnanolone was lower in AN and OW/OB than HC (AN 95.3±56.4 vs OW/OB 73.8±31.3 vs HC 199.5±167.8 pg/ml, p=0.01), despite comparable mean serum progesterone. Allopregnanolone levels, but not progesterone levels, were negatively associated with depression and anxiety symptom severity, independent of BMI. Serum 3α-androstanediol levels did not differ among groups and were not associated with depression or anxiety scores, despite a significant negative association between free testosterone levels and both anxiety and depression severity. In conclusion, women at both extremes of the weight spectrum have low mean serum allopregnanolone, which is associated with increased depression and anxiety severity, independent of BMI. Neuroactive steroids such as allopregnanolone may be potential therapeutic targets for depression and anxiety in traditionally treatment-resistant groups, including AN.
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Affiliation(s)
- Laura E Dichtel
- Neuroendocrine Unit, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA,Neuroendocrine Unit, Massachusetts General Hospital, BUL457B, 55 Fruit Street, Boston, MA 02114, USA, Tel: +1 617 726 3870, Fax: +1 617 726 5072, E-mail:
| | - Elizabeth A Lawson
- Neuroendocrine Unit, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Melanie Schorr
- Neuroendocrine Unit, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Erinne Meenaghan
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA
| | | | - Kamryn T Eddy
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Graziano Pinna
- The Psychiatric Institute, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Marianela Nelson
- The Psychiatric Institute, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Ann M Rasmusson
- National Center for PTSD, Department of Veterans Affairs, VA Boston Healthcare System, Boston, MA, USA,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Anne Klibanski
- Neuroendocrine Unit, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Karen K Miller
- Neuroendocrine Unit, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
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8
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Kamin HS, Kertes DA. Cortisol and DHEA in development and psychopathology. Horm Behav 2017; 89:69-85. [PMID: 27979632 DOI: 10.1016/j.yhbeh.2016.11.018] [Citation(s) in RCA: 167] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 11/19/2016] [Accepted: 11/30/2016] [Indexed: 01/01/2023]
Abstract
Dehydroepiandrosterone (DHEA) and cortisol are the most abundant hormones of the human fetal and adult adrenals released as end products of a tightly coordinated endocrine response to stress. Together, they mediate short- and long-term stress responses and enable physiological and behavioral adjustments necessary for maintaining homeostasis. Detrimental effects of chronic or repeated elevations in cortisol on behavioral and emotional health are well documented. Evidence for actions of DHEA that offset or oppose those of cortisol has stimulated interest in examining their levels as a ratio, as an alternate index of adrenocortical activity and the net effects of cortisol. Such research necessitates a thorough understanding of the co-actions of these hormones on physiological functioning and in association with developmental outcomes. This review addresses the state of the science in understanding the role of DHEA, cortisol, and their ratio in typical development and developmental psychopathology. A rationale for studying DHEA and cortisol in concert is supported by physiological data on the coordinated synthesis and release of these hormones in the adrenal and by their opposing physiological actions. We then present evidence that researching cortisol and DHEA necessitates a developmental perspective. Age-related changes in DHEA and cortisol are described from the perinatal period through adolescence, along with observed associations of these hormones with developmental psychopathology. Along the way, we identify several major knowledge gaps in the role of DHEA in modulating cortisol in typical development and developmental psychopathology with implications for future research.
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Affiliation(s)
- Hayley S Kamin
- Department of Psychology, University of Florida, Gainesville, FL 32611, USA
| | - Darlene A Kertes
- Department of Psychology, University of Florida, Gainesville, FL 32611, USA; University of Florida Genetics Institute, University of Florida, Gainesville, FL 32611, USA.
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9
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Lang K, Lopez C, Stahl D, Tchanturia K, Treasure J. Central coherence in eating disorders: an updated systematic review and meta-analysis. World J Biol Psychiatry 2014; 15:586-98. [PMID: 24882144 DOI: 10.3109/15622975.2014.909606] [Citation(s) in RCA: 142] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES A bias towards local information over the global "gist" (weak central coherence, WCC), has been identified as a possible contributing and maintaining factor in eating disorders (ED). The present study aimed to provide an updated review of the WCC literature and examine the hypothesis that individuals with ED have WCC. METHODS The new search found 12 eligible studies. Meta-analyses were performed on nine of these 12 studies, the remaining three were commented on individually. Data were combined with data from the previous 2008 review, and meta- analyses were performed on 16 studies (nine studies from the new search and seven studies from 2008 review). RESULTS Meta-analysis of the Group Embedded Figures Task provided evidence of superior local processing across all ED subtypes (pooled effect size of d = -0.62 (95% CI = -0.94, -0.31), P < 0.001). Evidence of poorer global processing in ED groups was found from meta-analyses of the Rey-Osterrieth Complex Figures task (d = -0.63 (95% CI = -0.77, -0.49, P < 0.001), and the Object Assembly Task (d = -0.65 (95% CI = -0.94, -0.37), P < 0.0001). CONCLUSIONS As well as supporting the results of previous studies by providing evidence of inefficient global processing, this review has provided evidence of superior local processing, which supports the WCC hypothesis in ED.
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Affiliation(s)
- Katie Lang
- King's College London (KCL), Psychological Medicine, Section of Eating Disorders Institute of Psychiatry , UK
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Merlotti E, Mucci A, Volpe U, Montefusco V, Monteleone P, Bucci P, Galderisi S. Impulsiveness in patients with bulimia nervosa: electrophysiological evidence of reduced inhibitory control. Neuropsychobiology 2014; 68:116-23. [PMID: 23881271 DOI: 10.1159/000352016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 05/06/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Bulimia nervosa (BN) is associated with a deficit of self-regulatory control and impulsivity. The present study aimed to clarify whether an impaired inhibitory control due to hyperarousal underlies impulsivity in BN subjects. METHODS Event-related potentials (ERPs) were recorded in 17 female patients with BN and 17 healthy controls during a three-tone oddball task. ERP components related to inhibition of irrelevant distractor stimuli, as well as effortful processing, were analyzed. Standardized low-resolution electromagnetic tomography (sLORETA) was used to assess ERP source activity. RESULTS Compared to healthy controls, BN patients showed reduced amplitude and shorter latency of the N200 (N2), increased amplitude and shorter latency of the target slow wave (SW), and higher amplitude of the P300 for distractor stimuli (P3a) and for targets (P3b). sLORETA showed the following: (1) higher activity of the P3a generators in the left parietal cortex, bilateral precuneus and right frontal and anterior cingulate for distractor stimuli and (2) lower activity of the SW generators in the left medial frontal gyrus, bilateral superior frontal, anterior cingulate and cuneus for target stimuli. The reduction of the N2 latency was associated with the Barratt scores for impulsiveness. CONCLUSIONS The observed electrophysiological abnormalities suggest a condition of hyperarousal, with impaired suppression of irrelevant stimuli due to abnormal cortical activation and reduced signal-to-noise ratio. Our findings point to functional abnormalities within a neural system that subserves attention and self-regulatory control, which may contribute to impulsive behaviors in BN.
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Molina-Carballo A, Justicia-Martínez F, Moreno-Madrid F, Cubero-Millán I, Machado-Casas I, Moreno-García L, León J, Luna-Del-Castillo JDD, Uberos J, Muñoz-Hoyos A. Differential responses of two related neurosteroids to methylphenidate based on ADHD subtype and the presence of depressive symptomatology. Psychopharmacology (Berl) 2014; 231:3635-45. [PMID: 24599397 DOI: 10.1007/s00213-014-3514-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 02/15/2014] [Indexed: 11/25/2022]
Abstract
RATIONALE Attention deficit with hyperactivity disorder is a neurodevelopmental disorder associated with alterations in the prefrontal cortex via dopaminergic and noradrenergic neurotransmission. Neurosteroids (e.g. allopregnanolone and dehydroepiandrosterone) modulate the release of multiple neurotransmitters. OBJECTIVE This study aims to determine the baseline concentrations and daily variations in allopregnanolone and dehydroepiandrosterone in children with attention deficit hyperactivity disorder (ADHD) and to determine the effect of chronic administration of methylphenidate on clinical symptoms and on the concentrations of these two neurosteroids. METHODS We included 148 children aged 5 to 14 years, subdivided into two groups: ADHD group (n = 107, with a diagnosis of ADHD (DSM-IV-TR criteria), further classified in subtypes by an "attention deficit and hyperactivity scale" and subgroups by the "Children's Depression Inventory") and a control group (n = 41). The clinical workup included blood samples that were drawn at 20:00 and 09:00 hours, at inclusion in both groups, and after 4.61 ± 2.29 months of treatment only in the ADHD group, for measurements for allopregnanolone and dehydroepiandrosterone. Factorial analysis, adjusted for age and gender, was performed by using Stata 12.0. RESULTS Methylphenidate induced the doubling of allopregnanolone levels in the predominantly inattentive ADHD patients without depressive symptoms (27.26 ± 12.90 vs. 12.67 ± 6.22 ng/ml, morning values). Although without statistical differences, baseline dehydroepiandrosterone levels were higher and slightly increased after methylphenidate in the ADHD subtype with depressive symptoms (7.74 ± 11.46 vs. 6.18 ± 5.99 ng/ml, in the morning), opposite to the lower baseline levels, and further decrease after methylphenidate in the inattentive subtype with depressive symptoms. CONCLUSIONS Different neurosteroids may have different baseline concentrations and differential responses to methylphenidate treatment as a function of ADHD subtype and subgroup. These differential responses may be a clinical marker of ADHD subtype and/or co-morbidities.
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Affiliation(s)
- Antonio Molina-Carballo
- Servicio de Neuropediatría, Neuropsicología y Atención Temprana, Unidad de Gestión Clínica de Pediatría, Hospital Clínico San Cecilio, Complejo Hospitalario Granada, Granada, Spain,
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12
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Weider S, Indredavik MS, Lydersen S, Hestad K. Intellectual function in patients with anorexia nervosa and bulimia nervosa. EUROPEAN EATING DISORDERS REVIEW 2014; 22:15-24. [PMID: 24185818 DOI: 10.1002/erv.2260] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 08/29/2013] [Accepted: 09/02/2013] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This study aimed to examine cognitive function in individuals with anorexia nervosa (AN) and bulimia nervosa (BN) on the basis of IQ measures, indexes and subtests of the Wechsler Adult Intelligence Scale – Third Edition (WAIS-III). METHODS A total of 41 patients with AN, 40 patients with BN and 40 healthy controls (HC), matched for sex, age and education, were recruited consecutively to complete the WAIS-III. RESULTS The AN group showed a significantly lower performance than the HC group on most global measures and on eight of the 13 administered subtests. Minor differences in verbal function were detected between the BN group and the HC group. CONCLUSION The patients with eating disorders showed normal intellectual functions compared with the normative population. However, the AN group displayed a consistently lower performance than the matched HC group, which performed above normative means. The BN group performed at a level between that of the AN and HC groups.
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Monteleone P, Maj M. Dysfunctions of leptin, ghrelin, BDNF and endocannabinoids in eating disorders: beyond the homeostatic control of food intake. Psychoneuroendocrinology 2013; 38:312-30. [PMID: 23313276 DOI: 10.1016/j.psyneuen.2012.10.021] [Citation(s) in RCA: 114] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 10/29/2012] [Accepted: 10/29/2012] [Indexed: 12/18/2022]
Abstract
A large body of literature documents the occurrence of alterations in the physiology of both central and peripheral modulators of appetite in acute patients with anorexia nervosa (AN) and bulimia nervosa (BN). Until more recently the role of most of the appetite modulators in the control of eating behavior was conceptualized solely in terms of their influence on homeostatic control of energy balance. However, it is becoming more and more evident that appetite modulators also affect the non-homeostatic cognitive, emotional and rewarding component of food intake as well as non food-related reward, and, recently, AN and BN have been pathophysiologically linked to dysfunctions of reward mechanisms. Therefore, the possibility exists that observed changes in appetite modulators in acute AN and BN may represent not only homeostatic adaptations to malnutrition, but also contribute to the development and/or the maintenance of aberrant non-homeostatic behaviors, such as self-starvation and binge eating. In the present review, the evidences supporting a role of leptin, ghrelin, brain-derived neurotrophic factor and endocannabinoids in the homeostatic and non-homeostatic dysregulations of patients with AN and BN will be presented. The reviewed literature is highly suggestive that changes in the physiology of these modulators may play a pivotal role in the pathophysiology of eating disorders by providing a possible link between motivated behaviors, reward processes, cognitive functions and energy balance.
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Affiliation(s)
- Palmiero Monteleone
- Department of Medicine and Surgery, University of Salerno, via S. Allende, 84084 Baronissi (Salerno), Italy.
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15
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Cognitive flexibility in juvenile anorexia nervosa patients before and after weight recovery. J Neural Transm (Vienna) 2012; 119:1047-57. [PMID: 22644538 DOI: 10.1007/s00702-012-0821-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 05/06/2012] [Indexed: 01/06/2023]
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Harrison A, Tchanturia K, Treasure J. Measuring state trait properties of detail processing and global integration ability in eating disorders. World J Biol Psychiatry 2011; 12:462-72. [PMID: 21554026 DOI: 10.3109/15622975.2010.551666] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Women with eating disorders (EDs) are reported to have strengths in local or detailed information processing and difficulties with coherence or global processing/integration. METHODS This study aimed to replicate these findings and additionally explore a global integration task which has not previously been reported for an ED group, the Fragmented Pictures Task (FPT). Two hundred and twenty-two women (50 with anorexia nervosa (AN), 48 with bulimia nervosa (BN), 35 recovered from AN and 89 controls (HC)) completed the Rey-Osterrieth Complex Figure Task (RCFT) to measure global/local processing strategies, the Group Embedded Figures Task (GEFT) to measure local processing and the FPT to measure global integration. RESULTS Superior detail processing skills (GEFT) and a tendency to utilise detail processing strategies (RCFT) were associated with having AN, BN and being in recovery from AN. Global integration difficulties (FPT) were only observed in acute AN, whereas participants in the BN and recovered group performed similarly to HCs. CONCLUSIONS People currently ill with, and recovered from EDs are skilled at detail processing. The acute phase of AN is associated with difficulties in global integration.
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Affiliation(s)
- Amy Harrison
- Eating Disorders Research Unit, King's College London, Institute of Psychiatry, Department of Psychological Medicine and Psychiatry, 5th Floor, Bermondsey Wing, Guy's Hospital, London SE1 9RT, UK. amy.harrison@.kcl.ac.uk
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Galderisi S, Bucci P, Mucci A, Bellodi L, Cassano GB, Santonastaso P, Erzegovesi S, Favaro A, Mauri M, Monteleone P, Maj M. Neurocognitive functioning in bulimia nervosa: the role of neuroendocrine, personality and clinical aspects. Psychol Med 2011; 41:839-848. [PMID: 20594380 DOI: 10.1017/s0033291710001303] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Studies investigating neurocognitive impairment in subjects with eating disorders (EDs) have reported heterogeneous patterns of impairment and, in some instances, no dysfunction. The present study aimed to define the pattern of neurocognitive impairment in a large sample of bulimia nervosa (BN) patients and to demonstrate that neuroendocrine, personality and clinical characteristics influence neurocognitive performance in BN. METHOD Attention/immediate memory, set shifting, perseveration, conditional and implicit learning were evaluated in 83 untreated female patients with BN and 77 healthy controls (HC). Cortisol and 17β-estradiol plasma levels were assessed. Cloninger's Temperament and Character Inventory - Revised (TCI-R), the Bulimic Investigation Test Edinburgh (BITE) and the Montgomery-Asberg Depression Rating Scale (MADRS) were administered. RESULTS No impairment of cognitive performance was found in subjects with BN compared with HC. Cortisol and 'Self-directedness' were associated with better performance on conditional learning whereas 17β-estradiol had a negative influence on this domain; 'Reward dependence' was associated with worse performance on implicit learning; and depressive symptomatology influenced performance on the Wisconsin Card Sorting Test (WCST) negatively. CONCLUSIONS No cognitive impairment was found in untreated patients with BN. Neuroendocrine, personality and clinical variables do influence neurocognitive functioning and might explain discrepancies in literature findings.
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Affiliation(s)
- S Galderisi
- Department of Psychiatry, University of Naples SUN, Naples, Italy.
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Buehren K, Konrad K, Schaefer K, Kratzsch J, Kahraman-Lanzerath B, Lente C, Herpertz-Dahlmann B. Association between neuroendocrinological parameters and learning and memory functions in adolescent anorexia nervosa before and after weight recovery. J Neural Transm (Vienna) 2011; 118:963-8. [DOI: 10.1007/s00702-010-0567-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Accepted: 12/17/2010] [Indexed: 10/18/2022]
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Lopez C, Stahl D, Tchanturia K. Estimated intelligence quotient in anorexia nervosa: a systematic review and meta-analysis of the literature. Ann Gen Psychiatry 2010; 9:40. [PMID: 21182794 PMCID: PMC3016382 DOI: 10.1186/1744-859x-9-40] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2010] [Accepted: 12/23/2010] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND It has been hypothesised that people with anorexia nervosa have a higher intelligence quotient (IQ) level than the general population. The purpose of this review was to systematically appraise the research into reported IQ levels in people with anorexia nervosa. METHODS A search using the terms intelligence quotient, IQ, intelligence, cognition, eating disorders and anorexia was conducted in electronic databases only. RESULTS In all, 30 peer-reviewed studies written in English that used well established measures of intelligence quotient (the National Adult Reading Test and Wechsler Intelligence Scales) were identified. This review established that people with anorexia nervosa score 10.8 units and 5.9 units above the average intelligence quotient of the normative population on the National Adult Reading Test and Wechsler Intelligence Scales, respectively. An association was found between Body Mass Index and intelligence quotient, as measured by the National Adult Reading Test. CONCLUSIONS More studies including other eating disorder categories and recovered people are needed to explore important questions regarding the role of the intelligence quotient in treatment response.
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Affiliation(s)
- Carolina Lopez
- Institute of Psychiatry, Kings College London, London, UK
- Faculty of Medicine, University of Chile, Santiago, Chile
| | - Daniel Stahl
- Institute of Psychiatry, Kings College London, London, UK
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Ritsner MS, Strous RD. Neurocognitive deficits in schizophrenia are associated with alterations in blood levels of neurosteroids: a multiple regression analysis of findings from a double-blind, randomized, placebo-controlled, crossover trial with DHEA. J Psychiatr Res 2010; 44:75-80. [PMID: 19665142 DOI: 10.1016/j.jpsychires.2009.07.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2009] [Accepted: 07/03/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND While neurosteroids exert multiple effects in the central nervous system, their associations with neurocognitive deficits in schizophrenia are not yet fully understood. The purpose of this study was to identify the contribution of circulating levels of dehydroepiandrosterone (DHEA), its sulfate (DHEAS), androstenedione, and cortisol to neurocognitive deficits through DHEA administration in schizophrenia. METHODS Data regarding cognitive function, symptom severity, daily doses, side effects of antipsychotic agents and blood levels of DHEA, DHEAS, androstenedione and cortisol were collected among 55 schizophrenia patients in a double-blind, randomized, placebo-controlled, crossover trial with DHEA at three intervals: upon study entry, after 6weeks of DHEA administration (200mg/d), and after 6weeks of a placebo period. Multiple regression analysis was applied for predicting sustained attention, memory, and executive function scores across three examinations controlling for clinical, treatment and background covariates. RESULTS Findings indicated that circulating DHEAS and androstenedione levels are shown as positive predictors of cognitive functioning, while DHEA level as negative predictor. Overall, blood neurosteroid levels and their molar ratios accounted for 16.5% of the total variance in sustained attention, 8-13% in visual memory tasks, and about 12% in executive functions. In addition, effects of symptoms, illness duration, daily doses of antipsychotic agents, side effects, education, and age of onset accounted for variability in cognitive functioning in schizophrenia. CONCLUSIONS The present study suggests that alterations in circulating levels of neurosteroids and their molar ratios may reflect pathophysiological processes, which, at least partially, underlie cognitive dysfunction in schizophrenia.
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Affiliation(s)
- Michael S Ritsner
- The Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Sha'ar Menashe Mental Health Center, Hadera, Israel
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Abstract
Alterations of both central and peripheral feeding regulatory substances occur in the acute phases of anorexia nervosa (AN) and bulimia nervosa (BN) and, generally, reverse after recovery. Some of these alterations are believed not only to sustain the altered eating behavior but also to contribute to certain psychopathological aspects and/or etiopathogenetic processes of eating disorders (EDs). It has been suggested that EDs are clinical conditions linked to reward-related mechanisms leading to a kind of addiction to self-starvation and/or overeating. Most of the feeding regulatory substances, which are dysregulated in EDs, are also implicated in the modulation of reward, emotional, and cognitive functions, thus representing possible links between altered nutritional regulation, motivated behaviors and reward processes. In this chapter, the ED literature dealing with ghrelin, brain-derived neurotrophic factor, opioid peptides, and endocannabinoids, which have prominent effects on eating behavior, body weight, reward, emotional, and cognitive functions, is reviewed in view of the above suggested links. Moreover, the potential therapeutics of new medications developed on the basis of neuroendocrine aberrations found in EDs is also presented.
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Do Rego JL, Seong JY, Burel D, Leprince J, Luu-The V, Tsutsui K, Tonon MC, Pelletier G, Vaudry H. Neurosteroid biosynthesis: enzymatic pathways and neuroendocrine regulation by neurotransmitters and neuropeptides. Front Neuroendocrinol 2009; 30:259-301. [PMID: 19505496 DOI: 10.1016/j.yfrne.2009.05.006] [Citation(s) in RCA: 283] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2009] [Revised: 05/12/2009] [Accepted: 05/21/2009] [Indexed: 01/09/2023]
Abstract
Neuroactive steroids synthesized in neuronal tissue, referred to as neurosteroids, are implicated in proliferation, differentiation, activity and survival of nerve cells. Neurosteroids are also involved in the control of a number of behavioral, neuroendocrine and metabolic processes such as regulation of food intake, locomotor activity, sexual activity, aggressiveness, anxiety, depression, body temperature and blood pressure. In this article, we summarize the current knowledge regarding the existence, neuroanatomical distribution and biological activity of the enzymes responsible for the biosynthesis of neurosteroids in the brain of vertebrates, and we review the neuronal mechanisms that control the activity of these enzymes. The observation that the activity of key steroidogenic enzymes is finely tuned by various neurotransmitters and neuropeptides strongly suggests that some of the central effects of these neuromodulators may be mediated via the regulation of neurosteroid production.
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Affiliation(s)
- Jean Luc Do Rego
- Institut National de la Santé et de la Recherche Médicale (INSERM) Unité 413, 76821 Mont-Saint-Aignan, France
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Madsen IR, Hørder K, Støving RK. Remission of eating disorder during pregnancy: five cases and brief clinical review. J Psychosom Obstet Gynaecol 2009; 30:122-6. [PMID: 19533492 DOI: 10.1080/01674820902789217] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Eating disorder during pregnancy is associated with a diversity of adverse outcomes and is of potential danger to both mother and child. There is, however, a tendency for remission of the eating disorder during pregnancy with improvement of symptoms such as restrictive dieting, binging and purging, and some women actually manage to put the disease behind them. This case report describes five women with different eating disorders and focuses on the symptomatology during pregnancy and in the months postpartum. The discussion deals with the possible psychological, social and endocrinological reasons for remission and the subsequent relapse, the definition of recovery and the factors which should alert health care professionals of the at-risk pregnancies in cases of undisclosed eating disorder. Furthermore, therapeutic interventions are proposed.
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Affiliation(s)
- Ida Ringsborg Madsen
- Department of Endocrinology, Center for Eating Disorders, Odense University Hospital, Odense, Denmark.
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Nakazato M, Tchanturia K, Schmidt U, Campbell IC, Treasure J, Collier DA, Hashimoto K, Iyo M. Brain-derived neurotrophic factor (BDNF) and set-shifting in currently ill and recovered anorexia nervosa (AN) patients. Psychol Med 2009; 39:1029-1035. [PMID: 18752728 DOI: 10.1017/s0033291708004108] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Studies of patients with anorexia nervosa (AN) have shown that they do not perform well in set-shifting tasks but little is known about the neurobiological correlates of this aspect of executive function. The aim of this study was to measure serum brain-derived neurotrophic factor (BDNF) and to establish whether set-shifting difficulties are present in people with current AN and in those recovered from AN, and whether serum BDNF concentrations are correlated with set-shifting ability. METHOD Serum BDNF concentrations were measured in 29 women with current AN (AN group), 18 women who had recovered from AN (ANRec group) and 28 age-matched healthy controls (HC group). Set-shifting was measured using the Wisconsin Card Sorting Test (WCST). Eating-related psychopathology and depressive, anxiety and obsessive-compulsive symptomatology were evaluated using the Eating Disorder Examination Questionnaire (EDEQ), the Hospital Anxiety and Depression Scale (HADS), and the Maudsley Obsessive-Compulsive Inventory (MOCI) respectively. RESULTS Serum BDNF concentrations (mean+/-s.d.) were significantly lower in the AN group (11.7+/-4.9 ng/ml) compared to the HC group (15.1+/-5.5 ng/ml, p=0.04) and also compared to the ANRec group (17.6+/-4.8 ng/ml, p=0.001). The AN group made significantly more errors (total and perseverative) in the WCST relative to the HC group. There was no significant correlation between serum BDNF concentrations and performance on the WCST. CONCLUSIONS Serum BDNF may be a biological marker for eating-related psychopathology and of recovery in AN. Longitudinal studies are needed to explore possible associations between serum BDNF concentrations, illness and recovery and neuropsychological traits.
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Affiliation(s)
- M Nakazato
- Section of Eating Disorders, Institute of Psychiatry, King's College London, London, UK.
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Bühren K, Holtkamp K, Herpertz-Dahlmann B, Konrad K. Neuropsychologische Befunde bei Anorexia und Bulimia nervosa im Kindes- und Jugendalter. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2008; 36:377-86; quiz 387-8. [DOI: 10.1024/1422-4917.36.6.377] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung: Anorexia und Bulimia nervosa sind häufige psychiatrische Erkrankungen des Kindes- und Jugendalters, die insbesondere Mädchen betreffen. Im Akutzustand der Starvation treten bei Essstörungen eine Vielzahl von hormonellen, neuropsychologischen und hirnmorphologischen Veränderungen auf, von denen einige nur teilweise reversibel sind. Komorbide psychiatrische Erkrankungen verkomplizieren das Krankheitsbild und erschweren adäquate therapeutische Interventionen. Der folgende Artikel setzt sich ausführlich mit den neuropsychologischen Defiziten bei Essstörungen, möglichen Einflussfaktoren auf die kognitive Leistungsfähigkeit und daraus resultierenden Implikationen für den klinischen Alltag auseinander.
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Affiliation(s)
- Katharina Bühren
- Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Universitätsklinikum Aachen
| | - Kristian Holtkamp
- Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Universitätsklinikum Aachen
| | | | - Kerstin Konrad
- Lehr- und Forschungsgebiet Klinische Neuropsychologie des Kindes- und Jugendalters, Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Universitätsklinikum Aachen (Ärztliche Direktorin: Prof. Dr. med. B. Herpertz-Dahlmann)
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Abstract
BACKGROUND This review systematically appraised the research evidence for local versus global information processing to test the hypothesis that people with eating disorders (ED) had weak central coherence. METHOD Searches on Medline, EMBASE, PsycINFO and ISI Web of Science databases were conducted in November 2006 and subsequently updated in September 2007. Each search was conducted in two steps: (1) neuropsychological tasks measuring central coherence and (2) words related to cognitive functioning in eating disorders. Data were summarized in a meta-analysis if the number of studies for a given test was >5. RESULTS Data were extracted from 16 studies. Meta-analyses were conducted for four tasks obtaining moderate effect sizes. The majority of studies found global processing difficulties across the ED spectrum. The results are less clear regarding local processing. CONCLUSIONS People with ED have difficulties in global processing. It is less certain as to whether they have superior local processing. Currently, there is insufficient evidence to refute the weak central coherence hypothesis.
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Affiliation(s)
- C Lopez
- Division of Psychological Medicine, Eating Disorders Research Unit, Institute of Psychiatry, King's College London, London, UK.
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Southgate L, Tchanturia K, Treasure J. Information processing bias in anorexia nervosa. Psychiatry Res 2008; 160:221-7. [PMID: 18579218 DOI: 10.1016/j.psychres.2007.07.017] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2006] [Revised: 04/18/2007] [Accepted: 07/15/2007] [Indexed: 11/16/2022]
Abstract
The aim of this study was to investigate preferential information processing style in Eating Disorders (ED). We compared the performance of participants with EDs against healthy controls in a task that measures cognitive style (reflection-impulsivity) and cognitive efficiency (inefficient-efficient). Sixty non-medicated female participants (healthy controls n=26, anorexia nervosa n=20, bulimia nervosa n=14) took part in the Matching Familiar Figures Test (MFFT), a difficult visual search paradigm with high response uncertainty. Participants with anorexia scored significantly higher on the efficiency dimension score than the control group. No significant differences were found across groups on the dimension 'reflection-impulsivity'. Participants with anorexia are more efficient (quicker response latencies in conjunction with fewer errors) in this visual search task that requires an analytic approach. This supports the hypothesis that individuals with anorexia have a positive bias toward local detail processing, indicative of weak central coherence.
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Affiliation(s)
- Laura Southgate
- Division of Psychological Medicine, Kings College London, Institute of Psychiatry, UK.
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Strous RD, Maayan R, Weizman A. The relevance of neurosteroids to clinical psychiatry: from the laboratory to the bedside. Eur Neuropsychopharmacol 2006; 16:155-69. [PMID: 16257183 DOI: 10.1016/j.euroneuro.2005.09.005] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2005] [Revised: 08/08/2005] [Accepted: 09/15/2005] [Indexed: 11/28/2022]
Abstract
Neurosteroids are important neuroactive molecules with suggested central involvement in several neurophysiological and psychiatric disease processes. The discovery of neurosteroids followed the revelation that the brain exhibited the capacity to synthesize its own steroids in situ and thus be a potential site of steroidogenesis. In contrast to some steroids that exhibit traditional genomic steroid actions, most neurosteroids appear to regulate neuronal function by means of "non-genomic" mechanisms influencing neuronal excitability. Neurosteroids are synthesized either from CNS cholesterol or from peripheral steroid precursors and exhibit a wide range of modulatory effects on neurotransmitter receptor activity, most notably at the gamma-aminobutyric acid A (GABA(A)) receptor. Neurosteroids play an important role in neurodevelopment and neuroprotective effects, many aspects of which may have particular applicability to psychiatric disorders including various gender differences. Neurosteroids appear to be relevant to the pathophysiology and pharmacological treatment of many psychiatric disorders including the most notable mood and anxiety disorders, but also psychotic, childhood, eating, dementia, stress and postpartum disorders. It has been suggested that neurosteroids may become potential targets for pharmacological intervention in the future with further neurosteroid investigation contributing to a more comprehensive understanding of human behavior and psychopathology.
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Affiliation(s)
- Rael D Strous
- Beer Yaakov Mental Health Center, PO Box 1, Beer Yaakov 70350, Israel.
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Mo Q, Lu SF, Simon NG. Dehydroepiandrosterone and its metabolites: differential effects on androgen receptor trafficking and transcriptional activity. J Steroid Biochem Mol Biol 2006; 99:50-8. [PMID: 16524719 DOI: 10.1016/j.jsbmb.2005.11.011] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2005] [Accepted: 11/14/2005] [Indexed: 12/20/2022]
Abstract
Dehydroepiandrosterone (DHEA) is a multi-functional steroid that has been implicated in a broad range of biological effects in humans and rodents. Recent studies demonstrated that DHEA acts genomically through the androgen receptor (AR) in addition to its well-known effects on cell surface receptors. However, the relative contribution of DHEA and its major metabolites, including DHEA-Sulfate (DHEA-S), 7alpha-OH-DHEA, 7beta-OH-DHEA, 7-oxo-DHEA, androstenedione (Adione), and androstenediol (Adiol), in the production of genomic effects remains controversial, in part because the metabolism of DHEA varies in different cells and tissues. In the current study, the ability of DHEA and its metabolites to promote AR intracellular trafficking and regulate AR-mediated reporter gene expression, which are characteristic effects of androgens, was determined. Intracellular trafficking of AR-GFP protein was assessed in COS-7 cells while AR transcriptional activity was tested in CV-1 cells transiently co-transfected with AR expression plasmid and an MMTV-ARE-CAT reporter. The results demonstrated that DHEA, the 3beta-HSD metabolite Adione, and the 17beta-HSD metabolite Adiol, were androgenic. Each promoted AR-GFP intracellular trafficking, the formation of nuclear clusters, and AR-dependent transcriptional activity in a dose-dependent manner. In contrast, DHEA-S, 7alpha-OH-DHEA, 7beta-OH-DHEA, and 7-oxo-DHEA were ineffective and exhibited minimal androgenic activity, even at relatively high concentrations (10(-6) M). These results provide the first systematic comparison of the (i) androgenic activity of DHEA and its sulfated and hydroxylated metabolites, (ii) relative androgenicity of DHEA itself vs. the established androgens Adione and Adiol, and (iii) ability of DHEA and its major metabolites to promote AR-GFP intracellular trafficking. In addition to partitioning DHEA and its metabolites into compounds with (DHEA, Adione, Adiol) and without (DHEA-S, 7alpha-OH-DHEA, 7beta-OH-DHEA, and 7-oxo-DHEA) androgenic activity, the findings improve our understanding of the intracellular processes mediating the genomic effects of DHEA through AR.
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Affiliation(s)
- Qianxing Mo
- Department of Biological Sciences, Lehigh University, Bethlehem, PA 18015, United States
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Swaab DF. The human hypothalamus in metabolic and episodic disorders. PROGRESS IN BRAIN RESEARCH 2006; 153:3-45. [PMID: 16876566 DOI: 10.1016/s0079-6123(06)53001-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- D F Swaab
- Netherlands Institute for Neuroscience, Meibergdreef 47, 1105BA Amsterdam, The Netherlands.
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Grosso S, Luisi S, Berardi R, Mostardini R, Cordelli DM, Morgese G, Petraglia F, Balestri P. Post-ictal circulating levels of allopregnanolone in children with partial or generalized seizures. Epilepsy Res 2005; 63:97-102. [PMID: 15725389 DOI: 10.1016/j.eplepsyres.2004.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2004] [Revised: 12/10/2004] [Accepted: 12/12/2004] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Allopregnanolone (3alpha-hydroxy-5alpha-pregnan-20-one) is a neurosteroid with a potent modulating activity on the gamma-aminobutyric acid (GABA)(a) receptor complex. It plays a key role in the epileptogenesis of partial seizures. Serum allopregnanolone concentrations significantly increase in the postcritical phase. In the present study we investigated the post-ictal serum allopregnanolone levels in children with partial seizures and generalized seizures, respectively. PATIENTS AND METHODS Three groups of subjects were included in the study. Group 1 consisted of 18 children affected by complex partial seizures. Group 2 consisted of 11 children presenting with generalized epilepsy. Group 3 consisted of 20 healthy age-matched subjects. Serum allopregnanolone levels were assayed in the inter-ictal phase and within 30 min after an epileptic event. RESULTS The data we obtained suggest that circulating allopregnanolone level significantly increases in the post-ictal phase. However, we found no significant differences in the post-ictal serum allopregnanolone concentrations between patients with partial seizures and those with generalized seizures. CONCLUSIONS Further studies are needed to establish if allopregnanolone is a reliable circulating marker of epileptic seizures. However, our observations seem to indicate that post-ictal circulating allopregnanolone level is not useful in differentiating focal and generalized epilepsy events.
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Affiliation(s)
- Salvatore Grosso
- Department of Pediatrics, Obstetrics, and Reproductive Medicine, University of Siena, Viale M. Bracci, Le Scotte, 53100 Siena, Italy
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Monteleone P, Santonastaso P, Pannuto M, Favaro A, Caregaro L, Castaldo E, Zanetti T, Maj M. Enhanced serum cholesterol and triglyceride levels in bulimia nervosa: relationships to psychiatric comorbidity, psychopathology and hormonal variables. Psychiatry Res 2005; 134:267-73. [PMID: 15892986 DOI: 10.1016/j.psychres.2004.06.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2004] [Indexed: 11/26/2022]
Abstract
Increased levels of cholesterol have been reported in patients with bulimia nervosa (BN), but all but one of the published studies were performed on non-fasting subjects, which limits the interpretation of this finding. Moreover, the relationships between serum lipids and comorbid psychiatric disorders or bulimic psychopathology have scarcely been investigated. We measured serum levels of total cholesterol, triglycerides, glucose, 17beta-estradiol and thyroid hormones in 75 bulimic women and 64 age-matched healthy females after an overnight fast. Compared with healthy women, bulimic patients exhibited significantly enhanced serum levels of cholesterol and triglycerides, but similar values of glucose, 17beta-estradiol, FT3 and FT4. No significant differences emerged in these variables between patients with or without comorbid depression, borderline personality disorder or lifetime anorexia nervosa. Circulating cholesterol was positively correlated to the patients' drive for thinness, ineffectiveness, enteroceptive awareness and impulse regulation sub-item scores of the Eating Disorder Inventory-2. These findings confirm that BN is associated with increased levels of serum lipids. This alteration may be involved in the pathophysiology of certain psychopathological characteristics of BN and cannot be explained by the co-occurrence of other psychiatric disorders.
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Affiliation(s)
- Palmiero Monteleone
- Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie, 80138 Naples, Italy.
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Poór V, Bíró I, Bufa A, Gáti A, Fenyvesi I, Juricskay S, Tényi T, Kilár F. Urinary steroids in young women with eating disorders. ACTA ACUST UNITED AC 2004; 61:199-205. [PMID: 15560936 DOI: 10.1016/j.jbbm.2004.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2003] [Revised: 09/19/2004] [Accepted: 09/19/2004] [Indexed: 11/12/2022]
Abstract
Urinary steroid components were measured after enzyme hydrolysis and methoxym-silyl derivatization by capillary gas chromatography in young women with eating disorders. Using three internal standards, programmed temperature from 50 to 300 degrees C and flame ionization detection, on ULTRA-1 capillary column the separation of 28 steroid components is possible. Fifteen young women with different eating disorders, i.e. anorexia nervosa, bulimia nervosa and bulimarexia (aged 16-28 years) and 15 healthy women (aged 22-26 years) collected 24-h urine. A significant decrease of dehydroepiandrosterone (p<0.05) and a significant elevation of the stress marker allo-tetrahydrocorticosterone (p<0.05) were observed in the patients with compared to the controls. Among the patients two groups were defined due to a significant difference in the content of the cortisol metabolites compared to each other and to controls (p<0.01). The results confirm the role of dehydroepiandrosterone in eating disorders. The increased level of the stress marker allo-tetrahydrocorticosterone refers to the involvement of stress in these diseases, but the relevance of hormone alteration to the pathophysiology of eating disorders remains to be elucidated. The reason of the differences in cortisol metabolites levels in some patients needs further investigations.
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Affiliation(s)
- Viktória Poór
- Institute of Bioanalysis, Faculty of Medicine, University of Pécs, Szigeti út 12., Pécs, H-7624, Hungary.
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Mo Q, Lu SF, Hu S, Simon NG. DHEA and DHEA sulfate differentially regulate neural androgen receptor and its transcriptional activity. ACTA ACUST UNITED AC 2004; 126:165-72. [PMID: 15249140 DOI: 10.1016/j.molbrainres.2004.05.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2004] [Indexed: 11/15/2022]
Abstract
The mechanism of action of dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEA-S), two interconvertable neurosteroids, has not been fully characterized in the central nervous system (CNS). Previous studies demonstrated that DHEA was intrinsically androgenic, suggesting that it may act through a genomic pathway. However, it is not known whether DHEA-S also produces androgenic effects, an important question given that the concentration of DHEA-S in brain is some 7-12 times that of DHEA. The current study compared the potential androgenic effects of DHEA-S with DHEA by examining their capacity to induce two characteristic effects of an androgenic compound. These included the ability to (1) up-regulate neural androgen receptor (AR) protein level in mouse brain and immortalized GT1-7 hypothalamic cells and (2) assess their effect on reporter gene expression through AR in CV-1 cells cotransfected with pSG5-AR and pMMTV-ARE-CAT reporter. Semi-quantitative Western blot analysis showed that DHEA treatment significantly augmented AR in mouse brain and GT1-7 cells in a dose-dependent manner and that these effects were not blocked by trilostane (TRIL), a known 3beta-hydroxysteroid dehydrogenase inhibitor. DHEA also promoted AR-mediated reporter gene expression as a function of dose and the effect was comparable with or without the addition of TRIL. In contrast, DHEA-S treatment failed to increase AR level in the mouse brain or GT1-7 cells and modestly induced AR-mediated reporter gene expression only at substantially elevated concentrations compared to DHEA. The findings demonstrate that DHEA is capable of exerting androgenic effects through AR while the androgenicity of DHEA-S is negligible. The implications of the results for models of the mechanism of action of DHEA and its sulfate ester, DHEA-S, in the brain are considered.
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Affiliation(s)
- Qianxing Mo
- Department of Biological Sciences, Lehigh University, 111 Research Drive, Bethlehem, PA 18015, USA
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Pieters G, Maas Y, Hulstijn W, Vandereycken W, Probst M, Peuskens J, Sabbe B. Differentiation of cognitive and motor aspects in a digit symbol substitution test in Anorexia nervosa patients, before and after weight restoration. Psychopathology 2004; 37:227-32. [PMID: 15353889 DOI: 10.1159/000080718] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2003] [Accepted: 06/04/2004] [Indexed: 11/19/2022]
Abstract
BACKGROUND In a previous study, using computerized analysis of fine motor behaviour, seriously underweight anorexia nervosa patients in the early phase of treatment were found to have shorter reaction times, but not movement times, in experimental drawing and copying tasks. These differences persisted with weight restoration. SAMPLING AND METHODS Using computerized analysis of writing and drawing behaviour during the performance of a Digit Symbol Substitution Test, 15 anorexia nervosa patients were compared with 15 normal controls, matched for age, sex and educational level. Patients were retested after weight restoration, as were controls after a similar interval. RESULTS Patients turned out to be superior in the cognitive, but not in the motor aspects of the Digit Symbol Substitution Test. These differences persisted after weight restoration. A practice effect, due to repeated testing, was found in both groups, which turned out to be cognitive in nature. CONCLUSIONS The findings show that this new technique can add to the interpretation of classic neuropsychological tests. The results are compatible with previous findings of intact or even superior functioning in anorexia nervosa patients on neuropsychological tasks requiring considerable cognitive effort.
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Affiliation(s)
- Guido Pieters
- Behaviour Therapy Department, UC St. Jozef, Kortenberg, Belgium.
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Seed JA, Dahabra S, Heffernan T, Robertson B, Foster K, Venn H, Froom K, Williams T. Everyday memory and related processes in patients with eating disorders. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/j.cein.2005.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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