Stress-induced eating is mediated through endogenous opiates

Behavioral plasticity: Role of neuropeptides in shaping feeding responses

Behavioral plasticity refers to changes occurring due to external influences on an organism, including adaptation, learning, memory and enduring influences from early life experience. There are 2 types of behavioral plasticity: "developmental", which refers to gene/environment interactions affecting a phenotype, and "activational" which refers to innate physiology and can involve structural physiological changes of the body. In this review, we focus on feeding behavior, and studies involving neuropeptides that influence behavioral plasticity - primarily opioids, orexin, neuropeptide Y, and oxytocin. In each section of the review, we include examples of behavioral plasticity as it relates to actions of these neuropeptides. It can be concluded from this review that eating behavior is influenced by a number of external factors, including time of day, type of food available, energy balance state, and stressors. The reviewed work underscores that environmental factors play a critical role in feeding behavior and energy balance, but changes in eating behavior also result from a multitude of non-environmental factors, such that there can be no single mechanism or variable that can explain ingestive behavior.

The functional link between tail-pinch-induced food intake and emotionality and its possible role in stress coping in rats

Tail pinch facilitates eating in rats. We investigated an unidentified link between tail-pinch-induced eating behavior and individual emotionality in male Sprague-Dawley rats. Anxiety-like behavior was assessed on the elevated plus maze (EPM) and in the open field test (OFT). Tail-pinch-induced eating was observed as follows: After a 30-min habituation period, the tail pinch was applied for 5 min, followed by a 30-min recovery period. During the habituation and recovery periods, rats were allowed to access food ad libitum. During the recovery period, 14 of 24 rats ate more food than during the habituation period. Thus, we named them "high responders" and the others as "low responders". The food intake was significantly greater, while the times spent in the open arms in the EPM and in the center area in the OFT were significantly shorter in high responders than in low responders. This result suggests that the rats consuming more food after mild stress have higher anxiety.

Chronic and acute effects of stress on energy balance: are there appropriate animal models?

Stress activates multiple neural and endocrine systems to allow an animal to respond to and survive in a threatening environment. The corticotropin-releasing factor system is a primary initiator of this integrated response, which includes activation of the sympathetic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis. The energetic response to acute stress is determined by the nature and severity of the stressor, but a typical response to an acute stressor is inhibition of food intake, increased heat production, and increased activity with sustained changes in body weight, behavior, and HPA reactivity. The effect of chronic psychological stress is more variable. In humans, chronic stress may cause weight gain in restrained eaters who show increased HPA reactivity to acute stress. This phenotype is difficult to replicate in rodent models where chronic psychological stress is more likely to cause weight loss than weight gain. An exception may be hamsters subjected to repeated bouts of social defeat or foot shock, but the data are limited. Recent reports on the food intake and body composition of subordinate members of group-housed female monkeys indicate that these animals have a similar phenotype to human stress-induced eaters, but there are a limited number of investigators with access to the model. Few stress experiments focus on energy balance, but more information on the phenotype of both humans and animal models during and after exposure to acute or chronic stress may provide novel insight into mechanisms that normally control body weight.

Endogenous analgesia, dependence, and latent pain sensitization

Endogenous activation of µ-opioid receptors (MORs) provides relief from acute pain. Recent studies have established that tissue inflammation produces latent pain sensitization (LS) that is masked by spinal MOR signaling for months, even after complete recovery from injury and re-establishment of normal pain thresholds. Disruption with MOR inverse agonists reinstates pain and precipitates cellular, somatic, and aversive signs of physical withdrawal; this phenomenon requires N-methyl-D-aspartate receptor-mediated activation of calcium-sensitive adenylyl cyclase type 1 (AC1). In this review, we present a new conceptual model of the transition from acute to chronic pain, based on the delicate balance between LS and endogenous analgesia that develops after painful tissue injury. First, injury activates pain pathways. Second, the spinal cord establishes MOR constitutive activity (MORCA) as it attempts to control pain. Third, over time, the body becomes dependent on MORCA, which paradoxically sensitizes pain pathways. Stress or injury escalates opposing inhibitory and excitatory influences on nociceptive processing as a pathological consequence of increased endogenous opioid tone. Pain begets MORCA begets pain vulnerability in a vicious cycle. The final result is a silent insidious state characterized by the escalation of two opposing excitatory and inhibitory influences on pain transmission: LS mediated by AC1 (which maintains the accelerator) and pain inhibition mediated by MORCA (which maintains the brake). This raises the prospect that opposing homeostatic interactions between MORCA analgesia and latent NMDAR-AC1-mediated pain sensitization creates a lasting vulnerability to develop chronic pain. Thus, chronic pain syndromes may result from a failure in constitutive signaling of spinal MORs and a loss of endogenous analgesic control. An overarching long-term therapeutic goal of future research is to alleviate chronic pain by either (a) facilitating endogenous opioid analgesia, thus restricting LS within a state of remission, or (b) extinguishing LS altogether.

Orexigenic response to tail pinch: role of brain NPY(1) and corticotropin releasing factor receptors

Tail pinch stimulates food intake in rats. We investigated brain mechanisms of this response and the influence of repeated exposure. Sprague-Dawley rats received acute (5 min) or repeated (5 min/day for 14 days) tail pinch using a padded clip. Acute tail pinch increased 5-min food intake compared with control (0.92 ± 0.2 vs. 0.03 ± 0.01 g, P < 0.01). This response was inhibited by 76% by intracerebroventricular injection of BIBP-3226, a neuropeptide Y1 (NPY1) receptor antagonist, increased by 48% by astressin-B, a corticotropin-releasing factor (CRF) receptor antagonist, and not modified by S-406-028, a somatostatin subtype 2 antagonist. After the 5-min tail pinch without food, blood glucose rose by 21% (P < 0.01) while changes in plasma acyl ghrelin (+41%) and adrenocorticotropic hormone (+37%) were not significant. Two tail pinches (45 min apart) activate pontine and hindbrain catecholaminergic and hypothalamic paraventricular CRF neurons. After 14 days of repeated tail pinch, the 5-min orexigenic response was not significantly different from days 2 to 11 but reduced by 50% thereafter (P < 0.001). Simultaneously, the 5-min fecal pellet output increased during the last 5 days compared with the first 5 days (+58%, P < 0.05). At day 14, the body weight gain was reduced by 22%, with a 99% inhibition of fat gain and a 25% reduction in lean mass (P < 0.05). The orexigenic response to acute 5-min tail pinch is likely to involve the activation of brain NPY1 signaling, whereas that of CRF tends to dampen the acute response and may contribute to increased defecation and decreased body weight gain induced by repeated tail pinch.

kappa-Opioid receptor signaling and brain reward function

The dynorphin-like peptides have profound effects on the state of the brain reward system and human and animal behavior. The dynorphin-like peptides affect locomotor activity, food intake, sexual behavior, anxiety-like behavior, and drug intake. Stimulation of kappa-opioid receptors, the endogenous receptor for the dynorphin-like peptides, inhibits dopamine release in the striatum (nucleus accumbens and caudate putamen) and induces a negative mood state in humans and animals. The administration of drugs of abuse increases the release of dopamine in the striatum and mediates the concomitant release of dynorphin-like peptides in this brain region. The reviewed studies suggest that chronic drug intake leads to an upregulation of the brain dynorphin system in the striatum and in particular in the dorsal part of the striatum/caudate putamen. This might inhibit drug-induced dopamine release and provide protection against the neurotoxic effects of high dopamine levels. After the discontinuation of chronic drug intake these neuroadaptations remain unopposed which has been suggested to contribute to the negative emotional state associated with drug withdrawal and increased drug intake. kappa-Opioid receptor agonists have also been shown to inhibit calcium channels. Calcium channel inhibitors have antidepressant-like effects and inhibit the release of norepinephrine. This might explain that in some studies kappa-opioid receptor agonists attenuate nicotine and opioid withdrawal symptomatology. A better understanding of the role of dynorphins in the regulation of brain reward function might contribute to the development of novel treatments for mood disorders and other disorders that stem from a dysregulation of the brain reward system.

From taste hedonics to motivational drive: central μ-opioid receptors and binge-eating behaviour

Endogenous opioids and μ-opioid receptors (MORs) have long been implicated in the mechanism of appetite control and, in particular, hedonic processes associated with food evaluation, consumption and orosensory reward processes. In animal models of binge eating, selective MOR antagonists suppress food consumption. In humans, non-selective opioid receptor antagonists reduce hedonic taste preferences and food intake, particularly for palatable foods, and cause short-term weight loss. These effects have been linked to direct stimulation of MORs and modulation of dopamine release within the reward circuitry including the nucleus accumbens. These findings suggest that reduction of MOR-mediated hedonic and motivation processes driving consumption of highly palatable foods may be a promising therapeutic approach and provide a strong rationale for developing safer and more selective MOR antagonists or inverse agonists for disorders of 'appetitive motivation' including obesity and binge-eating disorder.

Galanin-like peptide stimulates food intake via activation of neuropeptide Y neurons in the hypothalamic dorsomedial nucleus of the rat

Galanin-like peptide (GALP), a 29-amino-acid neuropeptide, is located in the hypothalamic arcuate nucleus (ARC), binds to galanin receptor subtype 2, and induces food intake upon intracerebroventricular (icv) injection in rats. However, neural mechanisms underlying its orexigenic action remain unclear. We aimed to identify the nuclei and neuron species that mediate the food intake in response to icv GALP injection. Intracerebroventricular injection of GALP, as powerfully as that of neuropeptide Y (NYP), increased food intake for the initial 2 h. GALP injected focally into the dorsomedial nucleus (DMN), but not the ARC, lateral hypothalamus, or paraventricular nucleus (PVN), stimulated food intake for 2 h after injection. In contrast, galanin injected into the DMN had no effect. DMN-lesion rats that received icv GALP injection showed attenuated feeding compared with control rats. Intracerebroventricular GALP injection increased c-Fos expression in NPY-containing neurons in the DMN, but not the ARC. GALP increased the cytosolic calcium concentration ([Ca(2+)](i)) in NPY-immunoreactive neurons isolated from the DMN, but not the ARC. Furthermore, both anti-NPY IgG and NPY antagonists, when preinjected, counteracted the feeding induced by GALP injection. These data show that icv GALP injection induces a potent short-term stimulation of food intake mainly via activation of NPY-containing neurons in the DMN.

5-Hydroxy-L-tryptophan suppresses food intake in food-deprived and stressed rats

Giving L-tryptophan, serotonin's circulating precursor, or a serotonin-releasing drug can decrease food intake and body weight. Giving 5-hydroxy-L-tryptophan (5-HTP), serotonin's immediate intracellular precursor, has been thought to be ineffective in enhancing brain serotonin synthesis unless it is coadministered with a dopa decarboxylase inhibitor to protect 5-HTP from destruction outside the brain. We have examined the effect of 5-HTP on food consumption and tissue 5-HTP levels among rats subjected to two different hyperphagic stimuli, food deprivation and a standardized stress (tail pinch), and on plasma 5-HTP levels in humans. In rats, 5-HTP (3-200 mg/kg ip) suppressed food intake in a dose-dependent manner in both models, but was at least eight times more effective in our stress-hyperphagia model. (Differences in the two procedures might have contributed to the observed differences in potencies.) This suppression was blocked by coadministration of another large neutral amino acid (LNAA), L-valine. Brain 5-HTP levels correlated significantly with peak plasma 5-HTP (r(2)=.69) or 5-HTP/LNAA (r(2)=.81) levels. Additionally, among humans, oral 5-HTP (1.2-2.0 mg/kg) produced, after 1 and 2 h, a significant increase in plasma 5-HTP (1.5- to 2.3-fold). These observations suggest that 5-HTP may be useful in controlling the excessive food intake sometimes generated by stress, even if given without decarboxylase inhibitors or other drugs.

Endogenous opioids and feeding behavior: a 30-year historical perspective

This invited review, based on the receipt of the Third Gayle A. Olson and Richard D. Olson Prize for the publication of the outstanding behavioral article published in the journal Peptides in 2002, examines the 30-year historical perspective of the role of the endogenous opioid system in feeding behavior. The review focuses on the advances that this field has made over the past 30 years as a result of the timely discoveries that were made concerning this important neuropeptide system, and how these discoveries were quickly applied to the analysis of feeding behavior and attendant homeostatic processes. The discoveries of the opioid receptors and opioid peptides, and the establishment of their relevance to feeding behavior were pivotal in studies performed in the 1970s. The 1980s were characterized by the establishment of opioid receptor subtype agonists and antagonists and their relevance to the modulation of feeding behavior as well as by the use of general opioid antagonists in demonstrating the wide array of ingestive situations and paradigms involving the endogenous opioid system. The more recent work from the 1990s to the present, utilizes the advantages created by the cloning of the opioid receptor genes, the development of knockout and knockdown techniques, the systematic utilization of a systems neuroscience approach, and establishment of the reciprocity of how manipulations of opioid peptides and receptors affect feeding behavior with how feeding states affect levels of opioid peptides and receptors. The role of G-protein effector systems in opioid-mediated feeding responses, which was the subject of the prize-winning article, is then reviewed.

Our journey with neuropeptide Y: effects on ingestive behaviors and energy expenditure

Clark and colleagues first described the robust orexigenic effects of neuropeptide Y (NPY) in 1984. Our group as well as Stanley et al. confirmed these effects in the same year. During the next 20 years, we investigated the effects of NPY on diet preferences, opioid-related feeding, distributed neural feeding networks, energy metabolism, motivation and discriminative stimulus effects. These data together with data from other laboratories indicate that NPY increases feeding, even when rats work for food; that NPY decreases energy expenditure, particularly by altering thermogenesis; and that NPY's effects on energy metabolism are mediated by a widely distributed neural network involving other neuroregulators known to be involved in energy regulation.

Behavioral and Neurochemical Mechanisms of the Action of Mild Stress in the Enhancement of Feeding

Rats were trained to respond under a cyclic-ratio schedule of reinforcement composed of an ascending, followed by a descending, sequence of ratio values. Subjects were trained while exposed to 70 dB white noise, then tested while exposed to 70 or 90 dB white noise. Exposure to 90 dB white noise elevated the response function (p<.02). Naloxone was then administered intraperitoneally at 0.3. 1.0. and 3.0 mg/kg under 70 dB and 90 dB white noise. Naloxone administration (1.0 and 3.0 mg/kg) significantly depressed the response function obtained under 90 dB white noise (ps<.01) but did not affect the function obtained under 70 dB white noise. These findings suggest that mild stress increases food intake through a mechanism affecting palatability enhanced by the release of endogenous opioids.

Effect of environmental stressors on opiate and psychostimulant reinforcement, reinstatement and discrimination in rats: a review

Studies in humans suggest that exposure to life stressors is correlated with compulsive drug abuse and relapse to drugs during periods of abstinence. The behavioral and neurobiological mechanisms involved in the effect of stress on drug abuse, however, are not known. Here, we review data from studies using preclinical models in rats on the effect of environmental stressors on opiate and psychostimulant reinforcement, as measured by the intravenous drug self-administration and conditioned place preference procedures, on relapse to these drugs, as measured by the reinstatement procedure, and on the subjective effects of these drugs, as measured by the drug discrimination procedure. The results of the studies reviewed here suggest that while stressors are important modulators of the behavioral effects of opiate and psychostimulant drugs, the effect of stress on behavior in these animal models is stressor-specific, and to some degree, procedure- and drug-class-specific. The review of studies on the neurobiological mechanisms underlying stress-drug interactions in these animal models indicate that central noradrenaline and extrahypothalamic corticotropin-releasing factor mediate the effect of one form of stress (intermittent footshock) on reinstatement of opiate and psychostimulant seeking after prolonged drug-free periods. At present, however, little is known about the neuronal events that mediate the effect of environmental stressors on opiate and psychostimulant reinforcement or discrimination. The broader implications of the data reviewed here for future research and for the treatment of opiate and psychostimulant addiction are briefly discussed.

Beta-endorphin modulates the acute response to a social conflict in male mice but does not play a role in stress-induced changes in sleep

Beta-endorphin is an endogenous opioid peptide that is released during stress and has been associated with many physiological functions. In this experiment beta-endorphin deficient mice were used to study the role of endorphins in the acute physiological and behavioral responses to a social conflict, as well as their role in social stress-induced changes in sleep. Adult male beta-endorphin deficient and wild type mice were subjected to the stress of a 1 h social conflict with an aggressive dominant conspecific. After the conflict, the beta-endorphin deficient mice had higher corticosterone levels but the peak increase in body temperature was not different from that in wild type animals. In fact, body temperature returned to baseline levels faster in the beta-endorphin deficient mice. During their interaction with the aggressive conspecific several of the beta-endorphin deficient mice showed clear signs of counter aggression whereas this was not seen in any of the wild type mice. Overall, the beta-endorphin deficient mice and wild type mice had fairly similar sleep patterns under baseline conditions and also showed similar amounts of NREM sleep, REM sleep and EEG slow-wave energy after the social conflict. In addition, no differences were found in the sleep patterns of mice that showed counter aggression and mice that did not. In conclusion, the results suggest that beta-endorphin modulates the acute endocrine, thermoregulatory and behavioral response to a social conflict but the data do not support a major role for beta-endorphin in the regulation of sleep or social stress-induced alterations in sleep.

Corticotropin-releasing factor as well as opioid and dopamine are involved in tail-pinch-induced food intake of rats

Several kinds of stress such as psychological stress, restraint, and foot shock inhibit feeding behavior through corticotropin-releasing factor (CRF). In contrast, a mild tail pinch increases food intake in rats. Although dopamine and opioid are thought to be involved in tail-pinch-induced food intake, it is unknown whether CRF participates in this phenomenon. Therefore, we attempted to clarify this issue using rats. A 30-s tail pinch increased food intake in 30 min after the tail pinch, and this increase was blocked by intraperitoneal injection of CRF receptor type 1 selective antagonist. CRF increased food intake in 30 min after intracerebroventricular injection at a dose of 2 or 10 ng, and this increase was also blocked by CRF receptor type 1 antagonist. Tail-pinch- or CRF-induced food intake was blocked by naloxone, pimozide, and spiperone. These results suggest that CRF, through CRF receptor type 1 as well as opioid and dopaminergic systems, are involved in the mechanism of tail-pinch-induced food intake. The results also suggest that brain CRF has dual effects on food intake, hyperphagia and anorexia, in a stress-dependent manner.

Opioid peptides and the control of human ingestive behaviour

A variety of evidence suggests that endogenous opioid peptides play a role in the short-term control of eating. More recently, opioid receptor antagonists like naltrexone have been approved as a treatment for alcohol dependence. Here we review the evidence for a role of opioid peptides in both normal and abnormal eating and drinking behaviours and in particular try to identify the nature of the role of opioids in these behaviours. Particular attention is paid to the idea that opioid reward processes may be involved both in the short-term control of eating and hedonic aspects of alcohol consumption, and parallels are drawn between the effects of opiate antagonists on food pleasantness and the experience of drinking alcohol. The review also explores the extent to which data from studies using opiate antagonists and agonists provide evidence for a direct role of endogenous opioids in the control of ingestive behaviour, or alternatively whether these data may be better explained through non-specific effects such as the nausea commonly reported following administration of opiate antagonists. The review concludes that the present data suggests a single opioid mechanism is unlikely to explain all aspects of ingestive behaviour, but also concludes that opioid-mediated reward mechanisms play an important control in hedonic aspects of ingestion. The review also highlights the need for further empirical work in order to elucidate further the role of opioid peptides in human ingestive behaviour.

Carbohydrate ingestion, blood glucose and mood

A series of studies have reported that a high carbohydrate meal, or diets high in carbohydrate, were associated with feeling less energetic. However, after a drink containing pure sugar most studies report no effect. Meals almost exclusively carbohydrate increase the availability of tryptophan and hence serotonin synthesis in the brain, however, a small amount of protein blocks this mechanism making it an uncommon response. In many individuals, poor mood stimulates the eating of palatable high carbohydrate/high fat foods that stimulate the release of endorphins. There is a tendency for those with lower blood glucose, when performing cognitively demanding tasks, to report poorer mood. In a range of situations an association between a tendency for blood glucose levels to fall rapidly, and irritability, has been found. Differences in the ability to control blood glucose levels influence the association between carbohydrate intake and mood. There is a need in future research to contrast the impact of carbohydrate on mood in those distinguished because of their pre-existing psychological and physiological functioning.

Alzheimer's disease through the eye of a mouse. Acceptance lecture for the 2001 Gayle A. Olson and Richard D. Olson prize

There is now ample evidence that beta-amyloid proteins decrease memory. The SAMP8 mouse (P8) develops an early decline in the ability to learn and to retain new information. The studies reviewed here suggest that this is due to overproduction of beta-amyloid. Both antibodies to beta-amyloid and specific antisense to the amyloid precursor protein reverse these deficits in the P8 mouse. This antisense can cross the blood brain barrier. It is hypothesized that the overproduction of beta-amyloid leads to a decline in Delta(9) desaturase activity with an alteration in membrane fatty acids. This results in altered membrane mobility leading to a decline in neurotransmitter activity and a decreased release of acetylcholine. This decreased cholinergic activity results in a decreased ability of the P8 mouse to learn and retain new information.

Stress-induced relapse to drug seeking in the rat: role of the bed nucleus of the stria terminalis and amygdala

There is growing interest in the role that the bed nucleus of the stria terminalis (BNST) and central nucleus of the amygdala (CeA), components of the extended amygdala, play in drug addiction. Within the BNST and CeA, there is an extensive system of intrinsic, primarily GABAergic, interconnections known to synthesize a variety of neuropeptides, including corticotrophin-releasing factor (CRF). The actions of CRF at extrahypothalamic sites,including the BNST and CeA, have been implicated in stress responses and in the aversive effects of withdrawal from drugs of abuse. Most recently, we have shown a critical role for extrahypothalamic CRF in stress-induced reinstatement of drug seeking in rats. In attempting to determine which brain circuitry mediates the effect of stress on relapse and, more specifically, where in the brain CRF acts to initiate the behaviours involved in relapse, we focused on the BNST and CeA. In the present paper, we summarize studies we have conducted that explore the role of these brain sites in stress-induced relapse to heroin and cocaine seeking, and then consider how our findings can be understood within the more general context of what is known about the role of the BNST and CeA in stress-related and general approach behaviours, such as drug seeking.

Accelerative effect of olive oil on liver glycogen synthesis in rats subjected to water-immersion restraint stress

The effects of dietary oils on stress-induced changes in the liver glycogen metabolism of male Wistar rats at 6 weeks of age were investigated. The rats were subjected to repetitive water-immersion restraint and fed with a 20% saturated fatty acid mixture (PSC), olive oil (OLI), safflower oil (SAF), or linseed oil (LIS) diet. Stress loading decresed the body weight gain, although the food intake was hardly changed, and the weights of the liver and spleen generally declined regardless of the elapsed time after stress loading and the type of dietary oil. The adrenal weight was generally enhanced by stress in all deitary groups, and particularly tended to be greater in the OLI and PSC groups than in the other two. The plasma corticosterone concentration increased immediately after stressing (Stress-1), but approached the level of the rats with no stress (No stress) 2 h after releasing the stress load (Stress-2) in all groups. The enhancement of corticosterone level in the Stress-1 animals was large in the PSC and OLI groups, and the decline of this level in the Stress-2 animals was small in the OLI group when compared with the other groups. Although the concentrations of total cholesterol (T-CHOL) and triacylglycerol (TG) in the plasma were decreased by stress loading in all groups, these concentrations in the PSC and OLI groups were nearly always higher than in the other groups. The liver serine dehydratase (SDH) activity enhanced by stress was high in the OLI group and tended to be high in the PSC group when compared with the other groups. The contents of liver glycogen were reduced in the Stress-1 animals and extremely elevated in the Stress-2 animals of all groups, and particularly in the OLI group, the reduction in the Stress-1 animals was smaller and the enhancement in the Stress-2 animals was greater than in the other groups. These results suggest that feeding oleic acid to rats exposed to water-immersion restraint further accelerated liver glycogen synthesis through the rise in liver SDH activity due to increased corticosterone secretion when compared with the effect from linoleic and alpha-linolenic acids.

Medication response in the treatment of patients with anorexia nervosa

Anorexia nervosa (AN) is a serious mental disorder, characterized by severely low weight and cognitive distortions about body shape and weight. AN is generally associated with a constellation of psychological symptoms, including depression, anxiety, obsessionality, and ritualistic behaviors. The presence of these associated symptoms, together with the great challenge of treating patients with AN, has led clinicians to try many psychopharmacologic agents in the treatment of these patients, usually to no avail. Investigators have studied a range of agents, but have found little, if any, utility in treating underweight patients with medication. In this article, the authors review the literature regarding medication treatment for patients with AN, propose a theoretical basis for the poor response of these patients to the agents that have been tried, and conclude with recommendations for treatment strategies and additional research that should be pursued to further our understanding of this difficult illness.

Stress-induced relapse to heroin and cocaine seeking in rats: a review

Studies in humans suggest that exposure to stress increases the probability of relapse to drug use, but until recently there has been no animal model to study the mechanisms that mediate this effect. We have developed a reinstatement procedure that allows us to study the effect of stress on relapse to drug seeking in rats. Using this procedure, we have shown that exposure to intermittent footshock stress reliably reinstates heroin and cocaine seeking after prolonged drug-free periods. In the present paper, we summarize results from several studies on stress-induced reinstatement of heroin and cocaine seeking in rats. We first assess the degree to which the phenomenon of stress-induced relapse generalizes to other stressors, to behaviors controlled by other drugs of abuse, and to behaviors controlled by non-drug reinforcers. We then review evidence from studies concerned with the neurotransmitters, the brain sites, and the neural systems involved in stress-induced reinstatement of drug seeking. Finally, we consider the mechanisms that might underlie stress-induced relapse to drug seeking and the possible implications of the findings for the treatment of relapse to drug use in humans.

The hyperphagic effect of nociceptin/orphanin FQ in rats

Nociceptin/orphanin FQ (NC), the endogenous ligand of the opioid receptor-like1 (ORL1) receptor, has been reported to stimulate feeding in rats. The present article reviews the studies so far published on the effect of NC on food intake and reports new findings concerning the sensitivity of brain regions to the hyperphagic effect of NC in rats. The results obtained indicate that the hypothalamic arcuate nucleus is the most sensitive site among the brain regions so far investigated. On the basis of these findings and of the neurochemical and electrophysiological effects of NC, possible mechanisms of action and possible interactions with other neurotransmitter systems affecting feeding are discussed.

Sucrose consumption increases naloxone-induced c-Fos immunoreactivity in limbic forebrain

Opioids have long been known to have an important role in feeding behavior, particularly related to the rewarding aspects of food. Considerable behavioral evidence suggests that sucrose consumption induces endogenous opioid release, affecting feeding behavior as well as other opioid-mediated behaviors, such as analgesia, dependence, and withdrawal. In the present study, rats were given access to a 10% sucrose solution or water for 3 wk, then they were injected with 10 mg/kg naloxone or saline. Brains were subsequently analyzed for c-Fos immunoreactivity (c-Fos-IR) in limbic and autonomic regions in the forebrain and hindbrain. Main effects of sucrose consumption or naloxone injection were seen in several areas, but a significant interaction was seen only in the central nucleus of the amygdala and in the lateral division of the periaqueductal gray. In the central nucleus of the amygdala, naloxone administration to those rats drinking water significantly increased c-Fos-IR, an effect that was significantly enhanced by sucrose consumption, suggesting an upregulation of endogenous opioid tone in this area. The data from this study indicate that the central nucleus of the amygdala has a key role in the integration of gustatory, hedonic, and autonomic signals as they relate to sucrose consumption, if not to food intake regulation in general. Furthermore, the data from this study lend further support to the hypothesis that sucrose consumption induces the release of endogenous opioids.

Oral nalmefene therapy reduces scratching activity due to the pruritus of cholestasis: a controlled study

BACKGROUND

Intravenous naloxone frequently ameliorates the pruritus of cholestasis, but its low oral bioavailability precludes its use as a long-term therapy. Nalmefene is an orally bioavailable opiate antagonist.

OBJECTIVE

We assessed the efficacy of oral nalmefene in ameliorating the pruritus of cholestasis.

METHODS

In a prospective controlled study conducted in a tertiary referral hospital, 11 patients with generalized pruritus complicating chronic liver disease were randomized to receive either nalmefene or placebo in a double-blinded fashion for 2-month periods. Scratching activity was measured continuously for 24-hour periods at baseline and at the end of each treatment period.

RESULTS

Data on 8 patients who received at least 1 course of nalmefene were available for comparison with corresponding control data, which consisted of observations obtained during a course of placebo and/or at baseline. Nalmefene therapy was associated with a 75% reduction in the geometric mean hourly scratching activity (P <.01) and a decrease in the mean of a visual analogue score of the perception of pruritus in all 8 patients (mean decrease 77%, P <.01).

CONCLUSION

Oral administration of nalmefene can ameliorate pruritus complicating chronic liver disease.

The life-shortening effect of reduced physical activity is abolished by a fat rich diet

In female mice on a control diet (3.6% fat) reduced physical activity leads to a reduction of the average life span. So the average age at death of an inactive group is 500 +/- 166 compared to 565 +/- 175 days in an active control group. If the animals are kept on a fat rich diet (12.4% fat) this effect of physical activity restriction is no longer observable and the average age at death is 570 +/- 142 days, within the range of the control animals. The increased fat intake seems to reduce the stress or to increase the resistance to stress in the activity restricted animals. So stress is a crucial determinant of life span.

N(G)-nitro-L-arginine methyl ester reduces stress-related feeding in the rat tail-pinch model

A possible role of nitric oxide (NO) in stress-related feeding was investigated in male rats using the tail-pinch (TP) model, in within-subjects experimental designs. An initial experiment demonstrated a dose-related reduction in TP-induced solid food intake over a 10-min test period with increasing dose (10.25, and 50 mg/kg SC) of the NO-synthase (NOS) inhibitor, N(G)-nitro-L-arginine methyl ester (L-NAME), reaching statistical significance at 25 mg/kg L-NAME when compared to vehicle control (p < 0.05). Pattern analysis further revealed a decrease both in total duration of food-directed oral behavior and in percentage of longer duration (> 60 s) oral behavior bouts with increasing dose of L-NAME; both measures reached statistical significance at 50 mg/kg (p < 0.01). Pretreatment with 500 mg/kg of the NO precursor, L-arginine (L-arg), resulted in partial but not significant reversal of the attenuating effect of 25 mg/kg L-NAME on food intake. Latency to begin eating or gnawing was not significantly affected by L-NAME. In a subsequent experiment, L-arg alone (500 and 750 mg/kg) did not significantly alter TP-induced food intake. It is cautiously suggested that these results implicate involvement of NO in TP-induced feeding.

Open-label trial of oral nalmefene therapy for the pruritus of cholestasis

The aims of this study were to determine whether long-term oral administration of the opiate antagonist nalmefene is associated with any beneficial effects in patients with pruritus secondary to cholestatic liver disease and to assess the safety of long-term administration of this drug to these patients. Fourteen patients with unrelieved chronic pruritus of cholestasis were studied. Scratching activity, independent of limb movements, was recorded continuously for 24-hour periods before and during treatment with an initial ameliorating dose of nalmefene. Simultaneously, during these periods, visual analogue scores (VASs) of pruritus were recorded every 4 hours while patients were awake. The dose of nalmefene, which initially was 2 mg orally twice daily, was increased during the study, usually until a satisfactory clinical response was achieved. Five patients experienced a transient opioid withdrawal-like reaction that did not preclude continuing with nalmefene therapy. Serum biochemical indices of cholestasis did not change appreciably during treatment. Thirteen patients reported amelioration of the perception of pruritus on nalmefene. In 5 patients, exacerbations of pruritus occurred approximately 4 weeks after an initial ameliorating dose had been reached; these exacerbations were managed by increasing the dose. Baseline mean values for VAS and scratching activity were higher than corresponding means during nalmefene therapy in 13 (P = .002) and 12 (P = .013) patients, respectively. Possible tolerance to nalmefene occurred in 3 patients. Three patients experienced marked exacerbation of pruritus after nalmefene therapy was suddenly discontinued. Blood levels of nalmefene were consistent with normal pharmacokinetics of the drug. These results suggest that nalmefene may have a favorable risk-to-benefit ratio when it is administered orally long-term to patients with the pruritus of cholestasis.

Central opioid control of feeding behavior in the white-crowned sparrow, Zonotrichia leucophrys gambelii

Many behavioral responses to stress do not appear to be mediated by glucocorticoids, suggesting another mechanism. We tested the effects of intracerebroventricular administration of beta-endorphin, a neuropeptide implicated in the stress response, on feeding behavior in captive, wild-caught white-crowned sparrows (Zonotrichia leucophrys gambelii). The amount of time spent feeding and the number of feeding bouts were higher after infusion with beta-endorphin than after saline infusion. Beta-endorphin decreased the latency to feed compared with saline. Naloxone, an opioid antagonist, suppressed feeding behavior and increased latency to feed. These results support our hypothesis that neuropeptides associated with stress may initiate adaptive responses to natural stressors in wild species.

Hormonal regulation of appetite and food intake

Several clinical disorders are strongly influenced by hormones involved in appetite and weight regulation. Obesity and eating disorders are of major importance, because they are associated with severe morbidity and considered to be among the greatest health problems in the Western world today. This review describes recent findings in hormonal regulation of food intake by substances acting both centrally, such as corticotropin-releasing factor, neuropeptide Y and leptin, and peripherally, such as cholecystokinin and somatostatin. Sex hormones and glucocorticoids play an important role in long-term regulation of metabolism. The role of these hormones in appetite and weight changes during life as well as during pregnancy and lactation is discussed. Furthermore, the development of obesity and eating disorders is influenced, in particular, by steroid hormones. Treatment with sex hormones, as in hormone replacement therapy, affects appetite and weight and may have beneficial effects in preventing android obesity. Currently, there is great effort in developing endogenous neurohumoral substances into effective drugs for the treatment of obesity and eating disorders. Leptin and neuropeptide Y analogues are of interest as potential antiobesity agents.

Food cravings, endogenous opioid peptides, and food intake: a review

Extensive research indicates a strong relationship between endogenous opioid peptides (EOPs) and food intake. In the present paper, we propose that food cravings act as an intervening variable in this opioid-ingestion link. Specifically, we argue that altered EOP activity may elicit food cravings which in turn may influence food consumption. Correlational support for this opioidergic theory of food cravings is provided by examining various clinical conditions (e.g. pregnancy, menstruation, bulimia, stress, depression) which are associated with altered EOP levels, intensified food cravings, and increased food intake.

Appetitive operant behavior and free-feeding in rats exposed to acute stress

This study investigated whether appetitive operant food reinforcement or free-feeding behavior in rats, food-restricted to 85% of body weight, was disrupted by exposures to 3 h of restraint stress or by 3 h of restraint plus water immersion stress (RWI). Rats were trained under a 3-cycle 10-min time-out-10-min time-in fixed-ratio 15 (FR15) schedule of food reinforcement. Free-feeding was measured in a 3-cycle 10-min food jar-out-10-min food jar-in test conducted in the operant chambers. Three hours of restraint stress did not significantly affect response rate or food reinforcement in the operant FR15 task or in the free-feeding condition. In contrast, 3 h of RWI completely abolished operant food reinforcement and suppressed response rate, whereas free-feeding was significantly reduced but not abolished in food-restricted, hungry rats. We conclude that acute restraint stress in food-restricted, hungry rats does not affect their appetite or motor ability to lever-press for food nor did it affect their ability to feed in a free-feeding situation. In contrast, RWI stress may have induced a motor impairment, or some other aspect of motivation independent of hunger, that disrupted their performance in the operant FR15 task.

Psychopathology and personality of young women who experience food cravings

The objective of the present study was to investigate the psychopathology and personality characteristics of women who experience food cravings. A total of 101 young women selected at random from the community completed the Diagnostic Interview for Genetic Studies with a trained interviewer. The interview included a section about food-craving experiences and associated factors. Subjects also completed a self-report questionnaire booklet containing the Temperament and Character Inventory (TCI) and the Eating Disorder Inventory (EDI). Compared to noncravers, women who reported food cravings were significantly more likely to report a history of alcohol abuse/dependence (p = .003), significant weight changes (p = .003), and to have undertaken dieting (p = .02), bingeing (p = .05), vomiting (p = .02), exercise (p = .04), diet pill (p = .03), and laxative use (p = .01) to control weight. There was a trend for the cravers to have higher novelty-seeking scores on the TCI (p = .06). Our findings suggest that women who experience food cravings are more likely to have met criteria for alcohol abuse/dependence and tend to have temperament characterized by higher levels of novelty seeking. In addition the high rates of eating-disorder symptomatology implies overconcern with body weight and shape in the women who experienced food cravings.

Why do we eat? A neural systems approach

Neuroregulators found at various brain sites are involved in controlling food intake, a behavior that occurs for many reasons. Different neuroregulators may affect different stimuli that impact eating behavior. For example, neuropeptide Y may initiate feeding for energy needs, opioid peptides may provide the rewarding aspects of eating, and corticotropin releasing factor may affect stress-induced eating. We know that the neural networks regulating feeding also impact other components of energy balance. Neuropeptide Y not only increases eating, it also decreases energy expenditure in brown fat and increases enzymatic activity associated with fat storage in white fat, resulting in a more obese animal. What the sites of action are of these neuroregulators and how they interact with regulators at other sites are of utmost importance. Different regions of the brain, together with the periphery, communicate via signals acting in coordinated fashion, which leads to the final outcome: eating less or more and expending less or more energy.

Alterations of beta-endorphin-like immunoreactivity in CSF following behavioral training using a passive avoidance procedure

The central opioid system may have an important influence on memory processes. In view of this, the concentration of beta-endorphin-like immunoreactivity (beta-ELIR) in cerebrospinal fluid (CSF) was measured by a radioimmunoassay in rats trained in a passive avoidance procedure. The beta-ELIR in CSF was examined immediately, 2, 5, 10, and 30 min after the learning trial in which rats were exposed to footshock (0, 0.25, or 1.0 mA for 3 s). Avoidance latency and beta-ELIR in CSF were examined 24 and 120 h after the learning trial. The beta-ELIR in CSF was increased at 5 min after the learning trial in rats exposed to footshock of 0.25 mA. The beta-ELIR in CSF was elevated at 5 and 10 min, followed by a significant decrease at 30 min after the learning trial in rats exposed to a footshock of 1.0 mA. Thus, although an increase in beta-ELIR in CSF was not, the duration of the increase was, related to the shock intensity. Interestingly, a decrease followed the increase in beta-ELIR in CSF which was significant only in rats exposed to the high shock intensity. Avoidance latencies were enhanced in a shock intensity-dependent manner at both 24 and 120 h retention tests. No change in beta-ELIR in CSF was found during retention trials. The results suggest that behavioral manipulations alter beta-ELIR in CSF. An increase in beta-ELIR in CSF may be highly associated with stressful and emotional responses during behavioral training.

Acute and repeated activation of male sexual behavior by tail pinch: opioid and dopaminergic mechanisms

We studied the effect of tail pinch on male sexual behavior and its neurochemical basis. Male rats were gonadectomized and maintained on low doses of testosterone propionate (20.0 micrograms/day). Tail pinch significantly increased the percentage of males that mounted, intromitted, and ejaculated within a 30-min test, and these increases were attenuated by both pimozide (1.0 mg/kg, i.p.) and by naloxone (0.5, 1.0, and 2.0 mg/kg, s.c.). Moreover, tail pinch in the presence of an estrous female led to significantly increased female-directed behavior 48 h later during a test without tail pinch. Repeated tail pinch tests led to progressively more sexual activity, and the development of this behavioral sensitization was prevented by naloxone. These findings suggest that tail pinch increases the salience of the incentive characteristics of the female. Furthermore, during subsequent tests, with or without tail pinch, the increased salience of the female remains, as measured by the continued increases in sexual activity. These acute and sensitized behavioral increases might result from tail pinch-induced activation of the midbrain dopamine system via an opioid mechanism; either preventing tail pinch-induced dopamine activation (by an opioid antagonist) or blocking the effects of dopamine activation (by a dopamine antagonist) attenuated the long-term facilitation of sexual behavior seen after pairing the female with tail pinch.

Opioid involvement in feeding behaviour and the pathogenesis of certain eating disorders

Incidental findings from animal experiments involving administration of exogenous opioid agonists indicate that there are close links between the endogenous opioid system and feeding behaviour. Subsequent investigations aimed at elucidating the nature of the opioid-feeding relationship led to a wide variety of findings, some of them apparently contradictory. This paper examines the effects of opioid agonists and antagonists on feeding behaviour, and considers the evidence relating levels of endogenous opioids to feeding states, with particular reference to certain eating disorders, including anorexia nervosa, bulimia nervosa, Prader-Willi syndrome, and eating-induced obesity. The receptors which may be involved in opioid-feeding relationships are discussed. Relationships between the endogenous opioid system and other systems, such as the dopaminergic, noradrenergic and hormonal systems, are considered insofar as they may have bearing on the modulation of feeding behaviour. Finally, three theories are briefly outlined which attempt to link the endogenous opioid system with feeding modulation and the pathogenesis of certain eating disorders. The suggestion is put forward that anorexia nervosa may represent a pathological consequence of the triggering of a primitive mechanism for coping with unforeseen food shortages which may have short-term advantages, e.g., for masking or temporarily alleviating a depressed state.

Effects in the rat of intranigral morphine and DAGO on eating and gnawing induced by stress

Stress produced by pinching the tail is known to increase feeding behavior in rats, and endogenous opioids have been implicated in the mediation of this effect. We have reported previously that a nonspecific opioid antagonist and a mu-selective antagonist decrease this stress-induced eating (SIE) when they are microinjected into the substantia nigra (SN). The present study investigated the possibility that activation of opioid receptors in the SN might also alter SIE. Because oral stereotypy and nociception are affected by opioid mechanisms in the SN, measurements of gnawing and of tail flick and hot plate response latencies were also made. Bilateral injection of morphine (0.1-20 nmol) and the mu-selective agonist D-Ala2,N-Me-Phe4,Gly5-ol-enkephalin (DAGO; 0.03-1 nmol) increased response latency on the hot plate test and decreased gnawing produced by tail pinch. Tail flick latency and SIE were not affected. It is concluded that activation of opioid receptors in the SN does not produce an alteration in SIE as has been seen with opioid antagonists.

Involvement of mu1 and mu2 opioid receptor subtypes in tail-pinch feeding in rats

Tail-pinch feeding (TPF) in rats is decreased following general (naltrexone, NTX) and mu (Cys2-Tyr3-Orn5-Pen7-amide, CTOP) opioid antagonists, but not following kappa (nor-binaltorphamine. Nor-BNI) or delta (naltrindole, NTI) opioid antagonists. Because multiple mu (mu1 and mu2) and delta (delta 1 and delta 2) opioid receptor subtypes have been characterized, the present study evaluated whether TPF was differentially altered following ICV administration of general (NTX), mu (beta-funaltrexamine, B-FNA), mu1 (naloxonazine, NAZ), kappa (Nor-BNI), delta 1 ([D-Ala2, Leu5, Cys6]-enkephalin, DALCE) and delta 2 (NTI) opioid antagonists. Like the reversible mu antagonist CTOP, the irreversible mu antagonist B-FNA significantly and dose-dependently (1-20 micrograms) reduced TPF by up to 28%. In contrast, whereas NAZ (50 micrograms) reduced TPF by 32%, this effect was highly variable and failed to achieve significance. Neither NTX (5-10 mg/kg, SC), Nor-BNI (20 micrograms), DALCE (40 micrograms) nor NTI (20 micrograms) significantly altered TPF, suggesting that kappa, delta 1 and delta 2 opioid receptor subtypes were not involved. Because no antagonist altered the duration of food contact during tail pinch, it appears that the opioid effect modulates ingestive rather than activational mechanisms. The reliable inhibition of TPF by B-FNA (mu1 and mu2), together with the variable effect of naloxonazine (mu1), appears to implicate both mu binding sites in this response.

Norbinaltorphimine blocks the feeding but not the reinforcing effect of lateral hypothalamic electrical stimulation

The role of central kappa opioid receptors in the regulation of feeding and reward was evaluated using electrical brain stimulation paradigms in combination with the selective kappa antagonist, norbinaltorphimine (nor-BNI). Lateral ventricular injection of 10.0 and 50.0 nmol doses of nor-BNI increased the lateral hypothalamic stimulation frequency threshold for eliciting feeding behavior but had no effect on threshold for self-stimulation in the absence of food. This result is identical to those previously reported for naloxone and antibodies to dynorphin A and suggests that opioid activity is associated with feeding behavior rather than the eliciting brain stimulation. A further similarity between naloxone, dynorphin antiserum, and nor-BNI is their preferential effect on feeding threshold values obtained later, rather than initially, in a post-injection test session. This pattern of threshold elevation is shown to differ from that of the appetite suppressants, amphetamine and phenylpropanolamine, which elevate threshold uniformly throughout a post-injection test. The signature pattern of threshold elevation produced by opioid antagonism is consistent with the hypothesis that opioid activity is involved in the maintenance rather than the initiation of feeding. Specifically, it is hypothesized that a dynorphin A/kappa receptor mechanism is triggered by food taste and sustains feeding behavior by facilitating incentive reward.

Diagnosis and treatment of sexual addiction

Following a brief introduction to the concept of addiction, the definition of and diagnostic criteria for sexual addiction are presented. A theoretical framework for treatment of sexual addiction is then outlined, based on an understanding of the underlying addictive process: the compulsive dependence on external actions as a means of regulating one's internal states. Effective treatment addresses both addictive behavior and the addictive process. Addictive sexual behavior is addressed through behavioral symptom management, which includes relapse prevention and other cognitive-behavioral techniques. The addictive process is addressed by enhancing self-regulatory functions through individual psychotherapy, therapeutic group experience, and pharmacotherapy (medication treatment, when indicated). An integrated system for treatment of sexual addiction, which brings together these therapeutic methods in one theoretically coherent, clinically unified approach, is outlined.