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Wu CH, Chang CS, Yang YK, Shen LH, Yao WJ. Comparison of brain serotonin transporter using [I-123]-ADAM between obese and non-obese young adults without an eating disorder. PLoS One 2017; 12:e0170886. [PMID: 28182708 PMCID: PMC5300236 DOI: 10.1371/journal.pone.0170886] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Accepted: 01/12/2017] [Indexed: 11/25/2022] Open
Abstract
Cerebral serotonin metabolism has an important but controversial role in obesity. However, it is not given enough attention in morbidly obese young adults. We used single photon emission computed tomography (SPECT) with [I-123]-labeled 2-((2-((dimethylamino)methyl)phenyl)thio)-5-iodophenylamine (ADAM) to investigate changes in serotonin transporter (SERT) availability in 10 morbidly obese young adults without an eating disorder (M/F = 5/5, body mass index (BMI): 40.3 ± 4.1 kg/m2, percentage of body fat (BF%): 46.0 ± 3.9%) and 10 age- and sex-matched non-obese controls (BMI: 20.3 ± 1.2 kg/m2, BF%: 20.6 ± 8.9%). All participants underwent SPECT at 10 min and 6 h after an injection of 200 MBq of [I-123]-ADAM. The SERT binding site (midbrain) was drawn with cerebellum normalization. The BF% and fat distribution were measured using dual-energy X-ray absorptiometry. The midbrain/cerebellum SERT binding ratios (2.49 ± 0.46 vs. 2.47 ± 0.47; p = 0.912) at 6 h were not significantly different between groups, nor was the distribution of the summed images at 10 min (1.36 ± 0.14 vs. 1.35 ± 0.11; p = 0.853). There were no significant correlations between midbrain/cerebellum SERT binding ratio and age, BMI, BF%, or fat distribution. No significant difference in SERT availability in the midbrain between morbidly obese and non-obese young adults without an eating disorder indicates an unmet need for investigating the role of cerebral serotonin in obesity.
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Affiliation(s)
- Chih-Hsing Wu
- Departments of Family Medicine, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan
- Institutes of Behavioral Medicine, National Cheng Kung University College of Medicine, Tainan, Taiwan
- Institutes of Gerontology, National Cheng Kung University College of Medicine, Tainan, Taiwan
| | - Chin-Sung Chang
- Departments of Family Medicine, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan
- Institutes of Clinical Medicine, National Cheng Kung University College of Medicine, Tainan, Taiwan
| | - Yen Kuang Yang
- Institutes of Behavioral Medicine, National Cheng Kung University College of Medicine, Tainan, Taiwan
- Departments of Psychiatry, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan
| | - Lie-Hang Shen
- Institute of Nuclear Energy Research, Longtan Township, Taoyuan County, Taiwan
| | - Wei-Jen Yao
- Departments of Nuclear Medicine, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan
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Letra L, Pereira D, Castelo-Branco M. Functional Neuroimaging in Obesity Research. ADVANCES IN NEUROBIOLOGY 2017; 19:239-248. [PMID: 28933068 DOI: 10.1007/978-3-319-63260-5_10] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Functional neuroimaging is beginning to yield valuable insights into the neurobiological underpinnings of the effects of obesity on neural circuits. Functional magnetic resonance imaging (fMRI), positron emission tomography (PET), and single-photon emission computed tomography (SPECT) studies have been used to identify aberrant activation patterns in regions implicated in reward (e.g., striatum, orbitofrontal cortex, insula), emotion and memory (e.g., amygdala, hippocampus), sensory and motor processing (e.g., insula, precentral gyrus), and cognitive control and attention (e.g., prefrontal cortex, cingulate) in obese individuals. Although a great amount of research using these techniques has already unveiled the influence of different neural response patterns on obesogenic behaviors, in this chapter we will, otherwise, try to highlight the effects of obesity on specific neuronal circuits and discuss recent developments in fMRI-based neurofeedback approaches as an alternative in obesity treatment.
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Affiliation(s)
- Liliana Letra
- Institute of Physiology, Institute for Biomedical Imaging and Life Sciences-IBILI, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Neurology Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - Daniela Pereira
- IBILI-Institute for Biomedical Imaging and Life Sciences, Faculty of Medicine, University of Coimbra, Coimbra, Portugal. .,Neuroradiology Unit - Medical Imaging Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
| | - Miguel Castelo-Branco
- IBILI-Institute for Biomedical Imaging and Life Sciences, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Lemoine L, Lieberman BP, Ploessl K, Zheng P, Kung HF. Characterization of FlipIDAM as a SERT-selective SPECT imaging agent. Nucl Med Biol 2013; 40:879-86. [PMID: 23856117 DOI: 10.1016/j.nucmedbio.2013.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Revised: 05/23/2013] [Accepted: 06/04/2013] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Biological evaluation of ([(125)I]4), a new single-photon emission computed tomography (SPECT) radioligand for imaging the serotonin transporter (SERT) which displayed improved in vivo kinetics for mapping SERT binding sites in the brain. METHODS In vitro binding studies of [(125)I]4 were performed with membrane homogenates of LLC-PK1 cells stably transfected and overexpressing one of the monoamine transporter (SERT, DAT or NET) and rat cortical homogenates. Biodistribution and ex vivo autoradiography studies were carried out in rats. In vivo competition experiments were evaluated to determine the SERT selectivity of [(125)I]4 vs. ([(125)I]1). RESULTS In vitro binding studies of 4 showed excellent binding affinity (Ki,SERT=0.90 ± 0.05 nM) and excellent selectivity over the other monoamine transporters (100 fold and >4000 fold for NET and DAT respectively). Scatchard analysis of saturation binding of [(125)I]4 to rat cortical homogenates gave a Kd value of 0.5 ± 0.09 nM and a Bmax value of 801.4 ± 58.08 fmol/mg protein. The biodistribution study showed rapid high brain uptake (3.09 ± 0.11% dose/organ at 2 min) and a good target to non-target ratio (hypothalamus to cerebellum) at 30 min (2.62) compared to [(125)I]1 (2.19). Ex vivo autoradiography showed that FlipIDAM localizes in accordance with SERT distribution patterns in the brain. In vivo and ex vivo competition experiments with specific and non-specific SERT compounds also showed that [(125)I]4 binds specifically to SERT rich regions. CONCLUSIONS The biological evaluation of [(125)I]4 demonstrates that [(123)I]4 would be a good candidate for SPECT imaging of SERT.
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Affiliation(s)
- Laetitia Lemoine
- Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA 19104
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Frank GK, Kaye WH. Current status of functional imaging in eating disorders. Int J Eat Disord 2012; 45:723-36. [PMID: 22532388 PMCID: PMC3872533 DOI: 10.1002/eat.22016] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/11/2012] [Indexed: 11/11/2022]
Abstract
Eating Disorders are complex psychiatric problems that involve biologic and psychological factors. Brain imaging studies provide insights about how functionally connected brain networks may contribute to disturbed eating behavior, resulting in food refusal and altered body weight, but also body preoccupations and heightened anxiety. In this article, we review the current state of brain imaging in eating disorders, and how such techniques may help identify pathways that could be important in the treatment of those often detrimental disorders.
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Affiliation(s)
- Guido K.W. Frank
- University of Colorado Denver, Departments of Child & Adolescent Psychiatry and Neuroscience, Aurora CO
| | - Walter H. Kaye
- University of California San Diego, Department of Psychiatry, La Jolla CA
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Vaz-Leal FJ, Rodríguez-Santos L, García-Herráiz MA, Ramos-Fuentes MI. Neurobiological and psychopathological variables related to emotional instability: a study of their capability to discriminate patients with bulimia nervosa from healthy controls. Neuropsychobiology 2011; 63:242-51. [PMID: 21494052 DOI: 10.1159/000323445] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2009] [Accepted: 06/16/2010] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To analyze the capability of a set of neurobiological and psychopathological variables to discriminate bulimia nervosa (BN) patients from healthy controls. METHOD Seventy-five female patients with purging BN and 30 healthy controls were compared for psychopathology (impulsivity, borderline personality traits, depressive symptoms and self-defeating personality traits) and neurobiological parameters reflecting hypothalamic-pituitary-adrenal axis activity (morning serum cortisol before and after dexamethasone) and monoamine activity (24-hour urinary excretion of norepinephrine, serotonin, dopamine, and their main metabolites: 3-methoxy-4-hydroxyphenylglycol, 5-hydroxyindoleacetic acid, and homovanillic acid). Furthermore, the relationships between the 2 sets of variables were compared in the 2 samples. RESULTS BN patients displayed higher impulsivity, more severe depressive features, and more borderline and self-defeating personality traits than controls. The 4 psychopathological variables were strongly interrelated in patients, whereas only depressive features correlated with self-defeating personality traits in controls. Patients had lower 24-hour excretion of serotonin and dopamine than controls, as well as lower ability to suppress cortisol. The relations between the biochemical and the psychopathological variables were only significant in the BN patients, but not in the control group. When discriminant analysis methods were applied, patients and controls differed for psychopathology (impulsive behaviors and borderline personality traits) and biological parameters (baseline cortisol and dopamine excretion), but when the variables were analyzed together, the differences in neurobiological parameters appeared as mediated by the psychopathological status. DISCUSSION Our results suggest that hypothalamic-pituitary-adrenal axis activity, dopamine activity and other biological parameters are worthy of further study as potential dimensional markers of BN, although they seem to depend on the psychopathological status of the patients, in such a way that the psychopathological items associated with emotional instability (impulsivity and borderline personality traits) seem to be more reliable as clinical markers at the time being.
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Affiliation(s)
- Francisco J Vaz-Leal
- Department of Psychiatry, University of Extremadura Medical School, Badajoz, Spain.
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Abstract
Anorexia nervosa (AN) and bulimia nervosa (BN) are disorders characterized by aberrant patterns of feeding behavior, weight regulation, and disturbances in attitudes and perceptions toward body weight and shape. Several lines of evidence nominate disturbances of serotonin (5-HT) pathways as playing a role in the pathogenesis and pathophysiology of AN and BN. For example, 5-HT pathways are known to contribute to the modulation of a range of behaviors commonly seen in individuals with AN and BN. New technology using brain imaging with radioligands offers the potential for understanding previously inaccessible brain 5-HT neurotransmitter function and its dynamic relationship with human behaviors. Recent studies using positron emission tomography and single photon emission computed tomography with 5-HT-specific radioligands have consistently shown 5-HT(1A) and 5-HT(2A) receptor and 5-HT transporter alterations in AN and BN in cortical and limbic structures, which may be related to anxiety, behavioral inhibition, and body image distortions. These disturbances are present when subjects are ill and persist after recovery, suggesting that these may be traits that are independent of the state of the illness. Effective treatments for AN and BN have been elusive. A better understanding of neurobiology is likely to be important for developing specific and more powerful therapies for these often chronic and deadly disorders.
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Affiliation(s)
- Ursula F Bailer
- Department of Psychiatry and Psychotherapy, Division of Biological Psychiatry, Medical University of Vienna, Austria
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Wang JL, Deutsch EC, Oya S, Kung HF. FlipADAM: a potential new SPECT imaging agent for the serotonin transporter. Nucl Med Biol 2010; 37:577-86. [DOI: 10.1016/j.nucmedbio.2010.02.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2009] [Revised: 02/09/2010] [Accepted: 02/27/2010] [Indexed: 10/19/2022]
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van Hoeken D, Veling W, Sinke S, Mitchell JE, Hoek HW. The validity and utility of subtyping bulimia nervosa. Int J Eat Disord 2009; 42:595-602. [PMID: 19621467 DOI: 10.1002/eat.20724] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To review the evidence for the validity and utility of subtyping bulimia nervosa (BN) into a purging (BN-P) and a nonpurging subtype (BN-NP), and of distinguishing BN-NP from binge eating disorder (BED), by comparing course, complications, and treatment. METHOD A literature search of psychiatry databases for studies published in peer-reviewed journals that used the DSM-definitions of BN and BED, and included both individuals with BN-NP and individuals with BN-P and/or BED. RESULTS Twenty-three studies compared individuals with BN-NP (N = 671) to individuals with BN-P (N = 1795) and/or individuals with BED (N = 1921), two of which reported on course, 12 on comorbidity and none on treatment response-the indicators for validity and clinical utility. The differences found were mainly quantitative rather than qualitative, suggesting a gradual difference in severity from BN-P (most severe) through BN-NP to BED (least severe). DISCUSSION None of the comparisons provided convincing evidence for the validity or utility of the BN-NP diagnosis. Three options for the position of BN-NP in DSM-V were suggested: (1) maintaining the BN-NP subtype, (2) dropping nonpurging compensatory behavior as a criterion for BN, so that individuals currently designated as having BN-NP would be designated as having BED, and (3) including BN-NP in a broad BN category.
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Affiliation(s)
- Daphne van Hoeken
- Department of Research, Parnassia Bavo Psychiatric Institute, The Hague, The Netherlands
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Koskela A, Kauppinen T, Keski‐Rahkonen A, Sihvola E, Kaprio J, Rissanen A, Ahonen A. Brain Serotonin Transporter Binding of [123I]ADAM: Within‐Subject Variation between Summer and Winter Data. Chronobiol Int 2009; 25:657-65. [DOI: 10.1080/07420520802380000] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Van den Eynde F, Treasure J. Neuroimaging in eating disorders and obesity: implications for research. Child Adolesc Psychiatr Clin N Am 2009; 18:95-115. [PMID: 19014860 DOI: 10.1016/j.chc.2008.07.016] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Medicine and psychiatry have benefited from developments in investigational techniques. Neuroimaging is one such domain that has technically progressed enormously in recent years, resulting in, for example, higher temporal and spatial resolution. Neuroimaging techniques have been widely used in a range of psychiatric disorders, providing new insights into neural brain circuits and neuroreceptor functions in vivo. These imaging techniques allow researchers to study not only the configuration of brain structures but also aspects of normal and anomalous human behavior more accurately.
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Affiliation(s)
- Frederique Van den Eynde
- Institute of Psychiatry, Section of Eating Disorders PO59, De Crespigny Park, SE5 8AF, London, UK
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Wöckel L, Zepf FD, Koch S, Meyer-Keitel AE, Schmidt MH. Serotonin-induced decrease of intracellular Ca(2+) release in platelets of bulimic patients normalizes during treatment. J Neural Transm (Vienna) 2008; 116:89-95. [PMID: 19082524 DOI: 10.1007/s00702-008-0163-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2008] [Accepted: 11/18/2008] [Indexed: 12/01/2022]
Abstract
Numerous symptoms related to eating disorders have been shown to be influenced by serotonergic (5-HT) functioning, with the 5-HT(2A) receptor subtype being one of the most relevant involved in the pathophysiology of bulimia nervosa (BN). In line with this, Ca(2+) mobilization as mediated by 5-HT(2) receptors in platelets was shown to serve as a peripheral model for central nervous 5-HT functioning. Here, the 5-HT-induced intracellular Ca(2+) mobilization in platelets was measured in 13 female normal weight bulimic patients (14-18 years) upon admission and at the end of inpatient treatment. Findings were compared to 21 age-matched healthy female adolescents. 5-HT-induced Ca(2+) release was significantly decreased in bulimic patients upon admission and normalized during inpatient treatment. Antidepressive medication caused a significant improvement. The data provide further evidence that altered 5-HT(2) receptor functioning is involved in the pathophysiological underpinnings in BN.
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Affiliation(s)
- Lars Wöckel
- Department of Child and Adolescent Psychiatry and Psychotherapy, RWTH Aachen University, Neuenhofer Weg 21, 52074, Aachen, Germany.
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Frokjaer VG, Pinborg LH, Madsen J, de Nijs R, Svarer C, Wagner A, Knudsen GM. Evaluation of the Serotonin Transporter Ligand 123I-ADAM for SPECT Studies on Humans. J Nucl Med 2008; 49:247-54. [PMID: 18199621 DOI: 10.2967/jnumed.107.046102] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED Imaging serotonin transporters in the living human brain is important in several fields, such as normal psychophysiology, mood disorders, eating disorders, and neurodegenerative disorders. The aim of this study was to compare different kinetic and semiquantitative methods for assessing serotonin transporters using (123)I-labeled 2-((2-((dimethylamino)methyl)phenyl)thio)-5-iodophenylamine (ADAM) in humans: an arterial plasma input model, simplified and Logan reference tissue models, and standardized uptake value ratios. METHODS Nine subjects were scanned with dynamic (123)I-ADAM SPECT (mean age, 31 y; range, 24-43 y), and metabolite-corrected arterial input was measured. Tissue reference models (simplified reference tissue model, Logan reference tissue model, and ratio method) were validated against the outcome of a 1-tissue-compartment model, and performance with decreasing scan length was evaluated. The specificity of (123)I-ADAM binding was investigated in a blocking experiment. RESULTS Binding estimates from the simplified reference tissue and Logan reference tissue models correlated tightly with full kinetic modeling when based on a 240- or 360-min dynamic acquisition (r = 0.99); however, there were slight underestimations (3%-5%), especially in high-binding regions. Application of the ratio method to data from 200 to 240 min overestimated specific binding (on average, by 10% +/- 28%) and correlated only moderately with estimates from the 1-tissue-compartment model (r = 0.94). With an acquisition time of 0-120 min, the Logan model still yielded an acceptable outcome when a fixed clearance rate constant (k2') from the cerebellum was applied. Intravenously injected citalopram was not associated with a decrease in cerebellar binding. A lipophilic metabolite that did not seem to bind specifically to serotonin transporter was seen in 2 of 7 subjects. CONCLUSION Serotonin transporter binding with (123)I-ADAM SPECT can be assessed with the Logan model based on a 120-min acquisition when a constant k2' is applied. This model, because it allows for more accurate and less biased binding estimates and thus reduces the required sample size, is advantageous over the ratio method used in clinical studies so far. A single blocking experiment supported the use of the cerebellum as a reference region.
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Affiliation(s)
- Vibe G Frokjaer
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
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