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Langhans W, Watts AG, Spector AC. The elusive cephalic phase insulin response: triggers, mechanisms, and functions. Physiol Rev 2023; 103:1423-1485. [PMID: 36422994 PMCID: PMC9942918 DOI: 10.1152/physrev.00025.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 11/04/2022] [Accepted: 11/20/2022] [Indexed: 11/25/2022] Open
Abstract
The cephalic phase insulin response (CPIR) is classically defined as a head receptor-induced early release of insulin during eating that precedes a postabsorptive rise in blood glucose. Here we discuss, first, the various stimuli that elicit the CPIR and the sensory signaling pathways (sensory limb) involved; second, the efferent pathways that control the various endocrine events associated with eating (motor limb); and third, what is known about the central integrative processes linking the sensory and motor limbs. Fourth, in doing so, we identify open questions and problems with respect to the CPIR in general. Specifically, we consider test conditions that allow, or may not allow, the stimulus to reach the potentially relevant taste receptors and to trigger a CPIR. The possible significance of sweetness and palatability as crucial stimulus features and whether conditioning plays a role in the CPIR are also discussed. Moreover, we ponder the utility of the strict classical CPIR definition based on what is known about the effects of vagal motor neuron activation and thereby acetylcholine on the β-cells, together with the difficulties of the accurate assessment of insulin release. Finally, we weigh the evidence of the physiological and clinical relevance of the cephalic contribution to the release of insulin that occurs during and after a meal. These points are critical for the interpretation of the existing data, and they support a sharper focus on the role of head receptors in the overall insulin response to eating rather than relying solely on the classical CPIR definition.
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Affiliation(s)
- Wolfgang Langhans
- Physiology and Behavior Laboratory, ETH Zürich, Schwerzenbach, Switzerland
| | - Alan G Watts
- Department of Biological Sciences, USC Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, California
| | - Alan C Spector
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, Florida
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2
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Pullicin AJ, Glendinning JI, Lim J. Cephalic phase insulin release: A review of its mechanistic basis and variability in humans. Physiol Behav 2021; 239:113514. [PMID: 34252401 PMCID: PMC8440382 DOI: 10.1016/j.physbeh.2021.113514] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/16/2021] [Accepted: 06/30/2021] [Indexed: 12/17/2022]
Abstract
Cephalic phase insulin release (CPIR) is a transient pulse of insulin that occurs within minutes of stimulation from foods or food-related stimuli. Despite decades of research on CPIR in humans, the body of literature surrounding this phenomenon is controversial due in part to contradictory findings . This has slowed progress towards understanding the sensory and neural basis of CPIR, as well as its overall relevance to health. This review examines up-to-date knowledge in CPIR research and identifies sources of CPIR variability in humans in an effort to guide future research. The review starts by defining CPIR and discussing its presumed functional roles in glucose homeostasis and feeding behavior. Next, the types of stimuli that have been reported to elicit CPIR, as well as the sensory and neural mechanisms underlying the response in rodents and humans are discussed, and areas where knowledge is limited are identified. Finally, factors that may contribute to the observed variability of CPIR in humans are examined, including experimental design, test procedure, and individual characteristics. Overall, oral stimulation appears to be important for eliciting CPIR, especially when combined with other sensory modalities (vision, olfaction, somatosensation). While differences in experimental design and testing procedure likely explain some of the observed inter- and intra-study variability, individual differences also appear to play an important role. Understanding sources of these individual differences in CPIR will be key for establishing its health relevance.
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Affiliation(s)
- Alexa J Pullicin
- Department of Food Science & Technology, Oregon State University, Corvallis, OR 97331, USA
| | - John I Glendinning
- Departments of Biology and Neuroscience & Behavior, Barnard College, Columbia University, 3009 Broadway, New York, NY 10027 US
| | - Juyun Lim
- Department of Food Science & Technology, Oregon State University, Corvallis, OR 97331, USA.
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3
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Smith KR, Moran TH. Gastrointestinal peptides in eating-related disorders. Physiol Behav 2021; 238:113456. [PMID: 33989649 DOI: 10.1016/j.physbeh.2021.113456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 04/19/2021] [Accepted: 05/04/2021] [Indexed: 12/13/2022]
Abstract
Food intake is tightly controlled by homeostatic signals sensitive to metabolic need for the regulation of body weight. This review focuses on the peripherally-secreted gastrointestinal peptides (i.e., ghrelin, cholecystokinin, glucagon-like peptide 1, and peptide tyrosine tyrosine) that contribute to the control of appetite and discusses how these peptides or the signals arising from their release are disrupted in eating-related disorders across the weight spectrum, namely anorexia nervosa, bulimia nervosa, and obesity, and whether they are normalized following weight restoration or weight loss treatment. Further, the role of gut peptides in the pathogenesis and treatment response in human weight conditions as identified by rodent models are discussed. Lastly, we review the incretin- and hormone-based pharmacotherapies available for the treatment of obesity and eating-related disorders.
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Affiliation(s)
- Kimberly R Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States.
| | - Timothy H Moran
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
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4
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Wiedemann SJ, Rachid L, Illigens B, Böni-Schnetzler M, Donath MY. Evidence for cephalic phase insulin release in humans: A systematic review and meta-analysis. Appetite 2020; 155:104792. [DOI: 10.1016/j.appet.2020.104792] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 06/24/2020] [Accepted: 06/24/2020] [Indexed: 02/02/2023]
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5
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Lasschuijt MP, Mars M, de Graaf C, Smeets PAM. Endocrine Cephalic Phase Responses to Food Cues: A Systematic Review. Adv Nutr 2020; 11:1364-1383. [PMID: 32516803 PMCID: PMC7490153 DOI: 10.1093/advances/nmaa059] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 01/10/2020] [Accepted: 04/29/2020] [Indexed: 01/16/2023] Open
Abstract
Cephalic phase responses (CPRs) are conditioned anticipatory physiological responses to food cues. They occur before nutrient absorption and are hypothesized to be important for satiation and glucose homeostasis. Cephalic phase insulin responses (CPIRs) and pancreatic polypeptide responses (CPPPRs) are found consistently in animals, but human literature is inconclusive. We performed a systematic review of human studies to determine the magnitude and onset time of these CPRs. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to develop a search strategy. The terms included in the search strategy were cephalic or hormone response or endocrine response combined with insulin and pancreatic polypeptide (PP). The following databases were searched: Scopus (Elsevier), Science Direct, PubMed, Google Scholar, and The Cochrane Library. Initially, 582 original research articles were found, 50 were included for analysis. An insulin increase (≥1μIU/mL) was observed in 41% of the treatments (total n = 119). In 22% of all treatments the increase was significant from baseline. The median (IQR) insulin increase was 2.5 (1.6-4.5) μIU/mL, 30% above baseline at 5± 3 min after food cue onset (based on study treatments that induced ≥1 μIU/mL insulin increase). A PP increase (>10 pg/mL) was found in 48% of the treatments (total n = 42). In 21% of the treatments, the increase was significant from baseline. The median (IQR) PP increase was 99 (26-156) pg/mL, 68% above baseline at 9± 4 min after food cue onset (based on study treatments that induced ≥1 μIU/mL insulin increase). In conclusion, CPIRs are small compared with spontaneous fluctuations. Although CPPPRs are of a larger magnitude, both show substantial variation in magnitude and onset time. We found little evidence for CPIR or CPPPR affecting functional outcomes, that is, satiation and glucose homeostasis. Therefore, CPRs do not seem to be biologically meaningful in daily life.
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Affiliation(s)
- Marlou P Lasschuijt
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Monica Mars
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Cees de Graaf
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Paul A M Smeets
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
- Image Sciences Institute, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
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6
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Ilyas A, Hübel C, Stahl D, Stadler M, Ismail K, Breen G, Treasure J, Kan C. The metabolic underpinning of eating disorders: A systematic review and meta-analysis of insulin sensitivity. Mol Cell Endocrinol 2019; 497:110307. [PMID: 30393006 DOI: 10.1016/j.mce.2018.10.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 09/25/2018] [Accepted: 10/04/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND A recent study reported a positive genetic correlation between anorexia nervosa and insulin sensitivity using data from genome-wide association studies. Epidemiological studies have, on the other hand, suggested that bulimia nervosa and binge-eating disorder are associated with decreased insulin sensitivity. The aim of this study was to conduct a systematic review and meta-analysis of insulin sensitivity across the spectrum of eating disorders. METHODS EMBASE, Medline, and PsycINFO were searched for all relevant studies published until January 2017, and retrieved studies were assessed for eligibility by two independent reviewers as per predefined inclusion criteria. The associations between eating disorder subtypes and insulin sensitivity were analysed separately. Individual effect sizes were standardized, and a meta-analysis was performed to calculate a pooled effect size using random effects. RESULTS Of 296 citations retrieved, 22 studies met the inclusion criteria, and 12 studies had appropriate data for meta-analysis. Using the random effects model, the pooled effect size (95% confidence interval) was 1.66 (0.79, 2.54) in people with anorexia nervosa (n = 340) and -0.57 (-0.80, -0.34) in people with bulimia nervosa (n = 120) and binge-eating disorders (n = 3241). INTERPRETATION Anorexia nervosa is associated with increased insulin sensitivity whilst bulimia nervosa and binge-eating disorders are associated with decreased insulin sensitivity. The possible mechanism underpinning these findings needs to be determined.
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Affiliation(s)
- Athif Ilyas
- Imperial College London, UK; Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Christopher Hübel
- Social, Genetic, Developmental and Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Daniel Stahl
- Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Marietta Stadler
- Diabetes Research Group, Faculty of Life Sciences and Medicine, King's College London, UK
| | - Khalida Ismail
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Gerome Breen
- Social, Genetic, Developmental and Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Janet Treasure
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Carol Kan
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
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Bodnar RJ. Endogenous opioid modulation of food intake and body weight: Implications for opioid influences upon motivation and addiction. Peptides 2019; 116:42-62. [PMID: 31047940 DOI: 10.1016/j.peptides.2019.04.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 03/04/2019] [Accepted: 04/08/2019] [Indexed: 12/12/2022]
Abstract
This review is part of a special issue dedicated to Opioid addiction, and examines the influential role of opioid peptides, opioid receptors and opiate drugs in mediating food intake and body weight control in rodents. This review postulates that opioid mediation of food intake was an example of "positive addictive" properties that provide motivational drives to maintain opioid-seeking behavior and that are not subject to the "negative addictive" properties associated with tolerance, dependence and withdrawal. Data demonstrate that opiate and opioid peptide agonists stimulate food intake through homeostatic activation of sensory, metabolic and energy-related In contrast, general, and particularly mu-selective, opioid receptor antagonists typically block these homeostatically-driven ingestive behaviors. Intake of palatable and hedonic food stimuli is inhibited by general, and particularly mu-selective, opioid receptor antagonists. The selectivity of specific opioid agonists to elicit food intake was confirmed through the use of opioid receptor antagonists and molecular knockdown (antisense) techniques incapacitating specific exons of opioid receptor genes. Further extensive evidence demonstrated that homeostatic and hedonic ingestive situations correspondingly altered the levels and expression of opioid peptides and opioid receptors. Opioid mediation of food intake was controlled by a distributed brain network intimately related to both the appetitive-consummatory sites implicated in food intake as well as sites intimately involved in reward and reinforcement. This emergent system appears to sustain the "positive addictive" properties providing motivational drives to maintain opioid-seeking behavior.
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology, Queens College, City University of New York, United States; Psychology Doctoral Program and CUNY Neuroscience Collaborative, The Graduate Center of the City University of New York, United States.
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8
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Abstract
This review summarizes the current state of the literature regarding hormonal correlates of, and etiologic influences on, eating pathology. Several hormones (e.g., ghrelin, CCK, GLP-1, PYY, leptin, oxytocin, cortisol) are disrupted during the ill state of eating disorders and likely contribute to the maintenance of core symptoms (e.g., dietary restriction, binge eating) and/or co-occurring features (e.g., mood symptoms, attentional biases). Some of these hormones (e.g., ghrelin, cortisol) may also be related to eating pathology via links with psychological stress. Despite these effects, the role of hormonal factors in the etiology of eating disorders remains unknown. The strongest evidence for etiologic effects has emerged for ovarian hormones, as changes in ovarian hormones predict changes in phenotypic and genetic influences on disordered eating. Future studies would benefit from utilizing etiologically informative designs (e.g., high risk, behavioral genetic) and continuing to explore factors (e.g., psychological, neural responsivity) that may impact hormonal influences on eating pathology.
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9
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Bodnar RJ. Endogenous opioids and feeding behavior: A decade of further progress (2004-2014). A Festschrift to Dr. Abba Kastin. Peptides 2015; 72:20-33. [PMID: 25843025 DOI: 10.1016/j.peptides.2015.03.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 03/23/2015] [Accepted: 03/25/2015] [Indexed: 12/13/2022]
Abstract
Functional elucidation of the endogenous opioid system temporally paralleled the creation and growth of the journal, Peptides, under the leadership of its founding editor, Dr. Abba Kastin. He was prescient in publishing annual and uninterrupted reviews on Endogenous Opiates and Behavior that served as a microcosm for the journal under his stewardship. This author published a 2004 review, "Endogenous opioids and feeding behavior: a thirty-year historical perspective", summarizing research in this field between 1974 and 2003. The present review "closes the circle" by reviewing the last 10 years (2004-2014) of research examining the role of endogenous opioids and feeding behavior. The review summarizes effects upon ingestive behavior following administration of opioid receptor agonists, in opioid receptor knockout animals, following administration of general opioid receptor antagonists, following administration of selective mu, delta, kappa and ORL-1 receptor antagonists, and evaluating opioid peptide and opioid receptor changes in different food intake models.
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Behavioral and Cognitive Neuroscience Doctoral Program Cluster, Queens College, City University of New York, Flushing, NY 11367, United States.
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10
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Dossat AM, Bodell LP, Williams DL, Eckel LA, Keel PK. Preliminary examination of glucagon-like peptide-1 levels in women with purging disorder and bulimia nervosa. Int J Eat Disord 2015; 48:199-205. [PMID: 24590464 PMCID: PMC4155021 DOI: 10.1002/eat.22264] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 02/11/2014] [Accepted: 02/11/2014] [Indexed: 01/19/2023]
Abstract
OBJECTIVE This study examined pre- and postprandial glucagon-like peptide 1 (GLP-1) levels in women with bulimia nervosa (BN), purging disorder (PD), and non-eating disorder control women to better understand whether alterations in satiation-related hormones in BN may be linked to binge-eating episodes or other altered ingestive behaviors. METHOD Participants included women with BN (n = 19), PD (n = 14), or controls (n = 14). Participants provided subjective ratings for hunger and fullness and plasma samples before and after consumption of a standardized test meal. RESULTS As expected, GLP-1 levels increased significantly following test meal consumption; however, participants with BN displayed significantly lower GLP-1 levels compared to PD and control participants both before and after consumption of the test meal. There were no significant differences between PD and control participants in GLP-1 levels, but individuals with PD displayed significantly higher levels of fullness throughout the test meal as compared to both control and BN participants. DISCUSSION Our findings provide preliminary evidence that reduced GLP-1 levels in individuals with BN may be associated with binge-eating episodes. Additionally, increased fullness in individuals with PD does not appear to be accounted for by exaggerated postprandial GLP-1 release.
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Affiliation(s)
- Amanda M. Dossat
- Department of Biomedical Sciences, Florida State University, Tallahassee, Florida,Program in Neuroscience, Florida State University, Tallahassee, Florida
| | - Lindsay P. Bodell
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Diana L. Williams
- Department of Psychology, Florida State University, Tallahassee, Florida,Program in Neuroscience, Florida State University, Tallahassee, Florida
| | - Lisa A. Eckel
- Department of Psychology, Florida State University, Tallahassee, Florida,Program in Neuroscience, Florida State University, Tallahassee, Florida
| | - Pamela K. Keel
- Department of Psychology, Florida State University, Tallahassee, Florida,Correspondence to: Pamela K. Keel, Ph.D., Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL, 32306.
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Zhu Y, Hsu WH, Hollis JH. Modified sham feeding of foods with different macronutrient compositions differentially influences cephalic change of insulin, ghrelin, and NMR-based metabolomic profiles. Physiol Behav 2014; 135:135-42. [DOI: 10.1016/j.physbeh.2014.06.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 06/10/2014] [Accepted: 06/11/2014] [Indexed: 12/25/2022]
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12
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RADELOFF DANIEL, WILLMANN KATHRIN, OTTO LISA, LINDNER MICHAEL, PUTNAM KAREN, VAN LEEUWEN SARA, KAYE WALTERH, POUSTKA FRITZ, WAGNER ANGELA. High-fat taste challenge reveals altered striatal response in women recovered from bulimia nervosa: A pilot study. World J Biol Psychiatry 2014; 15:307-16. [PMID: 22540408 PMCID: PMC4301574 DOI: 10.3109/15622975.2012.671958] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Individuals with anorexia nervosa (AN) and bulimia nervosa (BN) tend to have disordered thinking and eating behaviours in regards to fat containing foods. This is the first study to investigate neuronal pathways that may contribute to altered fat consumption in eating disordered patients. METHODS We used functional magnetic resonance imaging (fMRI) to compare responses to a high-fat cream stimulus, water, and a non-caloric viscous stimulus (CMC) to control for response to viscosity in individuals recovered from AN (N = 15), BN (N = 14) and a healthy control sample (CW, N = 18). RESULTS An interaction analysis (ANOVAR) comparing the three groups (AN, BN, CW) and the three conditions (cream, CMC, water) revealed significant differences in the left anterior ventral striatum (AVS). A post hoc analysis displayed a higher magnitude of response for the contrast cream/water in BN compared to AN or CW and for the contrast CMC/water in BN compared to AN. CONCLUSIONS BN showed an exaggerated AVS response for the cream/water contrast in comparison to AN or CW. Moreover, BN showed an exaggerated AVS response for the CMC/water contrast in comparison to AN. These findings support the possibility that BN have an altered hedonic and/or motivational drive to consume fats.
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Affiliation(s)
- DANIEL RADELOFF
- Department of Child & Adolescent Psychiatry, J.W. Goethe University of Frankfurt, Frankfurt, Germany,Department of Pediatric Neurology, J.W. Goethe University of Frankfurt, Frankfurt, Germany
| | - KATHRIN WILLMANN
- Department of Child & Adolescent Psychiatry, J.W. Goethe University of Frankfurt, Frankfurt, Germany
| | - LISA OTTO
- Department of Child & Adolescent Psychiatry, J.W. Goethe University of Frankfurt, Frankfurt, Germany
| | - MICHAEL LINDNER
- Center for Economics and Neuroscience, University of Bonn, Bonn, Germany
| | - KAREN PUTNAM
- School of Medicine, Department of Environmental Health, Division of Epidemiology and Biostatistics, University of Cincinnati, Cincinnati, OH, USA
| | - SARA VAN LEEUWEN
- Department of Neurophysiology, Max Planck Institute for Brain Research, Frankfurt, Germany
| | - WALTER H KAYE
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - FRITZ POUSTKA
- Department of Child & Adolescent Psychiatry, J.W. Goethe University of Frankfurt, Frankfurt, Germany
| | - ANGELA WAGNER
- Department of Child & Adolescent Psychiatry, J.W. Goethe University of Frankfurt, Frankfurt, Germany,Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
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13
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Mettler LN, Shott ME, Pryor T, Yang TT, Frank GK. White matter integrity is reduced in bulimia nervosa. Int J Eat Disord 2013; 46:264-73. [PMID: 23354827 PMCID: PMC3722416 DOI: 10.1002/eat.22083] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/19/2012] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To investigate brain white matter (WM) functionality in bulimia nervosa (BN) in relation to anxiety. METHOD Twenty-one control women (CW, mean age 27 ± 7 years) and 20 BN women (mean age 25 ± 5 years) underwent brain diffusion tensor imaging to measure fractional anisotropy (FA; an indication of WM axon integrity) and the apparent diffusion coefficient (ADC; reflecting WM cell damage). RESULTS FA was decreased in BN in the bilateral corona radiata extending into the posterior limb of the internal capsule, the corpus callosum, the right sub-insular WM, and right fornix. In CW but not BN, trait anxiety correlated negatively with fornix, corpus callosum, and left corona radiata FA. ADC was increased in BN compared with CW in the bilateral corona radiata, corpus callosum, inferior fronto-occipital, and uncinate fasciculus. Alterations in BN WM functionality were not due to structural brain alterations. DISCUSSION WM integrity is disturbed in BN, especially in the corona radiata, which has been associated with taste and brain reward processing. Whether this is a premorbid condition or an effect from the illness is yet uncertain. The relationships between WM FA and trait anxiety in CW but not BN may suggest that altered WM functionality contributes to high anxious traits in BN.
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Affiliation(s)
- Lisa N. Mettler
- University of Colorado School of Medicine, Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Megan E. Shott
- University of Colorado School of Medicine, Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - Tony T. Yang
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Francisco, CA, USA,Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California, San Diego, CA, USA
| | - Guido K.W. Frank
- University of Colorado School of Medicine, Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA,Neuroscience Program, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA
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14
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Cardona Cano S, Merkestein M, Skibicka KP, Dickson SL, Adan RAH. Role of ghrelin in the pathophysiology of eating disorders: implications for pharmacotherapy. CNS Drugs 2012; 26:281-96. [PMID: 22452525 DOI: 10.2165/11599890-000000000-00000] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Ghrelin is the only known circulating orexigenic hormone. It increases food intake by interacting with hypothalamic and brainstem circuits involved in energy balance, as well as reward-related brain areas. A heightened gut-brain ghrelin axis is an emerging feature of certain eating disorders such as anorexia nervosa and Prader-Willi syndrome. In common obesity, ghrelin levels are lowered, whereas post-meal ghrelin levels remain higher than in lean individuals. Agents that interfere with ghrelin signalling have therapeutic potential for eating disorders, including obesity. However, most of these drugs are only in the preclinical phase of development. Data obtained so far suggest that ghrelin agonists may have potential in the treatment of anorexia nervosa, while ghrelin antagonists seem promising for other eating disorders such as obesity and Prader-Willi syndrome. However, large clinical trials are needed to evaluate the efficacy and safety of these drugs.
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Abstract
This paper is the thirty-third consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2010 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior (Section 2), and the roles of these opioid peptides and receptors in pain and analgesia (Section 3); stress and social status (Section 4); tolerance and dependence (Section 5); learning and memory (Section 6); eating and drinking (Section 7); alcohol and drugs of abuse (Section 8); sexual activity and hormones, pregnancy, development and endocrinology (Section 9); mental illness and mood (Section 10); seizures and neurologic disorders (Section 11); electrical-related activity and neurophysiology (Section 12); general activity and locomotion (Section 13); gastrointestinal, renal and hepatic functions (Section 14); cardiovascular responses (Section 15); respiration (Section 16); and immunological responses (Section 17).
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, Flushing, NY 11367, USA.
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