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1.
Nan Fang Yi Ke Da Xue Xue Bao ; 40(5): 609-615, 2020 May 30.
Artigo em Chinês | MEDLINE | ID: mdl-32897201

RESUMO

OBJECTIVE: To investigate the potential neural pathway connecting the nucleus accumbens (NAc) and the rostral ventrolateral medulla (RVLM), and whether the pathway participates in the regulation of cardiovascular function in a model rat of anorexia nervosa (AN). METHODS: Rat models of AN were established by allowing voluntary activity in a running wheel with restricted feeding, with the rats having free access to normal chow without exercise as the control group. FluoroGold (FG) retrograde tracing method and multi-channel simultaneous recording technique were used to explore the possible pathway between the NAc and the RVLM. RESULTS: The rats in AN group exhibited significantly reduced systolic blood pressure (SBP), mean arterial pressure (MAP) and heart rate (HR) with significantly increased discharge frequency of RVLM neurons in comparison with the control rats. After the injection of FG into the RVLM, retrograde labeled neurons were observed in the NAc of the rats in both the normal control and AN groups. In both groups, SBP and HR were significantly decreased in response to 400 µA electrical stimulation of the NAc accompanied by an obvious increase in the discharge frequency of the RVLM neurons; the diastolic blood pressure (DBP) and MAP were significantly lower in AN model rats than in the normal rats in response to the stimulation. CONCLUSIONS: We successfully established a rat model of AN via hyperactivity and restricted feeding and confirm the presence of a neural pathway connecting the NAc and the RVLM. This pathway might participate in the regulation of cardiovascular function in AN model rats.


Assuntos
Anorexia Nervosa , Núcleo Accumbens , Animais , Pressão Sanguínea , Modelos Animais de Doenças , Bulbo , Vias Neurais , Ratos , Ratos Sprague-Dawley
2.
Medicine (Baltimore) ; 99(29): e20826, 2020 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-32702825

RESUMO

RATIONALE: The typical clinical presentations of patients with primary aldosteronism (PA) include generalized weakness, fatigue, high blood pressure, and potassium deficiency. However, normotensive PA is rare. Therefore, an atypical presentation of normal blood pressure is a challenge for the diagnosis and treatment of PA. PATIENT CONCERNS: A 43-year-old, thin, and tall woman (body mass index, 18.6 kg/m) with generalized weakness for 1 day presented to our emergency department, where hypokalemia was a significant finding. The initial diagnosis was anorexia nervosa with the evidence of renal potassium wasting with low urinary sodium and chloride levels, metabolic alkalosis, normal blood pressure, and low body mass index. However, neither vomiting features nor other specific induced vomiting features were noted. DIAGNOSES: The laboratory examination revealed high plasma aldosterone level, low plasma renin activity, and extremely high aldosterone-to-renin ratio indicating the diagnosis of PA, confirmed via adrenal computed tomography. INTERVENTIONS: Surgical adrenalectomy was performed. Pathological diagnosis was a benign cortical adenoma. OUTCOMES: Patient's serum potassium level and hormonal status became normalized after surgical removal of adrenal adenoma. She fully recovered without any further sequelae. LESSONS: It is too early to rule out PA based on the presence of normal blood pressure in a patient with metabolic alkalosis and renal wasting hypokalemia. Moreover, PA should be considered in a normotensive patient with an unknown hypokalemic etiology to avoid delayed diagnosis and treatment.


Assuntos
Anorexia Nervosa/diagnóstico , Hiperaldosteronismo/diagnóstico por imagem , Hipopotassemia/diagnóstico , Adenoma/cirurgia , Adrenalectomia/métodos , Adulto , Aldosterona/sangue , Alcalose/etiologia , Anorexia Nervosa/psicologia , Pressão Sanguínea/fisiologia , Diagnóstico Diferencial , Serviço Hospitalar de Emergência , Feminino , Humanos , Hiperaldosteronismo/sangue , Hiperaldosteronismo/patologia , Hiperaldosteronismo/cirurgia , Hipopotassemia/etiologia , Debilidade Muscular/etiologia , Renina/sangue , Sódio/urina , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
5.
Neuropsychopharmacol Hung ; 22(2): 72-76, 2020 Jun.
Artigo em Húngaro | MEDLINE | ID: mdl-32683331

RESUMO

In the treatment of anorexia nervosa the dominant role of psychotherapies is proposed, while pharmacotherapy has a limited effi cacy. Because of the broad comorbidity spectrum of the disorder, other psychiatric disorders are often present. Among them depression is frequent, so one of the selective theories of eating disorders stresses the importance of the relationship with depression. In everyday practice we frequently encounter anorexic patients whose depressive symptoms are mild or moderate, and these are often regarded as usual accompanying phenomena of anorexia. The three case reports described in the present study support that it is worth to consider the application of antidepressants in such situations. In all three cases antidepressants were initiated following ineffi cacy of psychotherapy, and they produced a dramatic eff ectiveness not only in depressive symptoms, but also in the whole anorexic syndrome. In the complex therapy of anorexia nervosa antidepressants may yield a very good therapeutic eff ect in cases with comorbid, even subthreshold depression.


Assuntos
Anorexia Nervosa , Antidepressivos/uso terapêutico , Anorexia Nervosa/tratamento farmacológico , Comorbidade , Transtornos da Alimentação e da Ingestão de Alimentos , Humanos , Psicoterapia
6.
PLoS One ; 15(7): e0235346, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32667951

RESUMO

Several studies have recently suggested that an abnormal processing of respiratory interoceptive and nociceptive (painful) stimuli may contribute to eating disorder (ED) pathophysiology. Mood and anxiety disorders (MA) are also characterized by abnormal respiratory symptoms, and show substantial comorbidity with ED. However, no studies have examined both respiratory and pain processing simultaneously within ED and MA. The present study systematically evaluated responses to perturbations of respiratory and nociceptive signals across the levels of physiology, behavior, and symptom report in a transdiagnostic ED sample (n = 51) that was individually matched to MA individuals (n = 51) and healthy comparisons (HC; n = 51). Participants underwent an inspiratory breath-holding challenge as a probe of respiratory interoception and a cold pressor challenge as a probe of pain processing. We expected both clinical groups to report greater stress and fear in response to respiratory and nociceptive perturbation than HCs, in the absence of differential physiological and behavioral responses. During breath-holding, both the ED and MA groups reported significantly more stress, feelings of suffocation, and suffocation fear than HC, with the ED group reporting the most severe symptoms. Moreover, anxiety sensitivity was related to suffocation fear only in the ED group. The heightened affective responses in the current study occurred in the absence of group differences in behavioral (breath hold duration, cold pressor duration) and physiological (end-tidal carbon dioxide, end-tidal oxygen, heart rate, skin conductance) responses. Against our expectations, there were no group differences in the response to cold pain stimulation. A matched-subgroup analysis focusing on individuals with anorexia nervosa (n = 30) produced similar results. These findings underscore the presence of abnormal respiratory interoception in MA and suggest that hyperreactivity to respiratory signals may be a potentially overlooked clinical feature of ED.


Assuntos
Anorexia Nervosa/fisiopatologia , Transtornos de Ansiedade/fisiopatologia , Transtornos da Alimentação e da Ingestão de Alimentos/fisiopatologia , Dor Nociceptiva/fisiopatologia , Adolescente , Adulto , Afeto/fisiologia , Anorexia Nervosa/complicações , Anorexia Nervosa/epidemiologia , Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/epidemiologia , Asfixia/fisiopatologia , Asfixia/terapia , Comorbidade , Medo/fisiologia , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Feminino , Humanos , Masculino , Transtornos do Humor/complicações , Transtornos do Humor/epidemiologia , Transtornos do Humor/fisiopatologia , Dor Nociceptiva/complicações , Dor Nociceptiva/epidemiologia , Dor/complicações , Dor/epidemiologia , Dor/fisiopatologia , Sistema Respiratório/fisiopatologia
7.
Artigo em Inglês | MEDLINE | ID: mdl-32491142

RESUMO

Oral problems are common in patients diagnosed with Eating Disorders (ED) and still require better elucidation. We aimed to analyze the prevalence of oral Candida spp in individuals with ED. The sample of the study was comprised of 30 women with purgative habits and 15 without purgative habits. Samples of the oral cavity were collected by sterile cotton swab rubbed on soft tissues and teeth. Yeasts were isolated on Sabouraud dextrose agar. Yeasts were isolated from the oral cavity of 53% of the patients yielding 75 yeast isolates; of these, 43 were identified by conventional mycological methods: C. parapsilosis (n=19), C. glabrata (n=16), Rhodotorula sp (n= 6), C. famata (n=2). The remaining 32 isolates were presumptively identified as C. albicans or C. dubliniensis and required mass spectrometry for the final differentiation: 28 isolates were confirmed as C. albicans and four as C. dubliniensis. Among the control group, only four subjects (26.7%) were found to harbor C. albicans. The four C. dubliniensis isolates were from two patients, one that was only colonized and the other, with severe ED, was diagnosed with an oral candidiasis as demonstrated by the presence of pseudohyphae on the direct mycological exam from different sites. The increased rate of isolation of non-albicans species, such as C. glabrata, C. parapsilosis, and C. dubliniensis in the oral cavity from ED patients with nutritional deficiency may suggest that purgative habits of these patients can lead to changes in normal flora and predispose to oral candidiasis.


Assuntos
Anorexia Nervosa/complicações , Bulimia Nervosa/complicações , Candidíase Bucal/complicações , Boca/microbiologia , Adulto , Candida/classificação , Candida/isolamento & purificação , Estudos de Casos e Controles , Feminino , Humanos , Espectrometria de Massas , Pessoa de Meia-Idade , Fenótipo
8.
Int J Eat Disord ; 53(7): 1142-1154, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32533799

RESUMO

The necessity to employ distance-based methods to deliver on-going eating disorder care due to the novel coronavirus (COVID-19) pandemic represents a dramatic and urgent shift in treatment delivery. Yet, TeleHealth treatments for eating disorders in youth have not been adequately researched or rigorously tested. Based on clinical experience within our clinic and research programs, we aim to highlight the common challenges clinicians may encounter in providing family-based treatment (FBT) via TeleHealth for children and adolescents with anorexia nervosa and bulimia nervosa. We also discuss possible solutions and offer practical considerations for providers delivering FBT in this format. Additional research in TeleHealth treatment for eating disorders in youth may lead to improved access, efficiency, and effectiveness of FBT delivered via videoconferencing.


Assuntos
Anorexia Nervosa/terapia , Bulimia Nervosa/terapia , Infecções por Coronavirus/prevenção & controle , Terapia Familiar/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Telemedicina/métodos , Adolescente , Betacoronavirus , Criança , Feminino , Humanos , Comunicação por Videoconferência
9.
Nat Commun ; 11(1): 2814, 2020 06 04.
Artigo em Inglês | MEDLINE | ID: mdl-32499508

RESUMO

Food consumption is fundamental for life, and eating disorders often result in devastating or life-threatening conditions. Anorexia nervosa (AN) is characterized by a persistent restriction of energy intake, leading to lowered body weight, constant fear of gaining weight, and psychological disturbances of body perception. Herein, we demonstrate that SIRT1 inhibition, both genetically and pharmacologically, delays the onset and progression of AN behaviors in activity-based anorexia (ABA) models, while SIRT1 activation accelerates ABA phenotypes. Mechanistically, we suggest that SIRT1 promotes progression of ABA, in part through its interaction with NRF1, leading to suppression of a NMDA receptor subunit Grin2A. Our results suggest that AN may arise from pathological positive feedback loops: voluntary food restriction activates SIRT1, promoting anxiety, hyperactivity, and addiction to starvation, exacerbating the dieting and exercising, thus further activating SIRT1. We propose SIRT1 inhibition can break this cycle and provide a potential therapy for individuals suffering from AN.


Assuntos
Anorexia Nervosa/metabolismo , Regulação da Expressão Gênica , Fator 1 Nuclear Respiratório/metabolismo , Receptores de N-Metil-D-Aspartato/metabolismo , Sirtuína 1/metabolismo , Animais , Peso Corporal , Carbazóis/farmacologia , Modelos Animais de Doenças , Feminino , Compostos Heterocíclicos de 4 ou mais Anéis/farmacologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Proteínas do Tecido Nervoso/metabolismo , Fenótipo , Resveratrol/farmacologia , Estresse Mecânico , Regulação para Cima
11.
Psychiatr Danub ; 32(1): 55-59, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32303030

RESUMO

BACKGROUND: Anorexia nervosa (AN) is a serious mental disorder with a high mortality rate and often a chronic course. In contrast to many other common mental disorders, there is no drug therapy approved for AN. METHODS: We performed a narrative literature review to consider whether a choline-containing molecule, such as phosphatidylcholine (PC), with an omega (ω)-3 long chain polyunsaturated fatty acid (LCPUFA) could be a potential future medicinal treatment for AN. RESULTS: Choline and LCPUFAs have individually shown benefit for mental health. Case series and pilot studies suggest ω-3 LCPUFAs may be effective in eating disorders. However, pharmacodynamic and pharmacokinetic considerations suggest a greater benefit from the combination of both components. CONCLUSION: The combination of a choline-containing molecule with an ω-3 LCPUFA may be clinically effective and well tolerated. This idea is supported by the current literature on the role of inflammation, the microbiome, the gut-brain-axis, hormonal, neurotransmitter and intracellular signalling, and on the structure and fluidity of nerve cells membranes in patients with AN.


Assuntos
Anorexia Nervosa/tratamento farmacológico , Ácidos Graxos Ômega-3/química , Ácidos Graxos Ômega-3/uso terapêutico , Fosfatidilcolinas/uso terapêutico , Anorexia Nervosa/metabolismo , Anorexia Nervosa/patologia , Encéfalo/metabolismo , Encéfalo/patologia , Humanos , Inflamação/metabolismo , Inflamação/patologia , Fosfatidilcolinas/química
12.
Expert Opin Pharmacother ; 21(9): 1045-1058, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32281881

RESUMO

INTRODUCTION: Anorexia nervosa is a severe psychiatric illness and no medication has been approved for its treatment. This lack of biological treatments requires the development of new directions for pharmacological research. AREAS COVERED: There is modest but emerging evidence that dopamine D2 and serotonin 1A and 2A receptor agonistic and antagonist medication might be beneficial for weight gain, although the underlying mechanisms are uncertain. Improving quality of life including treating comorbid conditions is an additional important outcome measure, but this has not been well researched. Biological and psychological risk factors together with neurobiological alterations during the illness maintain the disorder 's pathophysiology. Neuroscience research can be used to understand those interactions and advance the research agenda. The authors discuss the above as well as give perspectives on future research. EXPERT OPINION: If a multidisciplinary approach that includes evidence-based psychotherapy shows unsatisfactory success in weight normalization and cognitive-emotional recovery, then more experimental treatments that are safe and have indicated treatment effectiveness should be tried to augment treatment. Identification and treatment of comorbid conditions to improve quality of life of the patient should also be part of the treatment regimen, even if the effect on weight gain is uncertain.


Assuntos
Anorexia Nervosa/tratamento farmacológico , Qualidade de Vida/psicologia , Adolescente , Adulto , Feminino , Humanos , Adulto Jovem
14.
Gene ; 748: 144675, 2020 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-32315729

RESUMO

BACKGROUND: Accumulating evidence indicates that alterations in the serotonin system are related to changes in eating behavior. The serotonin transporter is encoded by the SLC6A4 gene and has been an interesting candidate for anorexia nervosa- restrictive type (AN-R) and bulimia nervosa (BN). Interestingly, functional variants have been identified in the coding region that could contribute to understand the role of this gene in eating disorders. The aim was to identify genetic variants in five exons of SLC6A4 gene using Sanger-sequencing in anorexia nervosa-restrictive and bulimia nervosa patients, and a control group. METHOD: The sample consisted of 86 patients and 50 control subjects. We obtained DNA samples from all subjects and performed Sanger-sequence analysis of the 1, 2, 3, 8 and 9 exons. The sequences were compared with the reference sequence of the SLC6A4 gene. RESULTS: The sequence analysis of the five exons of the gene identified several variants. In the AN-R, we observed two novel variants (g.130delA and c.1740G > A), three synonymous variants (rs57172732, rs55908624, rs74478645) and a missense variant (L90F) reporting a probably deleterious and damaging variant. In BN, we identified two novel variants (g.295C > G and c.1725G > A), and the non-synonymous (rs28914832/I425V), reported as benign. Interestingly, we observed the 425V variant in three patients in the BN, variant that previously was reported in patients with a spectrum obsessive-compulsive disorder. CONCLUSION: The results of our study suggest that variants of the SLC6A4 gene are related with a possible damaging or gain-of-function and may be involved in the susceptibility to AN-R and BN patients. However, the present findings should be considered as preliminary until replicated in large samples.


Assuntos
Anorexia Nervosa/genética , Bulimia Nervosa/genética , Éxons , Proteínas da Membrana Plasmática de Transporte de Serotonina/genética , Adolescente , Estudos de Casos e Controles , Feminino , Predisposição Genética para Doença , Humanos , Adulto Jovem
15.
J Paediatr Child Health ; 56(4): 661, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32307783
16.
Monash Bioeth Rev ; 38(1): 1-14, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32266592

RESUMO

Respect for autonomy is a central moral principle in bioethics. It is sometimes argued that authenticity, i.e., being "real," "genuine," "true to oneself," or similar, is crucial to a person's autonomy. Patients sometimes make what appears to be inauthentic decisions, such as when (decision-competent) anorexia nervosa patients refuse treatment to avoid gaining weight, despite that the risk of harm is very high. If such decisions are inauthentic, and therefore non-autonomous, it may be the case they should be overridden for paternalist reasons. However, it is not clear what justifies the judgment that someone or something is inauthentic. This article discusses one recent theory of what justifies judgments of inauthenticity. It is argued that the theory is seriously limited, as it only provides guidance in three out of nine identified cases. There are at least six authenticity-related problems to be solved, and autonomy theorists thus have reason to engage with the topic of authenticity in practical biomedicine.


Assuntos
Tomada de Decisões , Ética Médica , Julgamento , Paternalismo/ética , Participação do Paciente , Autonomia Pessoal , Pessoalidade , Anorexia Nervosa , Bioética , Ego , Humanos
17.
Metabolism ; 107: 154229, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32289345

RESUMO

Chronic energy deficiency can impair the hypothalamic-pituitary-gonadal (HPG) axis and lead to hypothalamic anovulation in underweight women. This review presents the syndromes related to underweight status that are associated with infertility, summarizes the underlying mechanisms, and reviews the available treatment options. Eating disorders, such as anorexia nervosa (AN), constitute the most common cause of infertility in underweight women, who, in addition, experience miscarriages, and sexual dysfunction. The relative energy deficiency in sports (RED-S; former terminology: athlete's triad) involves menstrual dysfunction due to low energy availability, which results in anovulation. Moreover, lipodystrophies, malnutrition, starvation, systematic illnesses (malignancies, endocrinopathies, infectious diseases, advanced chronic diseases, neurologic illnesses), and the utilization of drugs can cause excessive weight loss. They may result in fertility problems due to the loss of adipose tissue and the subsequent hormonal disturbances. Each of these conditions requires multidisciplinary management. Nutritional counseling should target the restoration of energy balance by increasing intake and reducing output. Medical treatment, recommended only for patients who did not respond to standard treatment, may include antipsychotics, antidepressants, or leptin administration. Finally, psychiatric treatment is considered an integral part of the standard treatment.


Assuntos
Infertilidade Feminina/etiologia , Infertilidade Masculina/etiologia , Reprodução , Magreza/complicações , Anorexia Nervosa , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/fisiopatologia , Feminino , Humanos , Infertilidade Feminina/epidemiologia , Infertilidade Masculina/epidemiologia , Masculino , Magreza/epidemiologia , Magreza/fisiopatologia
18.
J Assoc Physicians India ; 68(3): 80-82, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32138493

RESUMO

Cases have been reported about refeeding syndrome after bariatric surgery for obesity, in head and neck cancer patients, in patients with anorexia nervosa, hyperemesis gravidarum, in persons on hunger strike, malnourished alcoholic persons and persons doing religious fasting. Refeeding after prolonged fasting can cause severe morbidity and even mortality, if not done properly. Depletion of intracellular electrolytes, depletion of nutrients and vitamins, decreased BMR, decreased renal functions, decreased insulin, decreased GI functions all contribute to it, once you start refeeding. It takes sometime to regain the original functions by the organs and mismatch between supply and increased demand after refeeding can cause havoc. Here we report the case of a person, who did water only fasting for 51 days and developed refeeding syndrome and Wernike's encephalopathy four days after starting liquid diet.


Assuntos
Encefalopatias , Síndrome da Realimentação , Anorexia Nervosa , Eletrólitos , Jejum , Feminino , Humanos , Gravidez
19.
Medicine (Baltimore) ; 99(9): e19300, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32118747

RESUMO

To characterize the fractional amplitude of low-frequency fluctuation (fALFF) in drug-naïve first-episode female patients with anorexia nervosa (AN) using resting-state functional magnetic resonance imaging (rs-fMRI).Whole brain rs-fMRI data were collected from 7 drug-naïve first-episode female patients with DSM-5 AN and 14 age-matched healthy female controls. fALFF values were calculated and compared between the two groups using a two-sample t test. Correlation analysis between the fALFF values in the entire brain and body mass index (BMI) was performed.Compared with the healthy controls, increased fALFF values were observed in the AN patients in their right hippocampus and left superior frontal gyrus, while decreased fALFF values were observed in their left rectus and left middle occipital gyrus. Moreover, low BMI was significantly associated with decreased fALFF in the left inferior frontal gyrus but increased fALFF in the left calcarine. In particular, the z-standardized fALFF (zfALFF) value of the left rectus was positive associated with BMI.Our findings suggest that spontaneous brain activity in the frontal region, hippocampus and rectus, characterized by fALFF values, was altered in drug-naïve, first-episode female patients with AN.


Assuntos
Anorexia Nervosa/tratamento farmacológico , Imagem por Ressonância Magnética/normas , Adolescente , Adulto , Anorexia Nervosa/fisiopatologia , Anorexia Nervosa/psicologia , China , Feminino , Humanos , Imagem por Ressonância Magnética/métodos , Imagem por Ressonância Magnética/estatística & dados numéricos , Lobo Occipital/anormalidades , Lobo Occipital/anatomia & histologia , Córtex Pré-Frontal/anormalidades , Córtex Pré-Frontal/anatomia & histologia
20.
Am J Psychiatry ; 177(7): 601-610, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-32160766

RESUMO

OBJECTIVE: Anorexia nervosa has the highest mortality rate of any psychiatric condition, yet the pathophysiology of this disorder and its primary symptom, extreme dietary restriction, remains poorly understood. In states of hunger relative to satiety, the rewarding value of food stimuli normally increases to promote eating, yet individuals with anorexia nervosa avoid food despite emaciation. This study's aim was to examine potential neural insensitivity to these effects of hunger in anorexia nervosa. METHODS: At two scanning sessions scheduled 24 hours apart, one after a 16-hour fast and one after a standardized meal, 26 women who were in remission from anorexia nervosa (to avoid the confounding effects of malnutrition) and 22 matched control women received tastes of sucrose solution or ionic water while functional MRI data were acquired. Within a network of interest responsible for food valuation and transforming taste signals into motivation to eat, the authors compared groups across conditions on blood-oxygen-level-dependent (BOLD) signal and task-based functional connectivity. RESULTS: Participants in the two groups had similar BOLD responses to sucrose and water tastants. A group-by-condition interaction in the ventral caudal putamen indicated that hunger had opposite effects on tastant response in the control group and the remitted anorexia nervosa group, with an increase and a decrease, respectively, in BOLD response when hungry. Hunger had a similar opposite effect on insula-to-ventral caudal putamen functional connectivity in the remitted anorexia nervosa group compared with the control group. Exploratory analyses indicated that lower caudate response to tastants when hungry was associated with higher scores on harm avoidance among participants in the remitted anorexia nervosa group. CONCLUSIONS: Reduced recruitment of neural circuitry that translates taste stimulation to motivated eating behavior when hungry may facilitate food avoidance and prolonged periods of extremely restricted food intake in anorexia nervosa.


Assuntos
Anorexia Nervosa/fisiopatologia , Núcleo Caudado/fisiopatologia , Córtex Cerebral/fisiopatologia , Fome/fisiologia , Putamen/fisiopatologia , Paladar/fisiologia , Adulto , Estudos de Casos e Controles , Feminino , Neuroimagem Funcional , Humanos , Imagem por Ressonância Magnética , Vias Neurais/fisiopatologia , Indução de Remissão , Adulto Jovem
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