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1.
Behav Pharmacol ; 31(2&3): 256-271, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32101989

RESUMO

Chronic alcohol (ethyl alcohol, EtOH) binging has been associated with long-term neural adaptations that lead to the development of addiction. Many of the neurobiological features of EtOH abuse are shared with other forms of binging, like pathological feeding. The drinking-in-the-dark (DID) paradigm has been used extensively to study the neurobiology of EtOH binge-like drinking due to its ability to promote high intakes relevant to human behavior. DID can also generate high consumption of other tastants, but this procedure has not been fully adapted to study forms of binging behavior that are not alcohol-driven. In the present study, we used a modified version of DID that uses multiple bottle availability to promote even higher levels of EtOH drinking in male C57BL/6J mice and allows a thorough investigation of tastant preferences. We assessed whether administration of systemic naltrexone could reduce binging on EtOH, sucrose, and saccharin separately as well as in combination. Our multiple bottle DID procedure resulted in heightened levels of consumption compared with previously reported data using this task. We found that administration of the opioid receptor antagonist naltrexone reduced intakes of preferred, highly concentrated EtOH, sucrose, and saccharin. We also report that naltrexone was able to reduce overall intakes when animals were allowed to self-administer EtOH, sucrose, or saccharin in combination. Our modified DID procedure provides a novel approach to study binging behavior that extends beyond EtOH to other tastants (i.e. sucrose and artificial sweeteners), and has implications for the study of the neuropharmacology of binge drinking.


Assuntos
Comportamento Aditivo/tratamento farmacológico , Bebedeira/tratamento farmacológico , Naltrexona/farmacologia , Animais , Comportamento Aditivo/fisiopatologia , Bebedeira/metabolismo , Bebedeira/fisiopatologia , Transtorno da Compulsão Alimentar/fisiopatologia , Etanol/administração & dosagem , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Modelos Animais , Naltrexona/metabolismo , Antagonistas de Entorpecentes/uso terapêutico , Sacarina/administração & dosagem , Autoadministração/métodos , Sacarose/administração & dosagem
2.
Int J Eat Disord ; 53(1): 85-95, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31769054

RESUMO

OBJECTIVES: This study compared the patterns of moderate and vigorous physical activity (PA) and health conditions in a nationally representative sample of adults categorized with healthy weight (HW) without eating disorder history, obesity without eating disorder history (OB), or current binge-eating disorder (BED) with obesity (BED+OB). METHOD: We used the third National Epidemiological Survey on Alcohol and Related Conditions to compare PA intensity, duration, and their relationships with health indicators in the three groups: HW (n = 11,635), OB (n = 11,056), and BED+OB (n = 110). RESULTS: Prevalence of physical inactivity was significantly greater in OB (38.1%) and BED (51.4%) than HW (30.3%). Prevalence of vigorous PA was significantly lower in OB (45.5%) and BED (31.7%) than HW (54.0%). Duration of moderate and vigorous activity per week was significantly shorter in BED+OB than HW and duration of vigorous activity was shorter in OB than HW. Regardless of PA intensity, BED+OB reported poorer physical and mental health than OB and HW. Greater PA intensity and duration were associated with better physical health, particularly in OB. DISCUSSION: In this nationally representative study of U.S. adults, obesity was associated with physical inactivity. Comorbid obesity and BED was associated with lower PA levels and poorer health. Particularly among adults with obesity, greater PA intensity was associated with better physical health, and greater duration of PA was associated with better physical and mental health. The findings highlight the importance of screening for BED in addition to obesity status and for promoting PA to improve health in U.S. adults.


Assuntos
Transtorno da Compulsão Alimentar/fisiopatologia , Peso Corporal/fisiologia , Exercício Físico/fisiologia , Obesidade/fisiopatologia , Adulto , Transtorno da Compulsão Alimentar/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/psicologia , Prevalência , Estados Unidos
3.
Biol Res Nurs ; 22(1): 82-91, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31833410

RESUMO

BACKGROUND: Eating disorders are a significant cause of morbidity and mortality. The etiology and maintenance of eating-disorder symptoms are not well understood. Evidence suggests that there may be gustatory alterations in patients with eating disorders. OBJECTIVE: This article systematically reviews research assessing gustatory differences in patients with anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). METHOD: A systematic review was performed, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, examining taste and eating disorders. We reviewed electronic databases and identified 1,490 peer-reviewed English-language studies. Of these, 49 met inclusion criteria. RESULTS: Studies employed psychophysical measures (n = 27), self-reported questionnaires (n = 5), and neuroimaging techniques (i.e., electroencephalography, functional magnetic resonance imaging; n = 17). Psychophysical studies showed that individuals with BN, in general, had greater preference for sweetness than healthy controls, and those with AN had a greater aversion for fat than controls. In neuroimaging studies, findings suggested that predictable administration of sweet-taste stimuli was associated with reduced activation in taste-reward regions of the brain among individuals with AN (e.g., insula, ventral, and dorsal striatum) but increased activation in BN and BED. DISCUSSION: To our knowledge, this systematic review is the first to synthesize literature on taste differences in AN, BN, and BED. The inconsistency and variability in methods used across studies increased difficulties in comparing studies and disease processes. Further studies with well-defined population parameters are warranted to better understand how taste varies in patients with eating disorders.


Assuntos
Anorexia Nervosa/fisiopatologia , Transtorno da Compulsão Alimentar/fisiopatologia , Encéfalo/fisiologia , Bulimia Nervosa/fisiopatologia , Paladar/fisiologia , Adolescente , Adulto , Eletroencefalografia , Feminino , Humanos , Masculino , Inquéritos e Questionários , Adulto Jovem
4.
Expert Opin Investig Drugs ; 28(12): 1081-1094, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31714807

RESUMO

Introduction: Binge eating disorder (BED) is the most common eating disorder and is frequently associated with psychiatric and medical comorbidities and functional impairment. Although psychological treatments have been the cornerstones of BED treatment, pharmacologic interventions also play an important part of the multimodal management of this condition.Areas covered: This review examines investigational, approved and other pharmacological agents for the treatment of BED. We searched PubMed and clinicaltrials.gov to identify pharmacological interventions for the management of this condition.Expert opinion: BED pharmacological studies have incorporated new drug targets based on our enhanced understanding of the pathophysiology of BED. Neurobiological dysregulation in the reward center and impulse control circuitry and related disturbances in dopamine neurotransmission are among the neurobiological explanations that have been suggested for BED. These mechanisms serve as a pharmacodynamic foundation for the development of new compounds such as lisdexamfetamine (LDX) and dasotraline. Despite these advances, pharmacological trials in BED have numerous challenges that must be overcome. For most compounds studied, larger and more definitive trials is a high priority.


Assuntos
Transtorno da Compulsão Alimentar/tratamento farmacológico , Desenvolvimento de Medicamentos , Drogas em Investigação/administração & dosagem , Animais , Transtorno da Compulsão Alimentar/fisiopatologia , Transtorno da Compulsão Alimentar/psicologia , Dopamina/metabolismo , Drogas em Investigação/farmacologia , Humanos , Recompensa
5.
Physiol Behav ; 212: 112700, 2019 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-31614159

RESUMO

Binge eating disorder (BED), the most common eating disorder in the United States, is characterized by binge-type eating and is associated with higher body mass index and greater motivation for food. This disorder tends to first appear in late adolescence or young adulthood and is more common in women than men. While some animal models of BED have recapitulated both the overeating and the excessive body weight / fat of BED, very few have examined the motivational aspects of this disorder or utilized young females as subjects. In the present study, female Long-Evans rats, starting in late adolescence, were trained in operant chambers to self-administer the highly palatable Milk Chocolate Ensure Plus®, in 30-minute ("short access") or 6-hour ("long access") sessions, 5 days per week, over 6.5 weeks. For comparison, other subjects were provided with Ensure ad libitum or maintained on chow and water only. Both short and long access to Ensure led rats to develop binge-type eating, measured as greater 30-minute caloric intake than rats with ad libitum or chow access and as increasing 30-minute intake across weeks. Compared to those with short access, rats with long access demonstrated moderately increased motivation for Ensure (measured by progressive ratio testing) and, compared to those with only chow access, they eventually showed significant hyperphagia on Ensure access days and hypophagia on non-access days. Rats with long access also showed greater body weight/fat than those maintained on chow. These findings suggest that, while both short and long operant access to Ensure causes young female rats to meet the definition of binge-type eating, they lead to different phenotypes of this behavior, with long access promoting the development of a greater number of features found in clinical BED. Ultimately, both models may be useful in future studies aimed at identifying the neurobiological basis of binge eating.


Assuntos
Transtorno da Compulsão Alimentar/fisiopatologia , Condicionamento Operante/fisiologia , Sacarose na Dieta/efeitos adversos , Comportamento Alimentar/fisiologia , Alimentos Formulados/efeitos adversos , Alimentos , Autoadministração , Tecido Adiposo/fisiopatologia , Animais , Peso Corporal/fisiologia , Feminino , Motivação/fisiologia , Fenótipo , Ratos , Esquema de Reforço , Fatores de Tempo
6.
Psychiatr Danub ; 31(Suppl 3): 497-502, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488779

RESUMO

BACKGROUND: A link between abnormalities in circadian rhythms and the development of eating disorders was extensively hypothesized, mainly in consideration of the influence of the circadian clock on eating behavior. The present review is aimed at summarizing the evidence about biological rhythms disruptions in eating disorders, possibly clarifying their impact on the psychopathological profile of such patients. METHODS: Electronic database MEDLINE/PubMed/Index Medicus was systematically searched for original articles examining the prevalence of circadian rhythms disruptions in eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder). RESULTS: Studies included in the review confirmed the hypothesis of a high prevalence of circadian disruptions in eating disorders. The analyzed research mainly focused on sleep-wake cycle, rest-activity abnormalities and hormonal secretion, whilst literature about other circadian rhythms was scanty. Altered biological rhythms presented higher association with specific psychopathological features, but such relationship was assessed in few studies. CONCLUSIONS: Circadian rhythms disruptions were confirmed to be relevant aspects in the context of eating disorders. Further research is needed in order to clarify the role of biological rhythms in such illnesses, in the attempt to address adjunctive treatment strategies with the possible focus of circadian abnormalities.


Assuntos
Transtornos Cronobiológicos/complicações , Transtornos Cronobiológicos/fisiopatologia , Ritmo Circadiano , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Transtornos da Alimentação e da Ingestão de Alimentos/fisiopatologia , Anorexia Nervosa/complicações , Anorexia Nervosa/fisiopatologia , Transtorno da Compulsão Alimentar/complicações , Transtorno da Compulsão Alimentar/fisiopatologia , Bulimia Nervosa/complicações , Bulimia Nervosa/fisiopatologia , Humanos , Psicopatologia
7.
Int J Clin Pract ; 73(11): e13401, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31397950

RESUMO

OBJECTIVE: While physical activity (PA) is known to have positive effects on psychological and physical health, little is understood about the association between non-compensatory PA (ie, not compulsive or intended to control weight or shape) and psychopathology among individuals with eating-disorder features. The present study explored associations between non-compensatory PA and psychopathology among adults categorised with bulimia nervosa (BN) and binge-eating disorder (BED). We further explored the association between compensatory PA and psychopathology among those who engaged in that form of "purging." METHOD: Participants were recruited through Mechanical Turk, an online recruitment platform. Individuals categorised with core features of BED (N = 138) and BN (N = 138) completed measures of eating-disorder psychopathology (Eating Disorder Examination - Questionnaire [EDE-Q] and Questionnaire on Eating and Weight Patterns - 5), depression (Patient Health Questionnaire - 2) and PA (both non-compensatory and compensatory, measured using the EDE-Q and Godin Leisure-Time Exercise Questionnaire). RESULTS: Engagement in non-compensatory PA was associated with lower frequency of binge-eating episodes, lower overvaluation of shape/weight and lower dissatisfaction with shape/weight (Ps < .05). Engagement in compensatory PA was related to greater frequency of binge-eating episodes and greater restraint (Ps < .05). DISCUSSION: Non-compensatory PA was associated with lower eating-disorder psychopathology. This suggests that PA is an important, though understudied, health behaviour among persons with features of BED and BN. Future research should examine the potential role of non-compensatory PA in interventions for individuals with core features of these eating disorders.


Assuntos
Transtorno da Compulsão Alimentar/psicologia , Bulimia Nervosa/psicologia , Exercício Físico/psicologia , Comportamento Alimentar/psicologia , Adulto , Transtorno da Compulsão Alimentar/fisiopatologia , Peso Corporal , Bulimia/diagnóstico , Bulimia Nervosa/fisiopatologia , Depressão/psicologia , Feminino , Humanos , Masculino , Inquéritos e Questionários
8.
Nutrients ; 11(9)2019 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-31450770

RESUMO

Alterations of the immune system are known in eating disorders (EDs), however the importance of cytokine balance in this context has not been clarified. We compared cytokines and growth factors at opposite ends of BMI ranges, in 90 patients classified in relation to BMI, depressive and EDs comorbidities. Serum concentrations of interleukin (IL)-1α, IL-1ß, IL-2, IL-4, IL-6, IL-8, IL-10, interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), monocyte chemoattractant protein-1 (MCP-1), vascular endothelial growth factor (VEGF), and epidermal growth factor (EGF) were determined by a biochip analyzer (Randox Labs). Differences were calculated through ANOVA. Possible predictors of higher cytokine levels were evaluated through regression analysis. IL-1α, IL-10, EGF, and IFN-γ were altered individuals with anorexia nervosa (AN) and binge eating disorder (BED). Night-eating was associated with IL-8 and EGF levels, IL-10 concentrations with post-dinner eating and negatively with sweet-eating, long fasting with higher IFN-γ levels. IL-2 increase was not linked to EDs, but to the interaction of depression and BMI. Altogether, for the first time, IL-1α, IL-10, EGF, and IFN-γ were shown to differ between AN and HCs, and between AN and individuals with obesity with or without BED. Only IL-2 was influenced by depression. Dysfunctional eating behaviors predicted abnormal concentrations of IL-10, EGF, IL-8 and IFN-γ.


Assuntos
Índice de Massa Corporal , Encéfalo/metabolismo , Citocinas/sangue , Comportamento Alimentar , Transtornos da Alimentação e da Ingestão de Alimentos/sangue , Peptídeos e Proteínas de Sinalização Intercelular/sangue , Ganho de Peso , Perda de Peso , Adolescente , Adulto , Anorexia Nervosa/sangue , Anorexia Nervosa/imunologia , Anorexia Nervosa/fisiopatologia , Anorexia Nervosa/psicologia , Transtorno da Compulsão Alimentar/sangue , Transtorno da Compulsão Alimentar/imunologia , Transtorno da Compulsão Alimentar/fisiopatologia , Transtorno da Compulsão Alimentar/psicologia , Biomarcadores/sangue , Encéfalo/imunologia , Encéfalo/fisiopatologia , Estudos de Casos e Controles , Citocinas/imunologia , Transtornos da Alimentação e da Ingestão de Alimentos/imunologia , Transtornos da Alimentação e da Ingestão de Alimentos/fisiopatologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome do Comer Noturno/sangue , Síndrome do Comer Noturno/imunologia , Síndrome do Comer Noturno/fisiopatologia , Síndrome do Comer Noturno/psicologia , Fatores de Tempo , Adulto Jovem
9.
J Neuroendocrinol ; 31(8): e12771, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31283053

RESUMO

Previous theoretical models of bulimia nervosa (BN) and binge eating disorder (BED) have implicated cross-domain risk-taking behaviour as a significant maintenance factor in both disorders. The present study aimed to test this hypothesis by administering the Balloon Analogue Risk Task (BART) to 25 women with BN or BED and 27 healthy comparison women without a history of an eating disorder. Furthermore, we tested the effect of a divided dose of 64 IU of oxytocin on risk-taking behaviour in the BART. Contrary to our hypothesis, women with BN or BED did not exhibit baseline differences in performance on the BART in the placebo condition (t = 1.42, df = 50, P = 0.161, d = 0.39). Oxytocin did not have a main effect on performance in the BART (F = 0.01, df = 1, P = .907, η2 partial  < 0.001); however, there was an interaction, such that participants in the BN/BED participant group, compared to the healthy comparison group, demonstrated safer behaviour on the BART in the oxytocin condition, but not in the placebo condition (F = 4.29, df = 1, P = 0.044, η2 partial  = 0.082). These findings cast doubt on the common assumption that individuals with BN and BED exhibit greater risk-taking behaviour in all domains and add to the evidence that oxytocin plays a functional role in modulating behaviours that entail trade-offs between reward approach and risk in humans. We recommend that future dose-response studies investigate the effect of oxytocin on reward approach behaviour further in women with recurrent binge eating behaviour, as well as the clinical significance of this effect.


Assuntos
Transtorno da Compulsão Alimentar/psicologia , Bulimia Nervosa/psicologia , Ocitocina/farmacologia , Assunção de Riscos , Administração Intranasal , Adulto , Transtorno da Compulsão Alimentar/patologia , Transtorno da Compulsão Alimentar/fisiopatologia , Encéfalo/efeitos dos fármacos , Bulimia Nervosa/patologia , Bulimia Nervosa/fisiopatologia , Estudos Cross-Over , Método Duplo-Cego , Emoções/efeitos dos fármacos , Feminino , Humanos , Imagem por Ressonância Magnética , Ocitocina/administração & dosagem , Testes Psicológicos , Recompensa , Adulto Jovem
10.
Mol Cell Endocrinol ; 497: 110508, 2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31319096

RESUMO

In an obesity pandemic context, eating disorders (ED) have arisen as serious illnesses associated with severe disturbances and has a clear gender dependent bias. In this manuscript, we provide an overview of the oestrogen role in the homeostatic and hedonic control of food intake. We draw attention to the role of oestrogens in the various reward processes and their possible implication in the development of ED, a condition much more common in women. In here, we have summarized the most relevant studies conducted in animal models over the last few years. In particular, we want to emphasize on the importance of continuing thorough investigations in female animal models. We believe that understanding the molecular mechanisms that regulate gender differences in food intake may provide new potential targets for ED treatment.


Assuntos
Transtorno da Compulsão Alimentar/fisiopatologia , Comportamento Alimentar/fisiologia , Homeostase , Filosofia , Caracteres Sexuais , Metabolismo Energético , Feminino , Humanos , Masculino
11.
Expert Rev Neurother ; 19(9): 867-879, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31269819

RESUMO

Introduction: Clinical and genetic study of psychiatric conditions has underscored the co-occurrence of complex phenotypes and the need to refine them. Bipolar Disorder (BD) and Binge Eating (BE) behavior are common psychiatric conditions that have high heritability and high co-occurrence, such that at least one quarter of BD patients have BE (BD + BE). Genetic studies of BD alone and of BE alone suggest complex polygenic risk models, with many genetic risk loci yet to be identified. Areas covered: We review studies of the epidemiology of BD+BE, its clinical features (cognitive traits, psychiatric comorbidity, and role of obesity), genomic studies (of BD, eating disorders (ED) defined by BE, and BD + BE), and therapeutic implications of BD + BE. Expert opinion: Subphenotyping of complex psychiatric disorders reduces heterogeneity and increases statistical power and effect size; thus, it enhances our capacity to find missing genetic (and other) risk factors. BD + BE has a severe clinical picture and genetic studies suggests a distinct genetic architecture. Differential therapeutic interventions may be needed for patients with BD + BE compared with BD patients without BE. Recognizing the BD + BE subphenotype is an example of moving towards more precise clinical and genetic entities.


Assuntos
Transtorno da Compulsão Alimentar , Transtorno Bipolar , Comorbidade , Transtorno da Compulsão Alimentar/epidemiologia , Transtorno da Compulsão Alimentar/genética , Transtorno da Compulsão Alimentar/fisiopatologia , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/genética , Transtorno Bipolar/fisiopatologia , Humanos
12.
J Psychopharmacol ; 33(12): 1550-1561, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31161847

RESUMO

BACKGROUND: Pharmacological treatment approaches for eating disorders, such as binge eating disorder and bulimia nervosa, are currently limited. METHODS AND AIMS: Using a well-characterized animal model of binge eating, we investigated the epigenetic regulation of the A2A Adenosine Receptor (A2AAR) and dopaminergic D2 receptor (D2R) genes. RESULTS: Gene expression analysis revealed a selective increase of both receptor mRNAs in the amygdaloid complex of stressed and restricted rats, which exhibited binge-like eating, when compared to non-stressed and non-restricted rats. Consistently, pyrosequencing analysis revealed a significant reduction of the percentage of DNA methylation but only at the A2AAR promoter region in rats showing binge-like behaviour compared to the control animals. Focusing thus on A2AAR agonist (VT 7) administration (which inhibited the episode of binge systemically at 0.1 mg/kg or intra-central amygdala (CeA) injection at 900 ng/side) induced a significant increase of A2AAR mRNA levels in restricted and stressed rats when compared to the control group. In addition, we observed a significant decrease in A2AAR mRNA levels in rats treated with the A2AAR antagonist (ANR 94) at 1 mg/kg. Consistent changes in the DNA methylation status of the A2AAR promoter were found in restricted and stressed rats after administration of VT 7 or ANR 94. CONCLUSION: We confirm the role of A2AAR in binge eating behaviours, and we underline the importance of epigenetic regulation of the A2AAR gene, possibly due to a compensatory mechanism to counteract the effect of binge eating. We suggest that A2AAR activation, inducing receptor gene up-regulation, could be relevant to reduction of food consumption.


Assuntos
Transtorno da Compulsão Alimentar/genética , Bulimia/genética , Receptor A2A de Adenosina/genética , Receptores de Dopamina D2/genética , Adenina/análogos & derivados , Adenina/farmacologia , Tonsila do Cerebelo/metabolismo , Animais , Transtorno da Compulsão Alimentar/fisiopatologia , Metilação de DNA/genética , Modelos Animais de Doenças , Epigênese Genética , Feminino , Regulação da Expressão Gênica , RNA Mensageiro/metabolismo , Ratos , Ratos Sprague-Dawley
13.
J Psychiatr Res ; 115: 61-68, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31121393

RESUMO

Retrospective and experimental data demonstrate the importance of emotion regulation (ER) in the maintenance of binge episodes in binge eating disorder (BED). The current study tested whether mood and ER prospectively influence binge episodes in individuals with BED via ecological momentary assessment (EMA). Individuals with BED (n = 79) completed two weeks of EMA. Each sampling point consisted of a series of questions pertaining to participants' mood, ER, and eating behaviour. Successful application of adaptive ER strategies predicted subsequent abstinence, while rumination predicted subsequent binge episodes. However, neither successful application of adaptive ER, nor maladaptive ER, moderated the association between negative mood and probability of binge episodes. This naturalistic study emphasizes the importance of promoting the successful application of adaptive ER skills and cessation of rumination in treatment interventions designed to decrease the occurrence of binge episodes in BED.


Assuntos
Adaptação Psicológica/fisiologia , Afeto/fisiologia , Transtorno da Compulsão Alimentar/fisiopatologia , Bulimia/fisiopatologia , Regulação Emocional/fisiologia , Ruminação Cognitiva/fisiologia , Adulto , Idoso , Avaliação Momentânea Ecológica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
15.
Artigo em Inglês | MEDLINE | ID: mdl-30846367

RESUMO

BACKGROUND: Bulimia nervosa (BN) is associated with functional abnormalities in frontostriatal and frontolimbic circuits. Although structural alterations in the frontal portions of these circuits have been observed, this is the first study of subcortical surface morphometry and the largest study of subcortical volume in BN. METHODS: Anatomical magnetic resonance scans were acquired from 62 female participants with full and subthreshold BN (mean age ± SD, 18.7 ± 4.0 years) and 65 group-matched healthy control participants (mean age ± SD, 19.3 ± 5.7 years). General linear models were used to compare groups and assess the significance of group-by-age interactions on the shape and total volume of 15 subcortical structures (p < .05, familywise error corrected). Associations with illness severity and duration were assessed in the BN group. RESULTS: Subcortical volumes did not differ across groups, but vertexwise analyses revealed inward shape deformations on the anterior surface of the pallidum in BN relative to control participants that were associated with binge-eating frequency and illness duration. Inward deformations on the ventrolateral thalamus and dorsal amygdala were more pronounced with advancing age in the BN group, and inward deformations on the caudate, putamen, and amygdala were associated with self-induced vomiting frequency. CONCLUSIONS: Our findings point to localized deformations on the surface of subcortical structures in areas that comprise both reward and cognitive control circuits. These deformations were more pronounced among older BN participants and among those with the most severe symptoms. Such precise localization of alterations in subcortical morphometry may ultimately aid in efforts to identify markers of risk and BN persistence.


Assuntos
Tonsila do Cerebelo/patologia , Gânglios da Base/patologia , Transtorno da Compulsão Alimentar/patologia , Bulimia Nervosa/patologia , Tálamo/patologia , Adolescente , Adulto , Tonsila do Cerebelo/diagnóstico por imagem , Gânglios da Base/diagnóstico por imagem , Transtorno da Compulsão Alimentar/diagnóstico por imagem , Transtorno da Compulsão Alimentar/fisiopatologia , Bulimia Nervosa/diagnóstico por imagem , Bulimia Nervosa/fisiopatologia , Feminino , Humanos , Imagem por Ressonância Magnética , Tálamo/diagnóstico por imagem , Adulto Jovem
16.
Psychiatry Res Neuroimaging ; 286: 53-59, 2019 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-30903953

RESUMO

We examined the effects of lisdexamfetamine (LDX) treatment on ventral prefrontal cortex (VPFC) and striatal brain activation in binge eating disorder (BED). We hypothesized that participants with BED have an abnormal brain response to palatable food cues, and that VPFC and striatal regions would respond to such cues after LDX treatment. Twenty women with moderate to severe BED consented to a 12-week, open-label trial of LDX with fMRI before and after treatment. Twenty obese women without BED served as healthy controls and received one fMRI. LDX was started at 30 mg/d with a target of 70 mg/d at week 12. At baseline, women with BED showed greater activation in ventrolateral prefrontal cortex (VLPFC), striatum, and globus pallidus to food pictures and brain activation to food pictures predicted clinical outcome at 12 weeks. After 12 weeks of LDX treatment, BED women showed significant reductions in globus pallidus activation. Reductions in ventromedial prefrontal cortex (VMPFC) and thalamus activation specifically correlated with binge eating and obsessive-compulsive symptom reductions, respectively. Results suggest that BED is characterized by an abnormally large VPFC-subcortical brain response to palatable foods that LDX treatment helps modify. Moreover, VPFC-subcortical activation at baseline is a potential biomarker of LDX response.


Assuntos
Transtorno da Compulsão Alimentar/tratamento farmacológico , Encéfalo/efeitos dos fármacos , Inibidores da Captação de Dopamina/uso terapêutico , Dimesilato de Lisdexanfetamina/uso terapêutico , Rede Nervosa/efeitos dos fármacos , Obesidade/tratamento farmacológico , Adulto , Transtorno da Compulsão Alimentar/diagnóstico por imagem , Transtorno da Compulsão Alimentar/fisiopatologia , Encéfalo/diagnóstico por imagem , Encéfalo/fisiologia , Corpo Estriado/diagnóstico por imagem , Corpo Estriado/efeitos dos fármacos , Corpo Estriado/fisiologia , Inibidores da Captação de Dopamina/farmacologia , Feminino , Humanos , Dimesilato de Lisdexanfetamina/farmacologia , Pessoa de Meia-Idade , Rede Nervosa/diagnóstico por imagem , Rede Nervosa/fisiologia , Obesidade/diagnóstico por imagem , Obesidade/fisiopatologia , Projetos Piloto , Córtex Pré-Frontal/diagnóstico por imagem , Córtex Pré-Frontal/efeitos dos fármacos , Córtex Pré-Frontal/fisiologia , Resultado do Tratamento
17.
Psychiatry Res ; 274: 138-145, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30784782

RESUMO

Executive functions are a set of cognitive processes that are necessary for the cognitive control of behavior. They play a role in mediating self-control, self-regulation and decision-making. It has been suggested that the inability to control eating behavior in binge eating disorder (BED) may indicate deficits in executive functioning. This may be worsened by depressive symptoms. The aim of the present study was to compare executive functioning of patients with BED and no-to-mild depressive symptoms (n = 25), patients with BED and moderate-to-severe depressive symptoms (n = 66), and healthy controls (Body Mass Index <30) (n = 56), matched on age, educational level and gender. The participants were assessed by means of neuropsychological tests and questionnaires. The neuropsychological tests did not show significant differences in executive functioning between the groups. However, eating disorder psychopathology and depressive symptoms are associated with self-reported difficulties in executive functioning in daily life. A self-report questionnaire which evaluates the functional, real-world impact of executive dysfunction expressed in everyday activities seems to be more useful in this population than neuropsychological tests. This study highlights the importance of taking depressive symptoms into account when studying executive functioning in patients with (binge) eating disorders.


Assuntos
Transtorno da Compulsão Alimentar/fisiopatologia , Disfunção Cognitiva/fisiopatologia , Depressão/fisiopatologia , Transtorno Depressivo/fisiopatologia , Função Executiva/fisiologia , Adulto , Transtorno da Compulsão Alimentar/epidemiologia , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/etiologia , Comorbidade , Depressão/complicações , Depressão/epidemiologia , Transtorno Depressivo/complicações , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade
18.
Brain Behav ; 9(2): e01207, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30644179

RESUMO

INTRODUCTION: The etiology of bulimic-type eating (BTE) disorders such as binge eating disorder (BED) and bulimia nervosa (BN) is still largely unknown. Brain networks subserving the processing of rewards, emotions, and cognitive control seem to play a crucial role in the development and maintenance of eating disorders. Therefore, further investigations into the neurobiological underpinnings are needed to discern abnormal connectivity patterns in BTE disorders. METHODS: The present study aimed to investigate functional as well as seed-based connectivity within well-defined brain networks. Twenty-seven individuals with BED, 29 individuals with BN, 28 overweight, and 30 normal-weight control participants matched by age, gender, and education underwent resting-state functional magnetic resonance imaging. Functional connectivity was assessed by spatial group independent component analysis and a seed-based correlation approach by examining the default mode network (DMN), salience network (SN), and executive network (EN). RESULTS: Group comparisons revealed that BTE disorder patients exhibit aberrant functional connectivity in the dorsal anterior cingulate cortex (dACC) within the SN, as well as in the medial prefrontal cortex within the DMN. Furthermore, BED and BN groups differed from each other in functional connectivity within each network. Seed-based correlational analysis revealed stronger synchronous dACC-retrosplenial cortex activity in the BN group. CONCLUSION: Our findings demonstrate abnormalities in brain networks involved in salience attribution, self-referential processing, and cognitive control in bulimic-type eating disorders. Together with our observation of functional connectivity differences between BED and BN, this study offers a differentiated account of both similarities and differences regarding brain connectivity in BED and BN.


Assuntos
Conectoma/métodos , Giro do Cíngulo/fisiopatologia , Imagem por Ressonância Magnética/métodos , Córtex Pré-Frontal/fisiopatologia , Adulto , Transtorno da Compulsão Alimentar/fisiopatologia , Transtorno da Compulsão Alimentar/psicologia , Bulimia Nervosa/fisiopatologia , Bulimia Nervosa/psicologia , Emoções , Feminino , Humanos , Masculino , Recompensa , Autocontrole
19.
Eur Eat Disord Rev ; 27(2): 124-136, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30358028

RESUMO

To provide a basis for electroencephalography (EEG) neurofeedback protocols for bulimia nervosa (BN), binge-eating disorder (BED), and obesity, this systematic review investigates alterations in EEG-measured brain activity, specifically frequency bands. A systematic literature search with predefined search terms yielded N = 7 studies meeting the inclusion criteria. The risk of bias was assessed for all studies. In resting-state EEG, the beta activity was elevated in fronto-central regions in individuals with obesity and co-morbid BED. In food-cue conditions, both obese individuals with and without BED showed increased beta activity, suggesting increased awareness of food cues and a heightened attentional focus towards food stimuli. The level of beta activity was positively correlated with eating disorder psychopathology in resting and food-cue conditions. In individuals with BN, there was no evidence for altered EEG spectral power. The results indicate specific alterations in EEG-based brain activity in individuals with BED and obesity. More high-quality studies are needed to further confirm these findings and to transfer them into EEG-based interventions.


Assuntos
Transtorno da Compulsão Alimentar/fisiopatologia , Bulimia Nervosa/fisiopatologia , Obesidade/fisiopatologia , Eletroencefalografia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
20.
Psychol Psychother ; 92(3): 422-438, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-30003688

RESUMO

OBJECTIVES: The purpose of this study was to determine whether mood instability in people with anxiety disorders contributes to trait impulsivity, non-suicidal self-injury, and binge eating/purging. METHODS: Data were analysed from a general population sample of 7,221 adults (Mage  = 51.0 years; 56.9% female). Logistic regression analyses with effect decompositions were used to establish the associations of five anxiety disorders (generalized anxiety disorder, social phobia, panic disorder, agoraphobia, and obsessive-compulsive disorder) with impulsivity, non-suicidal self-injury, and binge eating/purging, and then to determine the extent that adding mood instability to each model reduced these relationships. RESULTS: Participants with an anxiety disorder were more likely to report impulsivity compared to participants without an anxiety disorder (ORs = 2.40-3.92, all p < .001), but these relationships reduced by 59-78% and became non-significant when mood instability was added to the models. Participants with an anxiety disorder were also more likely to report non-suicidal self-injury (ORs = 3.86-18.9, all p < .001) and binge eating/purging (ORs = 4.05-14.9, all p < .01); adding mood instability to the models reduced these relationships by at least 30%. CONCLUSIONS: Mood instability and impulsivity are common in people with anxiety disorders. Anxiety disorders are associated with impulsivity largely because of the association between mood instability and impulsivity. Mood instability may contribute to non-suicidal self-injury and binge eating/purging in people with anxiety disorders. Treatments for mood instability in addition to standard anxiety disorder treatment may reduce impulsivity, non-suicidal self-injury, and binge eating/purging in people with anxiety disorders. PRACTITIONER POINTS: Many patients with anxiety disorders experience mood instability, which is associated with impulsivity, non-suicidal self-injury, and binge eating/purging. Treating mood instability alongside anxiety may help reduce impulsivity, non-suicidal self-injury, and binge eating/purging in people with anxiety disorders.


Assuntos
Sintomas Afetivos/fisiopatologia , Transtornos de Ansiedade/fisiopatologia , Transtorno da Compulsão Alimentar/fisiopatologia , Comportamento Impulsivo/fisiologia , Comportamento Autodestrutivo/fisiopatologia , Adulto , Sintomas Afetivos/epidemiologia , Idoso , Transtornos de Ansiedade/epidemiologia , Transtorno da Compulsão Alimentar/epidemiologia , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Comportamento Autodestrutivo/epidemiologia , Adulto Jovem
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