gms | German Medical Science

4. Wissenschaftlicher Kongress der Deutschen Gesellschaft für Essstörungen e. V. (DGESS)

Deutsche Gesellschaft für Essstörungen e. V.

20.03. - 22.03.2014, Leipzig

Dopaminergic activity and altered reward modulation in adult individuals recovered from anorexia nervosa

Meeting Abstract

  • corresponding author presenting/speaker Ursula F. Bailer - University of California San Diego, Department of Psychiatry, La Jolla, California, United States; Medical University of Vienna, Department of Psychiatry and Psychotherapy, Division of Biological Psychiatry, Vienna, Austria
  • Julie C. Price - University of Pittsburgh, School of Medicine, Department of Radiology, Presbyterian University Hospital, Pittsburgh, Pennsylvania, United States
  • Carolyn C. Meltzer - Emory School of Medicine, Departments of Radiology, Neurology, and Psychiatry and Behavioral Sciences, Atlanta, Georgia, United States; Adjunct Professor of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
  • Angela Wagner - University of California San Diego, Department of Psychiatry, La Jolla, California, United States
  • Chester A. Mathis - University of Pittsburgh, School of Medicine, Department of Radiology, Presbyterian University Hospital, Pittsburgh, Pennsylvania, United States
  • Walter H. Kaye - University of California San Diego, Department of Psychiatry, La Jolla, California, United States

Deutsche Gesellschaft für Essstörungen e.V. (DGESS). 4. Wissenschaftlicher Kongress der Deutschen Gesellschaft für Essstörungen. Leipzig, 20.-22.03.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. Doc14dgess035

doi: 10.3205/14dgess035, urn:nbn:de:0183-14dgess0358

Veröffentlicht: 17. März 2014

© 2014 Bailer et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background: Several lines of evidence suggest that individuals with anorexia nervosa (AN) have altered striatal dopamine (DA) function. Using the radioligand [11C]raclopride and positron emission tomography (PET), we have recently found that individuals recovered (REC) from AN (REC AN) have increased binding of DA D2/D3 receptors at baseline in the anterior ventral striatum (AVS) relative to control women (CW) (Frank, 2005; Bailer, 2013). Moreover, [11C]raclopride BPNon-displaceable(ND) in the dorsal caudate was associated with harm avoidance, a measure of anxiety, in REC AN (Frank, 2005; Bailer, 2013). DA disturbances in AN may contribute to an altered modulation of appetitive behaviors. Animal studies indicate that DA in the striatum plays a key role in the optimal response to reward stimuli. To further understand striatal DA pathways and the relationship to reward, our group performed a fMRI study using a monetary choice task known to activate the striatum. REC AN (Wagner, 2007) failed to have a differential AVS response to positive and negative monetary feedback compared to CW. However, REC AN showed greater hemodynamic activation in the caudate than CW. Only REC AN showed a significant positive relationship between trait anxiety and the percentage change in hemodynamic signal in the caudate during either wins (r = .56, p = .04) or losses (r = .73, p = .005). Do such correlations imply that PET [11C]raclopride BPND might be related to the BOLD response to monetary choice in the dorsal caudate of REC AN?

Methods: We have done a post-hoc analysis of our PET and fMRI data and correlated baseline [11C]raclopride BPND and BOLD signal in twelve REC AN (age 27 ± 7, BMI 20.3 ± 2) who participated in both the fMRI study using the monetary choice task and the [11C]raclopride PET study.

Results: REC AN showed a positive relationship between [11C]raclopride BPND in the middle caudate and the BOLD signal in the dorsal caudate in response to losses (r = .71, p = .01) or wins (r = .64, p = .03), but not for the AVS (losses r = .32, ns; wins r = - .019, ns). Trait anxiety showed a positive relationship with [11C]raclopride BPND in the middle caudate (r=0.70; p = .01) and AVS (r=.75; 0.01)

Discussion: These findings show that in REC AN, DA D2/D3 receptor binding in the middle caudate was positively associated with the BOLD response in the dorsal caudate to both wins and losses in a monetary choice task, whereas no such associations were found in the AVS. These data are consistent with other imaging data showing that measures of DA metabolism tend to be associated with AVS activation in CW, and dorsal caudate activation in AN. It is well known that AN have exaggerated inhibition and anxiety, and are insensitive to reward. It may be that AN have an imbalance between ventral limbic and dorsal executive processes. Perhaps ventral limbic-striatal circuitry may be inhibited by “hyperactive” inputs from dorsal executive processes (Kaye, 2013), a theory supported by recent animal studies showing that dorsal caudate D2 receptor function plays a key role in risk avoidance and inhibition. Moreover, our recent study (Bailer 2011) supports the possibility that food-induced DA release in the dorsal caudate stimulates anxiety in AN. From a clinical perspective, it is very difficult to find “rewards” that AN individuals value more than food restriction, and AN individuals may in fact find that food refusal to be an effective means of diminishing anxiety. Thus, these insights may be of value in developing an effective treatment for this devastating disorder.