Neural response to catecholamine depletion in remitted bulimia nervosa: Relation to depression and relapse.
Bulimia nervosa has been associated with a dysregulated catecholamine system. Nevertheless, the influence of this dysregulation on bulimic symptoms, on neural activity, and on the course of the illness is not clear yet. An instructive paradigm for directly investigating the relationship between catecholaminergic functioning and bulimia nervosa has involved the behavioral and neural responses to experimental catecholamine depletion. The purpose of this study was to examine the neural substrate of catecholaminergic dysfunction in bulimia nervosa and its relationship to relapse. In a randomized, double-blind and crossover study design, catecholamine depletion was achieved by using the oral administration of alpha-methyl-paratyrosine (AMPT) over 24 h in 18 remitted bulimic (rBN) and 22 healthy (HC) female participants. Cerebral blood flow (CBF) was measured using a pseudo continuous arterial spin labeling (pCASL) sequence. In a follow-up telephone interview, bulimic relapse was assessed. Following AMPT, rBN participants revealed an increased vigor reduction and CBF decreases in the pallidum and posterior midcingulate cortex (pMCC) relative to HC participants showing no CBF changes in these regions. These results indicated that the pallidum and the pMCC are the functional neural correlates of the dysregulated catecholamine system in bulimia nervosa. Bulimic relapse was associated with increased depressive symptoms and CBF reduction in the hippocampus/parahippocampal gyrus following catecholamine depletion. AMPT-induced increased CBF in this region predicted staying in remission. These findings demonstrated the importance of depressive symptoms and the stress system in the course of bulimia nervosa.
['Mueller|Stefanie Verena|SV|', 'Mihov|Yoan|Y|', 'Federspiel|Andrea|A|', 'Wiest|Roland|R|', 'Hasler|Gregor|G|']
D000328:Adult D001921:Brain D052018:Bulimia Nervosa D002395:Catecholamines D018592:Cross-Over Studies D003863:Depression D004311:Double-Blind Method D005260:Female D005500:Follow-Up Studies D006801:Humans D008875:Middle Aged D012008:Recurrence D012074:Remission Induction D055815:Young Adult
Catecholamine depletion Bulimia nervosa Relapse Alpha-methyl-paratyrosine Cerebral blood flow Arterial spin labeling