Anorexia nervosa as a motivated behavior: Relevance of anxiety, stress, fear and learning
Anorexia nervosa as a motivated behavior: Relevance of anxiety, stress, fear and learning
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DOI：
10.1016/j.physbeh.2015.04.007
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发表时间：
2015-12-01
影响因子：
2.9
通讯作者：
Moran, Timothy H.
中科院分区：
文献类型：
--
作者：
Guarda, Angela S.;Schreyer, Colleen C.;Moran, Timothy H.
神经性厌食症（AN）与焦虑症之间的高合并症是公认的。AN是一种动机性行为障碍，其中习惯的形成可能导致异常饮食和运动行为的持续存在。在食物和运动的奖励价值基础上，大脑回路的继发性改变，以及由饥饿和过度运动引起的神经内分泌饥饿和饱腹感信号的干扰，可能是基因脆弱个体维持厌食行为的原因。恐惧条件反射在促进AN发病中的潜在作用，或受损的恐惧消退在导致体重恢复后观察到的高复发率方面的潜在作用值得关注。来自动物焦虑模型和人类实验室研究的证据表明，低雌激素会损害恐惧消退。因此，AN中的低雌二醇水平可能在最近体重恢复的患者对食物和脂肪的持续恐惧中发挥作用。基于活动的厌食症（ABA）啮齿动物模型以及恐惧消退和条件反射的神经影像学研究等转化模型有助于阐明AN中食物回避行为的潜在分子机制和神经回路。此外，对焦虑障碍有效的新治疗干预措施的适应可能有助于这种损害障碍的新治疗方法的发展。(C) 2015出版的爱思唯尔公司。
The high comorbidity between anorexia nervosa (AN) and anxiety disorders is well recognized. AN is a motivated behavioral disorder in which habit formation is likely to contribute to the persistence of abnormal eating and exercise behaviors. Secondary alterations in brain circuitry underlying the reward value of food and exercise, along with disturbances in neuroendocrine hunger and satiety signaling arising from starvation and excessive exercise, are likely contributors to the maintenance of anorectic behaviors in genetically vulnerable individuals. The potential role of fear conditioning in facilitating onset of AN, or of impaired fear extinction in contributing to the high relapse rates observed following weight restoration, is of interest. Evidence from animal models of anxiety and human laboratory studies indicate that low estrogen impairs fear extinction. Low estradiol levels in AN may therefore play a role in perpetuating fear of food and fat in recently weight restored patients. Translational models including the activity based anorexia (ABA) rodent model of AN, and neuroimaging studies of fear extinction and conditioning, could help clarify the underlying molecular mechanisms and neurocircuitry involved in food avoidance behaviors in AN. Moreover, the adaptation of novel treatment interventions with efficacy in anxiety disorders may contribute to the development of new treatments for this impairing disorder. (C) 2015 Published by Elsevier Inc.