SEROTONIN FUNCTION IN PATIENTS WITH EATING DISORDERS

神经性暴食症是一种严重的精神障碍。 以有心理症状的异常饮食模式为特征的 牵涉到对体型和体重的关注。神经性暴食症 据估计，影响多达2%的女性(以及较少数量的 (男性)高中和大学年龄，这是风险最高的人群。 最近，人们也越来越多地意识到 暴饮暴食的流行伴随着相关的心理困扰， 在超重受试者中暂时被确认为暴饮暴食障碍 不会净化的人。神经生物学的改变可能会导致 与这些疾病的初始发病和/或症状的永久存在有关。 目前有很多人对这一假设很感兴趣，即受损的中枢 5-羟色胺功能与餐后饱腹感反应迟钝有关 在神经性贪食症患者身上。这一假设与 临床前研究证实下丘脑5-羟色胺的主要作用 在调节进食引起的饱腹感方面。减少的初步证据 一些正常体重神经性暴食症患者的5-羟色胺功能 来自药理学/神经内分泌挑战的研究 反应、脑脊液代谢物和药物治疗 学习。利用单盲、安慰剂对照的急性药理作用 挑战5-羟色胺激动剂芬氟拉明，这项研究将比较 目前有症状的女性神经性暴食症的神经内分泌反应 体重正常的患者，症状缓解的神经性贪食症患者， 在有暴饮暴食症状的超重患者中， 没有暴饮暴食行为的患者，年龄和性别匹配 控制。作为确定可能的机制的后续步骤 神经性贪食症的5-羟色胺突触失调，该项目将 还进行双盲、安慰剂对照的药理学挑战 女性患者应用选择性5-羟色胺-1A受体激动剂的研究 患有神经性暴食症和健康对照。临床变量，如 暴食症的持续时间和严重程度、体重和饮食 抑郁症状的类型、严重程度和月经变化 功能将被评估为5-羟色胺能改变的预测因子 响应性。这项研究将提供有关可能的作用的新数据 神经性贪食症的中枢5-羟色胺能改变 以及暂时确定的暴饮暴食障碍综合征。

The syndrome of bulimia nervosa is a serious psychiatric disorder characterized by abnormal eating patterns with psychological symptoms involving preoccupation with body shape and weight. Bulimia nervosa is estimated to affect up to two per cent of women (and a smaller number of men) of high school and college age, the population at highest risk. Recently there has also been increased awareness of the significant prevalence of binge eating with associated psychological distress, provisionally identified as binge eating disorder, in overweight subjects who do not purge. Neurobiological alterations may contribute to the initial onset and / or to the perpetuation of symptoms in these disorders. There is much current interest in the hypothesis that impaired central serotonin function contributes to blunted post-prandial satiety responses in patients with bulimia nervosa. This hypothesis is consistent with preclinical studies demonstrating a major role for hypothalamic serotonin in mediating meal-induced satiety. Preliminary evidence for reduced serotonin function in some normal weight bulimia nervosa patients has emerged from studies of pharmacological / neuroendocrine challenge responses, cerebrospinal fluid metabolites, and pharmacological treatment studies. Utilizing single-blind, placebo-controlled acute pharmacological challenge with the serotonin agonist fenfluramine, this study will compare neuroendocrine responses in currently Symptomatic female bulimia nervosa patients at normal weight, in symptom remitted bulimia nervosa patients, in overweight patients with binge eating symptomatology, in overweight patients free of binge eating behaviors, and in age- and sex-matched controls. As a follow-up step in identifying possible mechanisms of serotonin synaptic dysregulation in bulimia nervosa, this project will also conduct double-blind, placebo-controlled pharmacological challenge studies with a selective serotonin-1A receptor agonist in female patients with bulimia nervosa and healthy controls. Clinical variables such as duration and severity of bulimic symptoms, body weight and dietary pattern, severity of depressive symptoms, and alterations in menstrual function will be evaluated as predictors of altered serotonergic responsiveness. This study will provide new data on the possible role of central serotonergic alterations in the pathophysiology of bulimia nervosa and in the provisionally identified syndrome of binge eating disorder.