Monteleone Palmiero
Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie, 80138 Naples, Italy.
Curr Top Behav Neurosci. 2011;6:189-208. doi: 10.1007/7854_2010_87.
Alterations of both central and peripheral feeding regulatory substances occur in the acute phases of anorexia nervosa (AN) and bulimia nervosa (BN) and, generally, reverse after recovery. Some of these alterations are believed not only to sustain the altered eating behavior but also to contribute to certain psychopathological aspects and/or etiopathogenetic processes of eating disorders (EDs). It has been suggested that EDs are clinical conditions linked to reward-related mechanisms leading to a kind of addiction to self-starvation and/or overeating. Most of the feeding regulatory substances, which are dysregulated in EDs, are also implicated in the modulation of reward, emotional, and cognitive functions, thus representing possible links between altered nutritional regulation, motivated behaviors and reward processes. In this chapter, the ED literature dealing with ghrelin, brain-derived neurotrophic factor, opioid peptides, and endocannabinoids, which have prominent effects on eating behavior, body weight, reward, emotional, and cognitive functions, is reviewed in view of the above suggested links. Moreover, the potential therapeutics of new medications developed on the basis of neuroendocrine aberrations found in EDs is also presented.
在神经性厌食症（AN）和神经性贪食症（BN）的急性期，中枢和外周进食调节物质都会发生改变，并且一般在康复后会恢复正常。其中一些改变不仅被认为维持了异常的进食行为，还促成了饮食失调（EDs）的某些精神病理学方面和/或病因发病过程。有人提出，饮食失调是与奖赏相关机制有关的临床病症，会导致对自我饥饿和/或暴饮暴食的某种成瘾。大多数在饮食失调中失调的进食调节物质，也参与奖赏、情绪和认知功能的调节，因此代表了营养调节改变、动机行为和奖赏过程之间的可能联系。鉴于上述联系，本章将综述有关胃饥饿素、脑源性神经营养因子、阿片肽和内源性大麻素的饮食失调文献，这些物质对进食行为、体重、奖赏、情绪和认知功能有显著影响。此外，还介绍了基于饮食失调中发现的神经内分泌异常开发的新药的潜在治疗方法。
