Wills Kristin E, Gosnell Savannah N, Curtis Kaylah N, Velasquez Kenia, Fowler J Christopher, Salas Ramiro
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA.
Eat Weight Disord. 2020 Oct;25(5):1475-1480. doi: 10.1007/s40519-019-00746-0. Epub 2019 Aug 2.
Despite anorexia nervosa having the highest mortality rate of mental illnesses, little is known regarding the brain mechanisms involved. Given that lack of interest for food in anorexic patients is related to alterations in the reward system, we tested the hypothesis that patients with past anorexia nervosa (pAN) have altered resting state functional connectivity (RSFC) between the habenula (a major component of the reward system) and its targets.
RSFC between the habenula and major targets (locus coeruleus, median and dorsal raphe nuclei, substantia nigra, and ventral tegmental area) was studied in 14 psychiatric inpatients with pAN and 14 psychiatric inpatient controls (PC, never-anorexic patients in same clinic, matched for comorbidities). Next, we tested possible correlations between RSFC and suicidal ideation, depression, and anxiety as determined by self-report questionnaires.
Left habenula/locus coeruleus RSFC was lower in pAN patients compared to PC. The left habenula/locus coeruleus RSFC was positively correlated with suicidal ideation (past 2 months) in pAN patients, but not in controls.
pAN patients showed long lasting alterations in habenular connectivity. This may have clinical implications, possibly including future evaluation of the habenula as a therapeutic target and the need to carefully monitor suicidality in pAN patients.
Basic science.
尽管神经性厌食症是死亡率最高的精神疾病，但人们对其涉及的脑机制知之甚少。鉴于厌食症患者对食物缺乏兴趣与奖赏系统的改变有关，我们检验了这样一个假设，即曾患神经性厌食症（pAN）的患者在缰核（奖赏系统的主要组成部分）与其靶点之间的静息态功能连接（RSFC）发生了改变。
对14名患有pAN的精神科住院患者和14名精神科住院对照者（PC，同一诊所中从未患过厌食症的患者，在合并症方面进行了匹配）研究了缰核与主要靶点（蓝斑、中缝核和背缝核、黑质以及腹侧被盖区）之间的RSFC。接下来，我们测试了RSFC与通过自我报告问卷确定的自杀意念、抑郁和焦虑之间可能存在的相关性。
与PC相比，pAN患者的左侧缰核/蓝斑RSFC较低。在pAN患者中，左侧缰核/蓝斑RSFC与自杀意念（过去2个月）呈正相关，但在对照组中并非如此。
pAN患者在缰核连接方面表现出长期改变。这可能具有临床意义，可能包括未来将缰核作为治疗靶点进行评估以及需要仔细监测pAN患者的自杀倾向。
基础科学。
