Lazzeri Gloria, Busceti Carla L, Polzella Alessandra, Frati Alessandro, Puglisi-Allegra Stefano, Fornai Francesco
Human Anatomy, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Roma 55, Pisa, 56100, PI, Italy.
Neuromed, IRCCS-Istituto di Ricovero e Cura a Carattere Scientifico, 86077, Pozzili, Italy.
J Neural Transm (Vienna). 2025 Apr;132(4):547-565. doi: 10.1007/s00702-025-02881-8. Epub 2025 Jan 24.
Anorexia nervosa (AN) represents an eating disorder, which features the highest rate of mortality among all psychiatric disorders. The disease prevalence is increasing steadily, and an effective cure is missing. The neurobiology of the disease is largely unknown, and only a few studies were designed to disclose specific brain areas, where altered neural transmission may occur. In AN behavioral alterations surpassing altered feeding are present, which often involve archaic behaviors finalized to the survival of the species. In fact, alterations of sleep and reward-driven behavior accompany the eating disorder, where a disruption of peripheral and central circadian rhythms occurs along with effortful behaviors, aberrant learning and mild cognitive impairment. Abnormal behavior often co-exists with a number of metabolic alterations in peripheral organs. The present article wishes to analyze the potential role of altered brain circuitry within the brainstem reticular formation during AN. In fact, this brain area contains neuronal nuclei and pathways, which are pivotal in connecting eating pattern with archaic behaviorsand autonomic activity within peripheral organs. A number of reticular nuclei releasing catecholamine and non-catecholamine neurotransmittersare evidenced in relationship with altered behavioral states and vegetative control to produce this psycho-metabolic disorder. The relevance of the reticular formation in sustaining the disorder is discussed in the light of developing effective therapeutic strategies.
神经性厌食症（AN）是一种饮食失调症，在所有精神疾病中死亡率最高。该疾病的患病率正在稳步上升，且尚无有效的治愈方法。这种疾病的神经生物学在很大程度上尚不清楚，仅有少数研究旨在揭示可能发生神经传递改变的特定脑区。在神经性厌食症中，存在超越进食改变的行为改变，这些改变通常涉及为物种生存而形成的古老行为。事实上，睡眠和奖励驱动行为的改变伴随着饮食失调，同时外周和中枢昼夜节律紊乱，伴有费力行为、异常学习和轻度认知障碍。异常行为往往与外周器官的一些代谢改变同时存在。本文旨在分析脑干网状结构内脑回路改变在神经性厌食症中的潜在作用。事实上，这个脑区包含神经核团和神经通路，它们在将进食模式与古老行为以及外周器官的自主活动联系起来方面起着关键作用。有证据表明，一些释放儿茶酚胺和非儿茶酚胺神经递质的网状核与行为状态改变和植物神经控制有关，从而导致这种心理 - 代谢紊乱。鉴于开发有效的治疗策略，本文讨论了网状结构在维持该疾病中的相关性。
