Serotonin transporter binding after recovery from bulimia nervosa

Abstract

Objective Physiological and pharmacological studies indicate that altered brain serotonin (5-HT) activity could contribute to a susceptibility to develop appetitive and behavioural alterations that are characteristic of bulimia nervosa (BN). Methods Eight individuals recovered from BN (REC BN) and eight healthy control women were scanned with [11C]DASB and positron emission tomography imaging of the 5-HT transporter (5-HTT). Logan graphical analysis was applied and parametric binding potential (BPnon displaceable (ND)) images were generated. Voxel-by-voxel t-tests and a region of interest (ROI) analysis were conducted. Results REC BN had significantly lower [11C]DASB BPND in midbrain, superior and inferior cingulate and significantly higher [11C]DASB BPND in anterior cingulate and superior temporal gyrus in the voxel based analysis. ROI analysis indicated lower [11C]DASB BPND in midbrain (p=.07), containing the dorsal raphe, in REC BN, consistent with our earlier studies. Discussion These preliminary findings of a small scale study confirm and extend previous data suggesting that ill and recovered BN have altered 5-HTT measures, which potentially contribute to BN symptomology and/or differential responses to medication.

Interaction between serotonin transporter and dopamine D2/D3 receptor radioligand measures is associated with harm avoidant symptoms in anorexia and bulimia nervosa

“…However, neither group was statistically different from healthy CW. In contrast, [ 11 C]McN5652 BP ND was normal in REC BN (n = 9), whereas other imaging and peripheral platelet studies have found evidence of reduced 5-HTT in ill and REC BN individuals (Kuikka et al 2001, Steiger et al 2005, Tauscher et al 2001), including a recent study from our group, using [ 11 C]DASB, a more specific radioligand for the 5-HTT (Pichika et al 2012). …”

Wide impairment of cerebral serotoninergic activity but inter-individual heterogeneity in bulimia nervosa patients: a pilot [18F]MPPF/PET study

“…Raphe nuclei also presented with increased ROI [ 18 F]MPPF binding in BN patients, suggesting a decreased 5-HT 1A activity of this brain stem structure with a crucial role in brain serotonin innervations. Decreased serotonin transporter availability in raphe nuclei was also reported in recovered BN patients (Bailer et al 2007a;Pichika et al 2012). Since the SSRIs administration modulate [ 18 F] MPPF binding in dorsal raphe nucleus (Sibon et al 2008), [ 18 F]MPPF/PET imaging could bring new elements in the assessment of BN patients responsiveness to SSRIs treatment.…”

“…On the other side, limbic cortex including parahippocampal/hippocampus cortex or cingulate gyrus/medial frontal cortex also presented with increased [ 18 F] MPPF binding in our group of BN patients. Lately, serotonin transporter dysfunction and high 5-HT 1A availability were also described in inter-hemispheric cortex including subgenual or anterior cingulate cortex of recovered BN patients (Bailer et al 2011;Pichika et al 2012). All these corroborated data underline the role of frontolimbic pathways in BN physiopathology (Phillips et al 2003).…”

Current status of functional imaging in eating disorders

“…Recent pilot data from our own group in recovered BN also suggest reduced 5-HTT availability in various cortical and subcortical brain regions. 92 A SPECT study compared 5-HTT availability in the midbrain and thalamus in 13 female twins with BN (9 with purging and 4 with non-purging) versus 25 CW using a different radiologand for 5-HTT, [123I]ADAM 93 . They found that purging-type BN had increased midbrain [123I]ADAM binding compared to CW, supporting a 5-HT-based distinction between those with purging and non-purging behaviors, across both studies.…”