Elsevier

Biological Psychiatry

Volume 58, Issue 11, 1 December 2005, Pages 908-912
Biological Psychiatry

Original article
Increased Dopamine D2/D3 Receptor Binding After Recovery from Anorexia Nervosa Measured by Positron Emission Tomography and [11C]Raclopride

https://doi.org/10.1016/j.biopsych.2005.05.003Get rights and content

Background

Several lines of evidence support the possibility that disturbances of dopamine (DA) function could contribute to alterations of weight, feeding, motor activity, and reward in anorexia nervosa (AN).

Methods

To assess possibly trait-related disturbances but avoid confounding effects of malnutrition, 10 women who were recovered from AN (REC AN) were compared with 12 healthy control women (CW). Positron emission tomography with [11C]raclopride was used to assess DA D2/D3 receptor binding.

Results

The women who were recovered from AN had significantly higher [11C]raclopride binding potential in the antero-ventral striatum than CW. For REC AN, [11C]raclopride binding potential was positively related to harm avoidance in the dorsal caudate and dorsal putamen.

Conclusions

These data lend support for the possibility that decreased intrasynaptic DA concentration or increased D2/D3 receptor density or affinity is associated with AN and might contribute to the characteristic harm avoidance or increased physical activity found in AN. Most intriguing is the possibility that individuals with AN might have a DA related disturbance of reward mechanisms contributing to altered hedonics of feeding behavior and their ascetic, anhedonic temperament.

Section snippets

Methods and Materials

Ten subjects who were recovered from AN (3 pure restricting-type [AN-R], 1 restricting-purge-type [AN-P], and 6 binge-purge-type AN [AN-BP]) were compared with 12 CW. Subjects were previously treated in the eating disorders treatment program at the Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania, or were recruited through advertisements. To be considered “recovered,” for at least one year before the study, subjects had to 1) maintain a weight above 85% average body weight (

Results

Subject groups were of similar age (CW 27 ± 6 years, REC AN 24 ± 5 years, p = .2) and body mass index (CW 23 ± 2, REC AN 22 ± 3, p = .3). The mean age of onset of AN was 15 ± 2 years, and REC AN subjects had been recovered for between 12 and 66 months. Compared with CW, REC AN scored higher on EDI-2 drive for thinness-worst ever (REC AN 19.7 ± 2, CW .3 ± 1, p < .001) and worst ever Perfectionism (REC AN 108 ± 13, CW 53 ± 11, p < .001). Current measures of Harm Avoidance (REC AN 13 ± 9, CW 9 ±

Discussion

This is the first study to investigate D2/D3 receptors in AN in vivo with PET. A mixed group of REC AN-R and REC AN-BP women had increased [11C]raclopride BP in the antero-ventral striatum. Because PET measures of [11C]raclopride binding are sensitive to endogenous DA concentrations (Drevets et al 2001), this difference could be accounted for either by a reduction in the intrasynaptic DA concentration or by an elevation of the density and/or affinity of the D2/D3 receptors in this region.

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