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Many Anorexics Need Extended Care for Brain Function

Many Anorexics Need Extended Care for Brain Function

New research discovers that even after weeks of treatment and weight gain, anorexic teenagers need additional time to regain normal brain function.

Researchers at the University of Colorado Anschutz Medical Campus said persistent brain alteration puts teen at risk for possible relapse.

In the study, investigators examined 21 female adolescents before and after treatment for anorexia and found that their brains still had an elevated reward system compared to 21 participants without the eating disorder.

“That means they are not cured,” said Guido Frank, M.D., senior author of the study and associate professor of psychiatry and neuroscience at the University of Colorado School of Medicine.

“This disease fundamentally changes the brain response to stimuli in our environment. The brain has to normalize and that takes time.”

The research has been published in the American Journal of Psychiatry.

Brain scans of anorexia nervosa patients have implicated central reward circuits that govern appetite and food intake in the disease. This study showed that the reward system was elevated when the patients were underweight and remained so once weight was restored.

The neurotransmitter dopamine might be the key, researchers said.

Dopamine mediates reward learning and is suspected of playing a major role in the pathology of anorexia nervosa. Animal studies have shown that food restriction or weight loss enhances dopamine response to rewards.

With that in mind, Frank, an expert in eating disorders, and his colleagues wanted to see if this heightened brain activity would normalize once the patient regained weight.

In the study, adolescent girls who were between 15 and 16 years old underwent a series of reward-learning taste tests while their brains were being scanned.

The results showed that reward responses were higher in adolescents with anorexia nervosa than in those without it. This normalized somewhat after weight gain but still remained elevated.

At the same time, the study showed that those with anorexia had widespread changes to parts of the brain like the insula, which processes taste along with a number of other functions including body self-awareness.

The more severely altered the brain, the harder it was to treat the illness, or in other words, the more severely altered the brain, the more difficult it was for the patients to gain weight in treatment.

“Generalized sensitization of brain reward responsiveness may last long into recovery,” the study said. “Whether individuals with anorexia nervosa have a genetic predisposition for such sensitization requires further study.”

Frank said more studies are also needed to determine if the continued elevated brain response is due to a heightened dopamine reaction to starvation and whether it signals a severe form of anorexia among adolescents that is more resistant to treatment.

In either case, Frank said the biological markers discovered here could be used to help determine the likelihood of treatment success. They could also point the way toward using drugs that target the dopamine reward system.

“Anorexia nervosa is hard to treat. It is the third most common chronic illness among teenage girls with a mortality rate 12 times higher than the death rate for all causes of death for females 15-24 years old,” Frank said.

“But with studies like this we are learning more and more about what is actually happening in the brain. And if we understand the system, we can develop better strategies to treat the disease.”

Source: University of Colorado/EurekAlert

Many Anorexics Need Extended Care for Brain Function

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2017). Many Anorexics Need Extended Care for Brain Function. Psych Central. Retrieved on August 19, 2018, from https://psychcentral.com/news/2017/03/02/many-anorexics-need-extended-care-for-brain-function/117091.html

 

Scientifically Reviewed
Last updated: 2 Mar 2017
Last reviewed: By John M. Grohol, Psy.D. on 2 Mar 2017
Published on PsychCentral.com. All rights reserved.