Elsevier

Biological Psychiatry

Volume 70, Issue 8, 15 October 2011, Pages 777-784
Biological Psychiatry

Archival Report
Brain Type 1 Cannabinoid Receptor Availability in Patients with Anorexia and Bulimia Nervosa

https://doi.org/10.1016/j.biopsych.2011.05.010Get rights and content

Background

The endocannabinoid system is a possible target in the treatment of eating disorders. We used positron emission tomography to investigate the type 1 cannabinoid receptor (CB1R) in bulimic and anorectic patients.

Methods

We investigated 16 female bulimia nervosa patients (BN) (age = 23.8 ± 7.1 years) and 14 female anorexia nervosa patients (AN) (age = 20.5 ± 3.6 years) using the selective CB1R ligand [18F]MK-9470. The control group consisted of 19 age-matched women (age = 25.2 ± 8.5 years). Statistical parametric mapping (pfamily-wise error < .05) and volume-of-interest analyses of CB1R availability were performed.

Results

Global CB1R availability was significantly increased in cortical and subcortical brain areas in AN patients compared with healthy control subjects (+24.5%, p = .0003). Regionally, CB1R availability was increased in the insula in both AN and BN patients (p = .01 and p = .0004) and the inferior frontal and temporal cortex in AN patients only (p = .02).

Conclusions

Global CB1R upregulation in AN patients is a possible long-term compensatory mechanism to an underactive endocannabinoid system in anorectic conditions. There is a similarity in CB1R dysregulation both in AN and BN in the insular cortex, which is involved in the integration of interoceptive information, gustatory information, reward, and emotion processing.

Section snippets

Participants and Procedure

Female AN and BN patients were recruited during hospitalization in an inpatient university center for eating disorders. Seven restricting and seven binging-purging AN patients were included, as well as 16 purging BN patients, as diagnosed according to DSM-IV criteria (12). Patients were between 17 and 45 years old. The control group (CON) consisted of 19 healthy age-matched women. Informed consent was obtained from all participants before study investigations, and the study was approved by the

Clinical Characteristics

Demographic and clinical characteristics and EDES/EDI (sub)scores for all subjects are given in Table 1. Weight and body mass index of AN patients were significantly lower compared with the BN patients and healthy control subjects (p < .001). No differences were found in disease duration between both patient groups. Anorexia nervosa and BN patients scored significantly lower on the EDES questionnaire (p < .001) and significantly higher on the EDI questionnaire relative to healthy control

Discussion

In this study, we observed strong changes in cerebral CB1R availability in vivo in female anorectic and bulimic patients in comparison with age-matched healthy volunteers. A widespread involvement of the ECS in anorexia nervosa is not surprising when considering its role in feeding modulation, in hedonics of food intake, and generally in reward (19). Stimulation of endocannabinoid signaling has an orexigenic effect, but the ECS is also physiologically involved in energy homeostasis through food

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