Correlatos neuroendocrinológicos y cognoscitivos de la anorexia nerviosa

Neuroendocrinological and cognitive correlates of anorexia nervosa

Los trastornos del comportamiento alimentario son desórdenes cuyos costos económicos, emocionales y físicos son incalculables tanto para el paciente como para su familia, otros significantes y los miembros del equipo de salud. La persona con anorexia nerviosa se caracteriza por presentar una negación a mantener el peso corporal igual o superior al esperado para la edad y la talla (reducción de un 15% o más del peso inicial), fuerte miedo a engordar, incluso estando en infrapeso, distorsión de la imagen corporal o la del peso, dependiendo la autoestima en exceso de su valoración y negando la repercusión del infrapeso en la salud y amenorrea, entre otros. Este artículo es el resultado de una revisión de la literatura reciente, se detiene fundamentalmente en la presentación de los correlatos que a nivel neuroendocrinológico y cognoscitivo se han identificado, llamando la atención en el papel de sustancias como la grhelina y la leptina, hasta las disfunciones cognoscitivas que acompañan el cuadro de anorexia nerviosa. Abreviaturas: AN, anorexia nerviosa; FNDC, factor neurotrófico derivado del cerebro; TEP, tomografia con emisión de positrones; DSM IV, manual diagnóstico de la Asociación Psiquiátrica Americana IV edición.

• Argyropoulos G, Rankinen T, Neufeld DR, Rice T, Province MA, Leon AS, et al. A polymorphism in the human agoutirelated protein is associated with late-onset obesity. J Clin Endocrinol Metab. 2002 Sep;87(9):4198-202.

• Artmann H, Grau H, Adelmann M, Schleiffer R. Reversible and non-reversible enlargement of cerebrospinal fluid spaces in anorexia nervosa. Neuroradiology. 1985;27(4):304- 12.

• Asakawa A, Inui A, Kaga T, Yuzuriha H, Nagata T, Ueno N, et al. Ghrelin is an appetite-stimulatory signal from stomach with structural resemblance to motilin. Gastroenterology. 2001 Feb;120(2):337-45.

• Bergen AW, van den Bree MB, Yeager M, Welch R, Ganjei JK, Haque K, Bacanu S. Candidate genes for anorexia nervosa in the 1p33-36 linkage region: serotonin 1D and delta opioid receptor loci exhibit significant association to anorexia nervosa. Mol Psychiatry. 2003 Apr;8(4):397-406.

• Braun CM, Chouinard MJ. Is anorexia nervosa a neuropsychological disease? Neuropsychol Rev. 1992 Jun;3(2):171-212.

• Broglio F, Gianotti L, Destefanis S, Fassino S, Abbate Daga G, Mondelli V, et al. The endocrine response to acute ghrelin administration is blunted in patients with anorexia nervosa, a ghrelin hypersecretory state. Clin Endocrinol (Oxf). 2004 May;60(5):592-9.

• Bruno JF, Olchovsky D, White JD, Leidy JW, Song J, Berelowitz M. Influence of food deprivation in the rat on hypothalamic expression of growth hormone-releasing factor and somatostatin. Endocrinology. 1990 Nov;127(5):2111-6.

• Cacabelos R, Niigawa H, Yamatodani A, Gomez-Pan A, Nishimura T, Wada H. Antagonistic effects of growth hormone-releasing factor and somatostatin on brain histamine. Endocrinology. 1988 Apr;122(4):1269-76.

• Cacabelos R, Yamatodani A, Niigawa H, Hariguchi S, Tada K, Nishimura T, Wada H, Brandeis L, Pearson J. Brain histamine in Alzheimer's disease. Methods Find Exp Clin Pharmacol. 1989 May;11(5):353-60.

• Curatola G, Camilloni MA, Vignini A, Nanetti L, Boscaro M, Mazzanti L. Chemical-physical properties of lipoproteins in anorexia nervosa. Eur J Clin Invest. 2004 Nov;34(11):747-51.

• Datlof S, Coleman PD, Forbes GB, Kreipe RE. Ventricular dilation on CAT scans of patients with anorexia nervosa. Am J Psychiatry. 1986 Jan;143(1):96-8.

• Delvenne V, Goldman S, De Maertelaer V, Simon Y, Luxen A, Lotstra F. Brain hypometabolism of glucose in anorexia nervosa: normalization after weight gain. Biol Psychiatry. 1996 Oct 15;40(8):761-8.

• Dolan RJ, Mitchell J, Wakeling A. Structural brain changes in patients with anorexia nervosa. Psychol Med. 1988 May; I 8(2):349-53.

• Eastwood H, Brown KM, Markovic D, Pieri LF. Variation in the ESR1 and ESR2 genes and genetic susceptibility to anorexia nervosa. Mol Psychiatry. 2002;7(1):86-9.

• Enzmann DR, Lane B. Cranial computed tomography findings in anorexia nervosa. Comput Assist Tomogr. 1977 Oct; I (4):410-4.

• Faust, J. Correlates of the drive for thinness in young female adolescents. J Clin Child Psicol. 16 (4), 313-319.

• Fox CF. Neuropsychological correlations of anorexia nervosa. Int J Psychiatry Med. 1981;11(3):285-90.

• Frey J, Neuhauser-Berthold M, Elis SA, Duncker S, Rose F. Lower serum leptin levels in female students of the nutritional sciences with eating disorders. Eur J Nutr. 2003 Jun;42(3):142-8.

• Fruhbeck G, Jebb SA, Prentice AM. Leptin: physiology and pathophysiology. Clin Physiol. 1998 S ep;18(5):399-419.

• Golden NH, Ashtari M, Kohn MR, Patel M, Jacobson MS, Fletcher A, Shenker IR. Reversibility of cerebral ventricular enlargement in anorexia nervosa, demonstrated by quantitative magnetic resonance imaging. J Pediatr. 1996 Feb;128(2):296-301.

• Goldner EM, Geller J, Birmingham CL, Remick RA. Comparison of shoplifting behaviours in patients with eating disorders, psychiatric control subjects, and undergraduate control subjects. Can J Psychiatry. 2000 Jun;45(5):471- 5.

• Gorwood P, Ades J, Bellodi L, Cellini E, Collier DA, Di Bella D. Framework V `Factors in Healthy Eating' consortium. The 5-HT(2A) -1438G/A polymorphism in anorexia nervosa: a combined analysis of 316 trios from six European centres. Mol Psychiatry. 2002;7(1):90-4.

• Green MW, EllimanNA, WakelingA, Rogers PJ. Cognitive functioning, weight change and therapy in anorexia nervosa. J Psychiatr Res. 1996 Sep-Oct;30(5):401-10.

• Grunwald M, Ettrich C, Krause W, Assmann B, Dahne A, Weiss T, et al. Haptic perception in anorexia nervosa before and after weight gain. J Clin Exp Neuropsychol. 2001 Aug;23(4):520-9.

• Hashimoto K, Koizumi H, Nakazato M, Shimizu E, Iyo M. Role of brain-derived neurotrophic factor in eating disorders: recent findings and its pathophysiological implications. Prog Neuropsychopharmacol Biol Psychiatry. 2005 May;29(4):499-504.

• Inui A. Eating behavior in anorexia nervosa--an excess of both orexigenic and anorexigenic signalling7 Mol Psychiatry. 2001 Nov;6(6):620-4.

• Inui A. Transgenic approach to the study of body weight regulation. Pharmacol Rev. 2000 Mar;52(1):35-61.

• Irael, M. Psychopharmacology for the clinician. Psychopharmacologie pratique. Rev. Psychiatr Neurosci. 2005;30(6)

• Jeanningros R. Control nervioso periférico de la ingesta alimentaria. Confront. Psiquiatr. 1989;25.

• Jones BP, Duncan CC, Brouwers P, Mirsky AF. Cognition in eating disorders. J Clin Exp Neuropsychol. 1991 Sep;13(5):711-28.

• Katzman DK, Zipursky RB, Lambe EK, Mikulis DJ. A longitudinal magnetic resonance imaging study of brain changes in adolescents with anorexia nervosa. Arch Pediatr Adolesc Med. 1997 Aug;151(8):793-7.

• Kaye W. Eating Disorders. Brain-derived neurotrophic factor reduced in eating disorders. Gene Ther. Wkly. 2005 Jul.

• Kerem NC, Katzman DK. Brain structure and function in adolescents with anorexia nervosa. Adolesc Med. 2003 Feb;14(1):109-18.b

• Kingston K, Szmukler G, Andrewes D, Tress B, Desmond P. Neuropsychological and structural brain changes in anorexia nervosa before and after refeeding. Psychol Med. 1996 Jan;26(1):15-28.

• Kipman A, Bruins-Slot L, Boni C, Hanoun N, Ades J, Blot P, et al. Mouren-Simeoni M, Gorwood P. 5-HT(2A) gene promoter polymorphism as a modifying rather than a vulnerability factor in anorexia nervosa. Eur Psychiatry. 2002 Jul;17(4):227-9.

• Krieg JC, Pirke KM, Lauer C, Backmund H. Endocrine, metabolic, and cranial computed tomographic findings in anorexia nervosa. Biol Psychiatry. 1988 Feb 15;23(4):377-87.

• Laessle RG, Fischer M, Fichter MM, Pirke KM, Krieg JC. Cortisol levels and vigilance in eating disorder patients. Psychoneuroendocrinology. 1992 Oct;17(5):475-84.

• Lambe EK, Katzman DK, Mikulis DJ, Kennedy SH, Zipursky RB. Cerebral gray matter volume deficits after weight recovery from anorexia nervosa. Arch Gen Psychiatry. 1997 Jun;54(6):537-42.

• Lauer CJ, Gorzewski B, Gerlinghoff M, Backmund H, Zihl J. Neuropsychological assessments before and after treatment in patients with anorexia nervosa and bulimia nervosa. J Psychiatr Res. 1999 Mar-Apr;33(2):129-38.

• Liu Y, Gold M: Human functional magnetic resonance imaging of Eating and satiety in Eating disorders and obesity. Psychiatr Ann 2003 Feb; 33: 127-32.

• Maxwell JK, Tucker DM, Townes BD. Asymmetric cognitive function in anorexia nervosa. Int J Neurosci. 1984 Aug;24(1):37-44.

• Miller KK, Grieco KA, Klibanski A. Testosterone administration in women with anorexia nervosa. J Clin Endocrinol Metab. 2005 Mar;90(3):1428-33.

• Milos G, Spindler A, Schnyder U. Psychiatric comorbidity and Eating Disorder Inventory (EDI) profiles in eating disorder patients. Can J Psychiatry. 2004 Mar;49(3):179- 84.

• Nagaya N, Uematsu M, Kojima M, Date Y, Nakazato M, Okumura H, et al. Elevated circulating level of ghrelin in cachexia associated with chronic heart failure: relationships between ghrelin and anabolic/catabolic factors. Circulation. 2001 Oct 23;104(17):2034-8.

• Neumarker KJ, Bzufka WM, Dudeck U, Hein J, Neumarker U. Are there specific disabilities of number processing in adolescent patients with Anorexia nervosa? Evidence from clinical and neuropsychological data when compared to morphometric measures from magnetic resonance imaging. Eur Child Adolesc Psychiatry. 2000;9 Suppl 2:11111-21.

• Porras S, Ortiz F, Gavilán C, Ortuño E, Vidal C. Estudio preliminar sobre la respuesta de la hormona de crecimiento a la estimulación con GRF (1-29) NH2 en la anorexia nerviosa. En: Papeles del Padre Jofré. (citado 2006 ene) Disponible en http://www.medired.com/spcv/papeles.

• Ribases M, Gratacos M, Fernandez-Aranda F, Bellodi L, Boni C, Anderluh M, et al. Association of BDNF with restricting anorexia nervosa and minimum body mass index: a family-based association study of eight European populations. Eur J Hum Genet. 2005 Apr;13(4):428-34.

• Sapolsky RM. Glucocorticoids and hippocampal atrophy in neuropsychiatric disorders. Arch Gen Psychiatry. 2000 Oct;57(10):925-35.

• Satiel H. Monoaminas cerebrales y comportamiento alimenticio. Confront. Psiquiatr. 1989;25.

• Shimizu Y, Nagaya N, Isobe T, Imazu M, Okumura H, Hosoda H, et al. Increased plasma ghrelin level in lung cancer cachexia. Clin Cancer Res. 2003 Feb;9(2):774-8.

• Steiger H. Eating disorders and the serotonin connection: state, trait and developmental effects. J Psychiatry Neurosci. 2004 Jan;29(1):20-9.

• Stoving RK, Andersen M, Flyvbjerg A, Frystyk J, Hangaard J, Vinten J, et al. Indirect evidence for decreased hypothalamic somatostatinergic tone in anorexia nervosa. Clin Endocrinol (Oxf). 2002 Mar;56(3):391-6.

• Swayze VW 2nd, Andersen A, Arndt S, Rajarethinam R, Fleming F, Sato Y, et al. Reversibility of brain tissue loss in anorexia nervosa assessed with a computerized Talairach 3-D proportional grid. Psychol Med. 1996 Mar;26(2):381- 90

• Takano A, Shiga T, Kitagawa N, Koyama T, Katoh C, Tsukamoto E, et al. Abnormal neuronal network in anorexia nervosa studied with 1-123-IMP SPECT. Psychiatry Res. 2001 Jul 1;107(1):45-50.

• Tschop M, Smiley DL, Heiman ML. Ghrelin induces adiposity in rodents. Nature. 2000 Oct 19;407(6806):908-13.

• Vink T, Hinney A, van Elburg AA, van Goozen SH, Sandkuijl LA, Sinke RJ, et al. Association between an agoutirelated protein gene polymorphism and anorexia nervosa. Mol Psychiatry. 2001 May;6(3):325-8.

• Wolfe BE, Jimerson DC, Orlova C, Mantzoros CS. Effect of dieting on plasma leptin, soluble leptin receptor, adiponectin and resistin levels in healthy volunteers. Clin Endocrinol (Oxf). 2004 Sep;61(3):332-8.