NOCICEPTION IN BULIMIA NERVOSA

神经性贪食症的伤害感受

• 批准号: 6430087
• 负责人: PATRICIA L FARIS
• 金额: $ 3.55万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 1993
• 资助国家: 美国
• 起止时间: 1993-08-01 至 2001-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6430087
• 关键词: analgesia; anorexia nervosa; bulimia nervosa; female; human subject; major depression; mechanical pressure; neural information processing; obesity; pain threshold; personality disorders; satiations; sensory mechanism; sensory thresholds; touch; vagus nerve

The eating disorder bulimia nervosa is characterized by periodic binge- eating usually followed by self-induced vomiting or laxative abuse. These symptoms clearly are related to alterations in meal size and meal patterning. With remarkably few exceptions, information relevant to meal termination is relayed to the central nervous system via the vagus nerve. We therefore hypothesize that an approach to the pathophysiology of bulimia nervosa is through studies of the neurocircuitry and neurochemistry of these satiety mechanisms. In addition to mediating short-term satiety, a rapidly growing body of literature suggests that the vagus Is also involved in modulating nociceptive information. Accordingly, the hypothesis that vagally- activated satiety mechanisms are abnormal in bulimia nervosa would predict that a related alteration in nociception might also be evident in this clinical group. In our initial study of 27 bulimia women and 31 age and sex matched controls, nociceptive thresholds, both pain detection and pain tolerance, were found to be significantly elevated in patients with an active diagnosis of bulimia nervosa compared to controls. Our Initial studies suggest that this effect- may be specific to nociceptive responsivity, since the ability to perceive an innocuous sensory stimulus did not differ between groups. In this application, we propose to further investigate this finding. Sensory processing (both tactile thresholds and pain responsivity) will be characterized in detail in a control population and in patients with either bulimia nervosa or with a psychiatric diagnosis which is frequently co-morbid with bulimia nervosa. We will also study this phenomena over the course of the binge/purge cycle, and in recovered bulimic patients. Regardless of the etiology of bulimia nervosa, we believe that the profound alterations in nutrient intake that characterize this disorder may affect, and in turn be affected by peripheral and central nervous system neurotransmission. Identification of alterations in nervous system function may lead to improved treatment.

饮食失调性贪食症的特点是周期性暴饮暴食 进食后通常会自行催吐或滥用泻药。这些 症状显然与膳食量和膳食的改变有关 图案化。除极少数例外情况外，与膳食相关的信息 终止通过迷走神经传递到中枢神经系统。 因此，我们假设一种病理生理学方法 神经性贪食症是通过对神经回路的研究和 这些饱腹感机制的神经化学。 除了调节短期饱腹感外，快速增长的身体 文献表明迷走神经也参与调节 伤害性信息。因此，迷走神经的假设- 神经性贪食症患者的激活饱腹感机制异常 预测伤害感受的相关改变也可能是明显的 在本临床组中。在我们对 27 名贪食症女性和 31 名贪食症患者的初步研究中， 年龄和性别匹配的对照、伤害性阈值、疼痛检测 发现患者的疼痛耐受性显着提高 与对照组相比，积极诊断出神经性贪食症。我们的 初步研究表明，这种效应可能是伤害性感受特有的 响应能力，因为感知无害的感官刺激的能力 组间没有差异。在本申请中，我们建议进一步 调查这一发现。感觉处理（触觉阈值和 疼痛反应性）将在对照中详细表征 人群以及患有神经性贪食症或患有神经性贪食症的患者 经常与神经性贪食症共存的精神病学诊断。 我们还将在暴饮暴食/净化过程中研究这种现象 周期，以及康复的贪食症患者。 无论神经性贪食症的病因是什么，我们都认为 营养摄入的深刻改变是这种疾病的特征 可能影响周围神经和中枢神经，并反过来受周围神经和中枢神经的影响 系统神经传递。识别神经系统的改变 功能可能会改善治疗。