Reduced 5-HT2A receptor binding after recovery from anorexia nervosa.
BACKGROUND
Several lines of evidence suggest that a disturbance of serotonin neuronal pathways may contribute to the pathogenesis of anorexia nervosa (AN). This study applied positron emission tomography (PET) to investigate the brain serotonin 2A (5HT2A) receptor, which could contribute to disturbances of appetite and behavior in AN.


METHODS
To avoid the confounding effects of malnutrition, we studied 16 women recovered from AN (REC AN, >1 year normal weight, regular menstrual cycles, no bingeing or purging) compared with 23 healthy control women (CW) using [18F]altanserin, a specific 5-HT2A receptor antagonist on PET imaging.


RESULTS
REC AN women had significantly reduced [18F]altanserin binding relative to CW in mesial temporal (amygdala and hippocampus), as well as cingulate cortical regions. In a subset of subjects (11 CW and 16 REC AN), statistical parametric mapping (SPM) confirmed reduced mesial temporal cortex 5HT2A receptor binding and, in addition, showed reduced occipital and parietal cortex binding.


CONCLUSIONS
This study extends research suggesting that altered 5-HT neuronal system activity persists after recovery from AN and may be related to disturbances of mesial temporal lobe function. Altered 5-HT neurotransmission after recovery also supports the possibility that this may be a trait-related disturbance that contributes to the pathophysiology of AN.
Frank
Guido K
GK
Department of Psychiatry, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania 15213, USA.
Kaye
Walter H
WH
Meltzer
Carolyn C
CC
Price
Julie C
JC
Greer
Phil
P
McConaha
Claire
C
Skovira
Kelli
K
D000328:Adult; D000856:Anorexia Nervosa / Q000378:metabolism* / Q000503:physiopathology / Q000628:therapy; D001667:Binding, Competitive; D001921:Brain / Q000098:blood supply / Q000378:metabolism* / Q000473:pathology; D002531:Cerebellum / Q000378:metabolism / Q000473:pathology; D003289:Convalescence; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D007650:Ketanserin / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D008032:Limbic System / Q000098:blood supply / Q000378:metabolism / Q000473:pathology; D008279:Magnetic Resonance Imaging; D009434:Neural Pathways / Q000378:metabolism; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D044402:Receptor, Serotonin, 5-HT2A; D011985:Receptors, Serotonin / Q000378:metabolism*; D014055:Tomography, Emission-Computed
D019275:Radiopharmaceuticals; D044402:Receptor, Serotonin, 5-HT2A; D011985:Receptors, Serotonin; D019788:Fluorodeoxyglucose F18; C071983:altanserin; D007650:Ketanserin