title: Serotonin transporter binding of [123I]ADAM in bulimic women, their healthy twin sisters, and healthy women: a SPET study.
abstract: BACKGROUND
  Bulimia Nervosa (BN) is believed to be caused by an interaction of genetic and environmental factors. Previous studies support the existence of a bulimia-related endophenotype as well as disturbances in serotonin (5-HT) transmission. We studied serotonin transporter (SERT) binding in BN, and to investigate the possibility of a SERT-related endophenotype for BN, did this in a sample of female twins. We hypothesized clearly reduced SERT binding in BN women as opposed to healthy women, and intermediate SERT binding in unaffected co-twins.
  
  
  METHODS
  We studied 13 female twins with BN (9 with purging and 4 with non-purging BN) and 25 healthy women, including 6 healthy twin sisters of BN patients and 19 women from 10 healthy twin pairs. [123I]ADAM, a selective SERT radioligand for single photon emission tomography (SPET) imaging, was used to assess SERT availability in the midbrain and the thalamus.
  
  
  RESULTS
  No differences in SERT binding were evident when comparing the BN women, their unaffected co-twins and the healthy controls (p = 0.14). The healthy sisters of the BN patients and the healthy control women had similar SERT binding in both brain regions. In a post hoc subgroup analysis, the purging bulimics had higher SERT binding than the healthy women in the midbrain (p = 0.03), but not in the thalamus.
  
  
  CONCLUSIONS
  Our finding of increased SERT binding in the midbrain in the purging BN women raises the possibility that this subgroup of bulimics might differ in serotonergic function from the non-purging ones. The similarity of the unaffected co-twins and the healthy controls doesn't support our initial assumption of a SERT-related endophenotype for BN. Due to the small sample size, our results need to be interpreted with caution and verified in a larger sample.
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, HUSLAB/Helsinki University Central Hospital, Helsinki, Finland. anu.koskela@helsinki.fi
authors.forename: Anu K
authors.initials: AK
authors.lastname: Koskela
authors.forename: Anna
authors.initials: A
authors.lastname: Keski-Rahkonen
authors.forename: Elina
authors.initials: E
authors.lastname: Sihvola
authors.forename: Tomi
authors.initials: T
authors.lastname: Kauppinen
authors.forename: Jaakko
authors.initials: J
authors.lastname: Kaprio
authors.forename: Aapo
authors.initials: A
authors.lastname: Ahonen
authors.forename: Aila
authors.initials: A
authors.lastname: Rissanen
mesh_terms: D000328:Adult; D002032:Bulimia / Q000235:genetics* / Q000378:metabolism*; D002928:Cinanserin / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D010641:Phenotype; D012701:Serotonin / Q000502:physiology; D050486:Serotonin Plasma Membrane Transport Proteins / Q000378:metabolism*
chemical_list: C413491:2-((2-((dimethylamino)methyl)phenyl)thio)-5-iodophenylamine; C493230:SLC6A4 protein, human; D050486:Serotonin Plasma Membrane Transport Proteins; D012701:Serotonin; D002928:Cinanserin