title: Oxytocin secretion is associated with severity of disordered eating psychopathology and insular cortex hypoactivation in anorexia nervosa.
abstract: BACKGROUND
  Animal data suggest that oxytocin is a satiety hormone. We have demonstrated that anorexia nervosa (anorexia), a disorder characterized by food restriction, low weight, and hypoleptinemia, is associated with decreased nocturnal oxytocin secretion. We have also reported functional magnetic resonance imaging (fMRI) hypoactivation in anorexia in brain regions involved in food motivation. The relationships between oxytocin, food-motivation neurocircuitry, and disordered eating psychopathology have not been investigated in humans.
  
  
  OBJECTIVE
  The objective of the study was to determine whether the oxytocin response to feeding in anorexia differs from healthy women and to establish the relationship between oxytocin secretion and disordered eating psychopathology and food-motivation neurocircuitry.
  
  
  METHODS
  This was a cross-sectional study.
  
  
  METHODS
  The study was conducted at a clinical research center.
  
  
  METHODS
  Participants included 35 women: 13 anorexia (AN), nine weight-recovered anorexia (ANWR), and 13 healthy controls (HC).
  
  
  METHODS
  Peripheral oxytocin and leptin levels were measured fasting and 30, 60, and 120 min after a standardized mixed meal. The Eating Disorder Examination-Questionnaire was used to assess disordered eating psychopathology. fMRI was performed during visual processing of food and nonfood stimuli to measure brain activation before and after the meal.
  
  
  RESULTS
  Mean oxytocin levels were higher in AN than HC at 60 and 120 min and lower in ANWR than HC at 0, 30, and 120 min and AN at all time points. Mean oxytocin area under the curve (AUC) was highest in AN, intermediate in HC, and lowest in ANWR. Mean leptin levels at all time points and AUC were lower in AN than HC and ANWR. Oxytocin AUC was associated with leptin AUC in ANWR and HC but not in AN. Oxytocin AUC was associated with the severity of disordered eating psychopathology in AN and ANWR, independent of leptin secretion, and was associated with between-group variance in fMRI activation in food motivation brain regions, including the hypothalamus, amygdala, hippocampus, orbitofrontal cortex, and insula.
  
  
  CONCLUSIONS
  Oxytocin may be involved in the pathophysiology of anorexia.
authors.affiliation: Neuroendocrine Unit, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, Massachusetts 02114, USA. ealawson@partners.org
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Lawson
authors.forename: Laura M
authors.initials: LM
authors.lastname: Holsen
authors.forename: McKale
authors.initials: M
authors.lastname: Santin
authors.forename: Erinne
authors.initials: E
authors.lastname: Meenaghan
authors.forename: Kamryn T
authors.initials: KT
authors.lastname: Eddy
authors.forename: Anne E
authors.initials: AE
authors.lastname: Becker
authors.forename: David B
authors.initials: DB
authors.lastname: Herzog
authors.forename: Jill M
authors.initials: JM
authors.lastname: Goldstein
authors.forename: Anne
authors.initials: A
authors.lastname: Klibanski
mesh_terms: D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000378:metabolism* / Q000503:physiopathology*; D002540:Cerebral Cortex / Q000502:physiology*; D003430:Cross-Sectional Studies; D004435:Eating / Q000502:physiology; D005215:Fasting / Q000502:physiology; D005247:Feeding Behavior / Q000502:physiology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000378:metabolism; D020738:Leptin / Q000097:blood; D008279:Magnetic Resonance Imaging; D010121:Oxytocin / Q000097:blood / Q000378:metabolism*; D019518:Postprandial Period / Q000502:physiology; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D020738:Leptin; D010121:Oxytocin; D006854:Hydrocortisone