title: The role of BDNF, leptin, and catecholamines in reward learning in bulimia nervosa.
abstract: BACKGROUND
  A relationship between bulimia nervosa and reward-related behavior is supported by several lines of evidence. The dopaminergic dysfunctions in the processing of reward-related stimuli have been shown to be modulated by the neurotrophin brain derived neurotrophic factor (BDNF) and the hormone leptin.
  
  
  METHODS
  Using a randomized, double-blind, placebo-controlled, crossover design, a reward learning task was applied to study the behavior of 20 female subjects with remitted bulimia nervosa and 27 female healthy controls under placebo and catecholamine depletion with alpha-methyl-para-tyrosine (AMPT). The plasma levels of BDNF and leptin were measured twice during the placebo and the AMPT condition, immediately before and 1 hour after a standardized breakfast.
  
  
  RESULTS
  AMPT-induced differences in plasma BDNF levels were positively correlated with the AMPT-induced differences in reward learning in the whole sample (P=.05). Across conditions, plasma brain derived neurotrophic factor levels were higher in remitted bulimia nervosa subjects compared with controls (diagnosis effect; P=.001). Plasma BDNF and leptin levels were higher in the morning before compared with after a standardized breakfast across groups and conditions (time effect; P<.0001). The plasma leptin levels were higher under catecholamine depletion compared with placebo in the whole sample (treatment effect; P=.0004).
  
  
  CONCLUSIONS
  This study reports on preliminary findings that suggest a catecholamine-dependent association of plasma BDNF and reward learning in subjects with remitted bulimia nervosa and controls. A role of leptin in reward learning is not supported by this study. However, leptin levels were sensitive to a depletion of catecholamine stores in both remitted bulimia nervosa and controls.
authors.affiliation: Department of Molecular Psychiatry, University Hospital of Psychiatry, University of Bern, Switzerland (Drs Homan and Hasler); Department of Psychiatry and Psychotherapy, University Hospital, Zurich, Switzerland (Dr Grob, Drs Milos and Schnyder); Neurobiology Laboratory for Brain Aging and Mental Health, Psychiatric University Clinics Basel, Switzerland (Dr Eckert); Psychiatric University Clinics Basel, Switzerland (Dr Lang). homan@puk.unibe.ch.
authors.forename: Philipp
authors.initials: P
authors.lastname: Homan
authors.affiliation: Department of Molecular Psychiatry, University Hospital of Psychiatry, University of Bern, Switzerland (Drs Homan and Hasler); Department of Psychiatry and Psychotherapy, University Hospital, Zurich, Switzerland (Dr Grob, Drs Milos and Schnyder); Neurobiology Laboratory for Brain Aging and Mental Health, Psychiatric University Clinics Basel, Switzerland (Dr Eckert); Psychiatric University Clinics Basel, Switzerland (Dr Lang).
authors.forename: Simona
authors.initials: S
authors.lastname: Grob
authors.affiliation: Department of Molecular Psychiatry, University Hospital of Psychiatry, University of Bern, Switzerland (Drs Homan and Hasler); Department of Psychiatry and Psychotherapy, University Hospital, Zurich, Switzerland (Dr Grob, Drs Milos and Schnyder); Neurobiology Laboratory for Brain Aging and Mental Health, Psychiatric University Clinics Basel, Switzerland (Dr Eckert); Psychiatric University Clinics Basel, Switzerland (Dr Lang).
authors.forename: Gabriella
authors.initials: G
authors.lastname: Milos
authors.affiliation: Department of Molecular Psychiatry, University Hospital of Psychiatry, University of Bern, Switzerland (Drs Homan and Hasler); Department of Psychiatry and Psychotherapy, University Hospital, Zurich, Switzerland (Dr Grob, Drs Milos and Schnyder); Neurobiology Laboratory for Brain Aging and Mental Health, Psychiatric University Clinics Basel, Switzerland (Dr Eckert); Psychiatric University Clinics Basel, Switzerland (Dr Lang).
authors.forename: Ulrich
authors.initials: U
authors.lastname: Schnyder
authors.affiliation: Department of Molecular Psychiatry, University Hospital of Psychiatry, University of Bern, Switzerland (Drs Homan and Hasler); Department of Psychiatry and Psychotherapy, University Hospital, Zurich, Switzerland (Dr Grob, Drs Milos and Schnyder); Neurobiology Laboratory for Brain Aging and Mental Health, Psychiatric University Clinics Basel, Switzerland (Dr Eckert); Psychiatric University Clinics Basel, Switzerland (Dr Lang).
authors.forename: Anne
authors.initials: A
authors.lastname: Eckert
authors.affiliation: Department of Molecular Psychiatry, University Hospital of Psychiatry, University of Bern, Switzerland (Drs Homan and Hasler); Department of Psychiatry and Psychotherapy, University Hospital, Zurich, Switzerland (Dr Grob, Drs Milos and Schnyder); Neurobiology Laboratory for Brain Aging and Mental Health, Psychiatric University Clinics Basel, Switzerland (Dr Eckert); Psychiatric University Clinics Basel, Switzerland (Dr Lang).
authors.forename: Undine
authors.initials: U
authors.lastname: Lang
authors.affiliation: Department of Molecular Psychiatry, University Hospital of Psychiatry, University of Bern, Switzerland (Drs Homan and Hasler); Department of Psychiatry and Psychotherapy, University Hospital, Zurich, Switzerland (Dr Grob, Drs Milos and Schnyder); Neurobiology Laboratory for Brain Aging and Mental Health, Psychiatric University Clinics Basel, Switzerland (Dr Eckert); Psychiatric University Clinics Basel, Switzerland (Dr Lang).
authors.forename: Gregor
authors.initials: G
authors.lastname: Hasler
mesh_terms: D000328:Adult; D001245:Association Learning; D015992:Body Mass Index; D019208:Brain-Derived Neurotrophic Factor / Q000097:blood*; D052018:Bulimia Nervosa / Q000097:blood / Q000523:psychology*; D002395:Catecholamines / Q000172:deficiency*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D020738:Leptin / Q000097:blood*; D009483:Neuropsychological Tests; D011897:Random Allocation; D012201:Reward; D055815:Young Adult; D019805:alpha-Methyltyrosine / Q000633:toxicity
chemical_list: D019208:Brain-Derived Neurotrophic Factor; D002395:Catecholamines; D020738:Leptin; D019805:alpha-Methyltyrosine
keywords: BDNF; alpha-methyl-para-tyrosine; bulimia nervosa; catecholamines; leptin; reward