Objective: Anorexia nervosa has the highest mortality rate of any psychiatric condition, yet the pathophysiology of this disorder and its primary symptom, extreme dietary restriction, remains poorly understood. In states of hunger relative to satiety, the rewarding value of food stimuli normally increases to promote eating, yet individuals with anorexia nervosa avoid food despite emaciation. This study’s aim was to examine potential neural insensitivity to these effects of hunger in anorexia nervosa.
Methods: At two scanning sessions scheduled 24 hours apart, one after a 16-hour fast and one after a standardized meal, 26 women who were in remission from anorexia nervosa (to avoid the confounding effects of malnutrition) and 22 matched control women received tastes of sucrose solution or ionic water while functional MRI data were acquired. Within a network of interest responsible for food valuation and transforming taste signals into motivation to eat, the authors compared groups across conditions on blood-oxygen-level-dependent (BOLD) signal and task-based functional connectivity.
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The participant will recognize that women in remission from anorexia nervosa exhibit abnormal response to taste stimulation in the hungry state.
This program is designed for all psychiatrists in clinical practice, residents in Graduate Medical Education programs, medical students interested in psychiatry, and other physicians who wish to advance their current knowledge of clinical medicine.
Duration: 1 hour
Begin Date: July 1, 2020
End Date: June 30, 2022
In order to earn CME credit, subscribers should read through the material presented in the article. After reading the article, complete the quiz and submit your evaluation and study hours (up to 1 AMA PRA Category 1 Credit™). A score of 60% or higher is required to receive credit.
The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The APA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Title: Neural Insensitivity to the Effects of Hunger in Women Remitted From Anorexia Nervosa
Authors: Walter H. Kaye, M.D., Christina E. Wierenga, Ph.D., Amanda Bischoff-Grethe, Ph.D., Laura A. Berner, Ph.D., Alice V. Ely, Ph.D., Ursula F. Bailer, M.D., Martin P. Paulus, M.D., Julie L. Fudge, M.D.
Affiliations: Department of Psychiatry, University of California, San Diego, San Diego (Kaye, Wierenga, Bischoff-Grethe, Berner, Ely, Bailer, Paulus); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Berner); Department of Psychiatry and Psychotherapy, Division of General Psychiatry, Medical University of Vienna, Vienna (Bailer); Laureate Institute for Brain Research, Tulsa, Okla. (Paulus); Departments of Neuroscience and Psychiatry, University of Rochester Medical Center, Rochester, New York (Fudge).
Disclosures: The authors report no financial relationships with commercial interests.
Discussion of unapproved or investigational use of products*: No.
*APA policy requires disclosure by CME authors of unapproved or investigational use of products discussed in CME programs. Off-label use of medications by individual physicians is permitted and common. Decisions about off-label use can be guided by scientific literature and clinical experience.
Ned H. Kalin, M.D. (Editor-in-Chief, AJP); Carolyn Rodriguez, M.D., Ph.D. (Deputy Editor, AJP); Michael D. Roy (Editorial Director, AJP); Michael A. Pogachar (Online Content Manager, Journals). Dr. Kalin has served as a consultant to the Board of Scientific Advisors, the Pritzker Neuropsychiatric Disorders Research Consortium, and the Skyland Trail Advisory Board and as Councilor, Society of Biological Psychiatry. Dr. Rodriguez has served as a consultant to Allergan, Blackthorn, Epiodyne, and Rugen. Mr. Roy and Mr. Pogachar report no financial relationships with commercial interests.
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