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Biomedical subjects

M Altemus

Publications and source records attributed to M Altemus.

At least 55 records · Page 3Linked to original sources
PubMed1994

Eating behavior in bulimia nervosa: multiple meal analyses.

Ten bulimic individuals were admitted to an inpatient unit and for 7 consecutive days eating behavior was observed and recorded. Age, sex, and weight-matched control subjects (n = 10) were admitted to the same unit for 4 d. All food and fluid intake, frequency of binge eating and purging, and ratings of appetite and mood before and after eating were recorded every 24 h. Bulimic patients demonstrated chaotic eating patterns that varied within as well as between individuals. Total daily energy intake was significantly higher for bulimic patients (41982 +/- 113 kJ; 10,034 +/- 2701 kcal) than for control subjects (8050 +/- 0427 kJ; 1924 +/- 102 kcal). On average, patients binged 1.6 times, purged three times, and ate one snack or meal without purging daily. Macronutrient analyses of intake revealed significantly less energy from protein and more energy from fat in bulimic patients compared with control subjects. Some improvement of mood was noted after binges, the magnitude of which was greatest after purging.

Adolescent↗
PubMed1993

The effects of the acute administration of RU 486 on dietary fat preference in fasted lean and obese men.

The effects of RU 486, a potent glucocorticoid antagonist, on dietary fat preference were explored in obese men and lean controls in a double-blind crossover study. An oral 10 mg/kg dose of RU 486 or placebo was administered at midnight the second night of a 48-h hospital stay. Macronutrient and caloric intakes were calculated each day and a taste test of six commercial dairy products (fat content by weight < 0.5%, 2.0%, 3.3%, 10.5%, 18%, and 36%) was performed. Dairy products were judged for pleasantness, creaminess, and overall preference. Subjects were then asked to consume their favorite dairy product until sated. Urinary free cortisol (UFC) and plasma adrenocorticotropic hormone (ACTH), cortisol, insulin, and glucose were determined. Intake of a self-selected diet was recorded. As expected, in response to RU 486, UFC increased from 120 +/- 25 micrograms/24 h to 297 +/- 73 micrograms/24 h (p < 0.05) in obese men and from 81 +/- 10 micrograms/24 h to 357 +/- 109 micrograms/24 h (p < 0.05) in lean men. Plasma cortisol increased from 26.1 +/- 1.1 microgram/dl to 31.8 +/- 1.0 microgram/dl (p < 0.05) in obese men and from 26.1 +/- 1.7 micrograms/dl to 32.2 +/- 1.7 micrograms/dl (p < 0.05) in lean men. Plasma insulin was significantly higher in obese 24.6 +/- 3.2 microIU/ml than in lean men 12.8 +/- 1.1 microIU/ml (p = 0.0001) but was unaffected by RU 486. RU 486 did not decrease fat intake in either obese or lean men.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenocorticotropic Hormone↗
PubMed1993

Relation of dissociative phenomena to levels of cerebrospinal fluid monoamine metabolites and beta-endorphin in patients with eating disorders: a pilot study.

Dissociation is made manifest by a failure to integrate thoughts, feelings, memories, and actions into a unified sense of consciousness. Although dissociation is presumed to be a special state of consciousness manifested by state-dependent memory and physiology, the psychobiology of dissociation is poorly understood. In this study, we examined cerebrospinal fluid levels of the major monoamine metabolites and beta-endorphin in patients with eating disorders (11 with anorexia nervosa, 16 with bulimia nervosa), while they were acutely ill. Dissociative capacity was measured using the Dissociative Experiences Scale (DES). We provide evidence that neurochemical changes in dopaminergic, serotonergic, and opioid systems may be associated with the clinical expression of dissociation in patients with eating disorders during the acute phase of their illness. These preliminary results are compatible with previous studies of neurochemical disturbances in the eating disorders and suggest that future work in dissociation should specifically include examination of these neurobiologic systems.

Adolescent↗
PubMed1993

CSF somatostatin in obsessive-compulsive disorder.

OBJECTIVE: Because the central administration of somatostatin to experimental animals produces behaviors with some similarities to the compulsions of patients with obsessive-compulsive disorder and because serotonin reuptake inhibitors have been reported to reduce brain content of somatostatin, the authors examined central somatostatin activity in patients with obsessive-compulsive disorder. METHOD: CSF for measurement of somatostatin was obtained from 15 drug-free outpatients with obsessive-compulsive disorder and 27 normal volunteers. RESULTS: The mean CSF somatostatin level was significantly higher in the patients with obsessive-compulsive disorder than in the normal subjects. CONCLUSIONS: Although the functional significance of this finding is unknown, these data are consistent with a role for somatostatin in the clinical symptomatology of obsessive-compulsive disorder and its response to neuropharmacological agents. The high levels of CSF somatostatin reported here in a patient subgroup whose predominant symptoms consisted of overly focused, perseverative thought processes are in contrast to the consistently low levels of CSF somatostatin seen in patients with a spectrum of disorders characterized by substantial cognitive deficits.

Adolescent↗
PubMed1993

Elevated CSF levels of interleukin-2 in neuroleptic-free schizophrenic patients.

Levels of CSF fluid interleukin-2, but not interleukin-1 alpha, were found to be higher in 10 neuroleptic-free schizophrenic patients than in 10 healthy subjects matched for sex and age. Because interleukin-2 increases dopaminergic neurotransmission and participates in autoimmunity and cell growth, the authors postulate that elevated levels of central interleukin-2 might contribute to the increased dopaminergic neurotransmission, autoimmune phenomena, and abnormal brain morphology described in some patients with schizophrenia.

Adult↗
PubMed1993

Attenuation of food-restriction-induced running by chronic fluoxetine treatment.

In rats, 90-minute daily access to food is sufficient to maintain or even increase body weight. However, when rats are provided with access to a running wheel for the remaining portion of the day, progressive increases in activity and decreases in weight reach life-threatening proportions within 1-2 weeks. To investigate this phenomenon as a possible animal model of obsessive-compulsive disorder (OCD), rats were treated i.p. daily for 5 weeks with fluoxetine, an antidepressant that relieves OCD symptoms; imipramine, an antidepressant that does not affect OCD symptoms; or saline prior to exposure to food restriction and the running wheel. Compared with saline-treated controls, rats treated with fluoxetine showed significant attenuation of wheel running, anorexia, and weight loss. However, rats treated with imipramine did not differ from saline-treated controls on any measures. These results indicate that food-restriction-induced compulsive running and the associated anorexia are selectively prevented by treatment with an antidepressant that blocks serotonin reuptake. This raises the possibility that this repetitive, maladaptive behavior may be a valid animal model for OCD.

Animals↗
PubMed1992

Chronic fluoxetine treatment reduces hypothalamic vasopressin secretion in vitro.

Patients with obsessive-compulsive disorder (OCD) hypersecrete the arousal producing neurohormone arginine vasopressin (AVP) into the cerebrospinal fluid and plasma. Because OCD responds preferentially to potent serotonin uptake inhibitors, we compared the effect of chronic fluoxetine treatment to that of other antidepressants (trazodone and desipramine) on AVP release from rat hypothalamic organ culture and showed that only fluoxetine significantly reduced in vitro AVP release.

Animals↗
PubMed1992

Abnormalities in the regulation of vasopressin and corticotropin releasing factor secretion in obsessive-compulsive disorder.

In light of prior data that the central administration of vasopressin in animals is associated with abnormal persistence of behaviors acquired under aversive conditioning, we studied the secretion of arginine vasopressin into the cerebrospinal fluid and plasma in patients with obsessive-compulsive disorder and controls. Patients with obsessive-compulsive disorder had significantly elevated basal levels of arginine vasopressin in the cerebrospinal fluid and significantly increased secretion of arginine vasopressin into the plasma in response to hypertonic saline administration. Moreover, seven of 12 patients with obsessive-compulsive disorder showed a loss of the normal linear relationship between plasma arginine vasopressin level and osmolality. In addition, cerebrospinal fluid corticotropin releasing hormone, which has synergistic effects with arginine vasopressin centrally and at the pituitary gland, was also significantly elevated in patients with obsessive-compulsive disorder compared with controls.

Adolescent↗
PubMed1992

Regional cerebral glucose metabolism in bulimia nervosa.

OBJECTIVE: The authors' purpose in this study was to further delineate the character of cerebral metabolism in bulimia nervosa and to determine if functional links could be made between regional cerebral metabolism and the symptoms of depression, obsessive-compulsive disorder, and bulimia nervosa. METHOD: Regional cerebral glucose metabolism was measured by using positron emission tomography in 11 inpatients with bulimia nervosa and 18 normal comparison subjects matched in sex (all were women), age, and educational level. The bulimic patients were also tested for symptoms of major depression and obsessive-compulsive disorder. RESULTS: The patients with bulimia showed a correlation between lower left anterolateral prefrontal regional cerebral glucose metabolism and greater depressive symptoms. However, the orbitofrontal regional cerebral glucose metabolism of patients with bulimia was not greater than that of comparison subjects, nor was higher orbitofrontal metabolism correlated with greater obsessive-compulsive disorder symptoms. CONCLUSIONS: These findings lead to the conclusion that left anterior lateral prefrontal cortex hypometabolism varies with the depressive symptoms observed in bulimia but that temporal lobe hypermetabolism and asymmetries appear to be independent of the mood state.

Adult↗
PubMed1992

Regulation of appetite and cholecystokinin secretion in anorexia nervosa.

Six patients with anorexia nervosa, the same patients after weight normalization, and six healthy control subjects had similar fasting and postprandial plasma cholecystokinin concentrations. These data do not support the hypothesis that low levels of hunger and food intake in anorexic patients reflect hypersecretion of this endogenous hormone, which is thought to inhibit hunger, promote satiety, and reduce feeding.

Adult↗
PubMed1992

Plasma and cerebrospinal fluid measures of arginine vasopressin secretion in patients with bulimia nervosa and in healthy subjects.

Bulimia nervosa is a psychiatric syndrome associated with intense hunger, deficient satiety mechanisms, an obsessional preoccupation with the adverse consequences of eating, ritualistic binge eating, and subsequent purging to forestall the effects of the binge. The morbidity of this illness reflects both the psychological suffering associated with a life organized around pathological eating behaviors, as well as medical complications such as fluid and electrolyte imbalances that occur largely as a result of purging and laxative abuse. We report here a study of the osmoregulation of plasma arginine vasopressin secretion and of vasopressin levels in the cerebrospinal fluid. This study was undertaken because vasopressin not only functions as the antidiuretic hormone, and thus as a principal modulator of fluid and electrolyte balance, but also because, in animals, centrally directed vasopressin delays the extinction of behaviors acquired during aversive conditioning. Thirteen normal-weight female patients with bulimia nervosa were studied after at least 1 month of nutritional stabilization and supervised abstinence from binge eating and purging. Plasma vasopressin, plasma sodium, and subjective thirst were measured serially before and during a 2-h infusion of 3% hypertonic saline (0.1 ml/kg min). In addition, cerebrospinal fluid was obtained by lumbar puncture upon admission and at 1 week before hypertonic saline infusion in 11 of these patients and in an additional 11 female patients who did not participate in the hypertonic infusion study. Fifteen healthy normal weight individuals (4 female, 11 male) served as controls for the hypertonic saline infusion and a separate group of 11 healthy normal weight female controls underwent puncture. Compared to controls, bulimic subjects showed a significant reduction in the plasma vasopressin response to hypertonic saline; in 12/13, plasma vasopressin correlated closely with plasma sodium, whereas in one patient vasopressin fluctuated erratically, with no relation to plasma sodium. Cerebrospinal fluid vasopressin levels were significantly higher in patients, and correlated positively with basal thirst level, which was enhanced in bulimics. Compared to controls, patients showed significant polyuria. We conclude that patients with bulimia nervosa have abnormal levels of vasopressin in their plasma and cerebrospinal fluid during abstinence from binge eating and purging. The disturbance in osmoregulation may aggravate the maintenance of adequate fluid volume in these patients, while the increase in centrally directed vasopressin may have relevance to their obsessional preoccupation with the aversive consequences of eating and weight gain.

Adult↗
PubMed1991

Bulimia nervosa. Its effect on salivary chemistry.

Erosion of the dental hard tissues and enlarged parotid and submandibular saliva glands are commonly associated with bulimia nervosa. In 15 patients and controls, no significant difference was detected in the concentrations of potassium, chloride, calcium, urea nitrogen or albumin. There was also no evidence of olfactory dysfunction.

Adult↗
PubMed1991

Symptoms of eating disorders in patients with obsessive-compulsive disorder.

OBJECTIVE: This study was designed to explore potential overlap of the symptoms of obsessive-compulsive disorder and eating disorders. METHOD: The authors administered a structured, self-rating scale, the Eating Disorder Inventory, to 59 outpatients at an obsessive-compulsive disorder clinic and to 60 sex-matched normal volunteers. The Eating Disorder Inventory has been previously validated as a reliable measure of the specific cognitive and behavioral dimensions of the psychopathology typical of patients with eating disorders. The scores of the patients with obsessive-compulsive disorder and of the healthy comparison subjects were compared with those of 32 female inpatients with anorexia nervosa (N = 10) or bulimia nervosa (N = 22) who had also been given the inventory. RESULTS: The patients with obsessive-compulsive disorder scored significantly higher than the healthy comparison subjects on all eight subscales of the Eating Disorder Inventory: drive for thinness, bulimia, body dissatisfaction, ineffectiveness, perfectionism, interpersonal distrust, interoceptive awareness, and maturity fears. Relative to the healthy subjects, male patients with obsessive-compulsive disorder had more symptoms than female patients with obsessive-compulsive disorder. The scores of the female patients with obsessive-compulsive disorder were midway between those of the 32 female patients with eating disorders and those of the 35 female normal subjects. CONCLUSIONS: These results suggest that patients with obsessive-compulsive disorder display significantly more disturbed eating attitudes and behavior than healthy comparison subjects and that they share some of the psychopathological eating attitudes and behavior that are common to patients with eating disorders.

Adult↗
PubMed1991

Decrease in resting metabolic rate during abstinence from bulimic behavior.

Among eight normal-weight bulimic women studied during 1 week of binge eating and vomiting and 7 weeks of abstinence without weight loss, resting metabolic rate and T3 and T4 levels fell significantly during abstinence. These data suggest that a physiological consequence of binge eating and vomiting is an increase in metabolic rate, in part due to increased thyroid hormone activity.

Adult↗
PubMed1989

Changes in perceptual asymmetry with the menstrual cycle.

Changes in perceptual asymmetry between the premenstrual and postmenstrual phases of the menstrual cycle were assessed in 39 women. Perceptual asymmetry was measured with fused, single response dichotic listening tests. The usual right ear advantage (REA) for auditory language-related stimuli was significantly greater in the postmenstrual phase of the cycle. Subjects with repressive personality styles were less likely to show a change in REA with the cycle. These neuropsychological findings are related to previously described physiological and psychological features of the menstrual cycle and the repressive personality style.

Adolescent↗
PubMed1989

Neurohypophyseal dysfunction: implications for the pathophysiology of eating disorders.

Vasopressin (AVP) and oxytocin (OT) are hypothalamic neuropeptides having distinct peripherally and centrally directed cell populations. While principally responsible for the regulation of osmotic equilibrium, AVP also participates in stress-mediated adrenocorticotropic hormone (ACTH) release, and in consolidation and retrieval of aversively conditioned behaviors. OT is principally known for its role in parturition and lactation, but also has effects opposite of AVP, antagonizing stress-mediated ACTH release and impairing the consolidation and retrieval of aversively conditioned behaviors. Our group has demonstrated novel peripheral osmoregulatory defects in underweight anorexics, coupled with hypersecretion of AVP into the cerebrospinal fluid (CSF). Conversely, a relative reduction of CSF OT is seen in underweight anorexics. Speculatively, these reciprocal changes in neurohypophyseal peptides in the underweight anorexic may enhance the observed neuroendocrine and cognitive abnormalities. In addition, the alterations in CSF OT may occur as a consequence of the abnormal gastrointestinal function present during the acute stages of anorexia nervosa.

Feeding and Eating Disorders↗
PubMedDate not supplied

Increased mRNA for corticotrophin releasing hormone in the amygdala of fawn-hooded rats: a potential animal model of anxiety.

Compared to the outbred Wistar rat strain, the Fawn-hooded rat strain has several characteristics which suggest that the Fawn-hooded strain is hyperaroused. Fawn-hooded rats exhibit more freezing behavior in response to stress, have an increased preference for alcohol, develop adult onset hypertension, and have elevated urinary catecholamine levels. We used quantitative in situ hybridization to investigate central components of the corticotropin releasing hormone (CRH), arginine vasopressin (AVP) and noradrenergic stress response and arousal systems in these rats. We also measured basal corticosterone levels and adrenal weights to assess tonic hypothalamic-pituitary-adrenal axis activity. Compared to Wistar rats, Fawn-hooded rats had significantly increased CRH mRNA in the central nucleus of the amygdala and reduced CRH mRNA in the paraventricular nucleus of the hypothalamus. Fawn-hooded rats also bad reduced AVP mRNA expression in the parvocellular cells of the hypothalamic paraventricular nucleus. There were no differences between strains in glucocorticoid receptor mRNA in the hippocampus or the paraventricular nucleus or in mineralocorticoid receptor mRNA in the hippocampus. There was also no difference between strains in tyrosine hydroxylase mRNA in the locus ceruleus. Finally, adrenal weights were significantly reduced in the Fawn-hooded rats while basal corticosterone levels were similar in the two strains, which suggests central hypoactivity of the hypothalamic-pituitary-adrenal axis in Fawn-hooded rats compared to Wistar rats. Increased CRH mRNA in the central nucleus of the amygdala and reduced tonic hypothalamic-pituitary-adrenal axis activity may play a role in the unique behavioral and physiological characteristics of Fawn-hooded rats.

Amygdala↗