Background
ANOREXIA NERVOSA, CORTISOL, HIPPOCAMPUS AND INSULA
Anorexia nervosa (AN) erodes quality of life, carries the highest fatality rate of any psychiatric disease and any other chronic disease in adolescence, and poses a huge health economic burden. There has been no significant improvement of treatments since the disease was described in the last century, and only a few pharmacologic treatments have been tested in a limited number of small, controlled studies. However, weight restoration is associated with cognitive improvements.
Starvation as well as psychological stress activate the hypothalamic - pituitary - adrenal (HPA) axis with secondary anorectic, depressiogenic, and cognition-impairing effects. It has been observed that the cortisol level correlated positively with anxiety and depression in AN. Thus, glucocorticoids may be involved in a vicious circle in the development and maintenance of AN. The hippocampus in the limbic system contains glucocorticoid receptors and is a critical structure for emotional processes as well as memory functions. Hippocampal atrophy clearly has been related to chronic stress and hypercortisolemia in studies on Cushing´s syndrome, depression and AN. However, the cause - effect associations need to be resolved by further biochemical and neuroimaging experimental studies.
Collaborating researchers and departments
Department of Endocrinology & Center for Eating Disorders. Odense University Hospital and Psychiatry in the region og Southern Denmark:
- Principial investigator, professor, MD, PhD René Klinkby Støving
- Jeanie Meincke Egedal, MD
Department of Clinical Science, Umeå university, Umeå, Sweden:
- Magnus Sjögren, Associate professor, MD, PhD
Department of Radiology, Odense University Hospital
- Ole Graumann, associate professor, MD
- Jonas Asgaard Bojsen, MD
Ruhr-University of Bochum, Medical Faculty, University Clinic for Psychosomatic Medicine and Psychotherapy
- Georgios Paslakis, MD, PhD