scholarly journals Ketamine as a Treatment for Anorexia Nervosa: A Narrative Review

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4158
Author(s):  
Johanna Louise Keeler ◽  
Janet Treasure ◽  
Mario F. Juruena ◽  
Carol Kan ◽  
Hubertus Himmerich
Keyword(s):  
Anorexia Nervosa ◽  
Theoretical Background ◽  
Future Research ◽  
Complex Disorder ◽  
Antidepressant Effects ◽  
Underweight Patients ◽  
New Treatment ◽  
Methodological Considerations ◽  
Conceptual Overview ◽  
The Brain

Anorexia nervosa (AN) is a highly complex disorder to treat, especially in severe and enduring cases. Whilst the precise aetiology of the disorder is uncertain, malnutrition and weight loss can contribute to reductions in grey and white matter of the brain, impairments in neuroplasticity and neurogenesis and difficulties with cognitive flexibility, memory and learning. Depression is highly comorbid in AN and may be a barrier to recovery. However, traditional antidepressants are often ineffective in alleviating depressive symptoms in underweight patients with AN. There is an urgent need for new treatment approaches for AN. This review gives a conceptual overview for the treatment of AN with ketamine. Ketamine has rapid antidepressant effects, which are hypothesised to occur via increases in glutamate, with sequelae including increased neuroplasticity, neurogenesis and synaptogenesis. This article provides an overview of the use of ketamine for common psychiatric comorbidities of AN and discusses particular safety concerns and side effects. Potential avenues for future research and specific methodological considerations are explored. Overall, there appears to be ample theoretical background, via several potential mechanisms, that warrant the exploration of ketamine as a treatment for adults with AN.

Contextualizing adolescent structural brain development

2021 ◽  
Author(s):  
Lia Ferschmann ◽  
Marieke Bos ◽  
Megan Herting ◽  
Kathryn L. Mills ◽  
Christian K. Tamnes
Keyword(s):  
Mental Health ◽  
Brain Development ◽  
Social Environment ◽  
Individual Variability ◽  
Neural Systems ◽  
Future Research ◽  
Structural Development ◽  
Policy Changes ◽  
Methodological Considerations ◽  
The Brain

The spatiotemporal group-level patterns of brain macrostructural development across adolescence have over the past decades been relatively well documented. Efforts are now being directed towards understanding individual variability in brain development, as well as its causes and consequences. While genetic factors and pre- and perinatal events have critical impact on brain structural development, calls are now made to also study the brain in dynamic transactional interplay with the different aspects of an individual’s physical and social environment across all stages of development. Such a focus is highly relevant for research on adolescence, a period of life involving a multitude of contextual changes paralleled by continued refinement of complex cognitive and affective neural systems. Insights into the relations between environmental factors and adolescent brain development and the consequences for mental health, have the potential to provide valuable directions for policy changes and targets for prevention. Here, we discuss associations between selected aspects of an individual’s physical and social environment and adolescent brain structural development, and possible links to mental health. We also touch on methodological considerations for future research.

Ghrelin response to hedonic eating in underweight and short-term weight restored patients with anorexia nervosa

2017 ◽  
Vol 41 (S1) ◽  
pp. S550-S550
Author(s):  
G. Fico ◽  
A.M. Monteleone ◽  
M. Nigro ◽  
G. Patriciello ◽  
U. Volpe ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Energy Homeostasis ◽  
Healthy Controls ◽  
Related Disorder ◽  
Structural Abnormalities ◽  
Before And After ◽  
Underweight Patients ◽  
Competing Interest ◽  
The Brain

IntroductionRecently, anorexia nervosa (AN) has been conceptualized as a reward-related disorder, and brain imaging studies have shown functional and structural abnormalities in areas of the brain involved in reward processes in both acute and recovered AN patients. However, the role of endogenous biochemical mediators, such as Ghrelin, in the modulation of reward processes has been poorly investigated in this eating disorder.ObjectivesHedonic eating, that is the consumption of food exclusively for pleasure and not to maintain energy homeostasis, is a useful paradigm to investigate the physiology of food-related reward.AimsWe assessed the Ghrelin response to food-related reward in symptomatic AN women in order to further explore the modulation of reward processes in this severe and debilitating disorder.MethodsPlasma levels of Ghrelin were measured in 7 underweight and 7 recently weight-restored satiated AN patients before and after the ingestion of a favorite (hedonic eating) and non-favorite (non-hedonic eating) food. Ghrelin responses were compared it that of previously studied healthy controls.ResultsWe found that in satiated underweight patients with AN plasma Ghrelin levels progressively decreased after the exposure and the consumption of both the favorite and non-favorite food whereas in satiated weight-restored AN patients and satiated healthy controls plasma Ghrelin concentrations significantly increased after the exposure to the favorite food and after eating it, but decreased after the non-favorite food.ConclusionsThese results suggest a derangement in the Ghrelin modulation of food-related pleasurable and rewarding feelings, which might sustain the reduced motivation toward food intake of acute AN patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Morphological Changes in the Brain of Acutely Ill and Weight-Recovered Patients with Anorexia Nervosa

2014 ◽  
Vol 42 (1) ◽  
pp. 7-18 ◽  
Author(s):  
Jochen Seitz ◽  
Katharina Bühren ◽  
Georg G. von Polier ◽  
Nicole Heussen ◽  
Beate Herpertz-Dahlmann ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Cognitive Deficits ◽  
Time Course ◽  
Morphological Changes ◽  
Meta Analysis ◽  
Short Term ◽  
Clinical Prognosis ◽  
Qualitative Review ◽  
Brain Changes ◽  
The Brain

Objective: Acute anorexia nervosa (AN) leads to reduced gray (GM) and white matter (WM) volume in the brain, which however improves again upon restoration of weight. Yet little is known about the extent and clinical correlates of these brain changes, nor do we know much about the time-course and completeness of their recovery. Methods: We conducted a meta-analysis and a qualitative review of all magnetic resonance imaging studies involving volume analyses of the brain in both acute and recovered AN. Results: We identified structural neuroimaging studies with a total of 214 acute AN patients and 177 weight-recovered AN patients. In acute AN, GM was reduced by 5.6% and WM by 3.8% compared to healthy controls (HC). Short-term weight recovery 2–5 months after admission resulted in restitution of about half of the GM aberrations and almost full WM recovery. After 2–8 years of remission GM and WM were nearly normalized, and differences to HC (GM: –1.0%, WM: –0.7%) were no longer significant, although small residual changes could not be ruled out. In the qualitative review some studies found GM volume loss to be associated with cognitive deficits and clinical prognosis. Conclusions: GM and WM were strongly reduced in acute AN. The completeness of brain volume rehabilitation remained equivocal.

Starving the brain: Structural abnormalities and cognitive impairment in adolescents with anorexia nervosa

2001 ◽  
Vol 6 (2) ◽  
pp. 146-152 ◽  
Author(s):  
Debra K. Katzman ◽  
Bruce Christensen ◽  
Arlene R. Young ◽  
Robert B. Zipursky
Keyword(s):  
Anorexia Nervosa ◽  
Cognitive Impairment ◽  
Structural Abnormalities ◽  
The Brain

Interpersonal Psychotherapy for the Treatment of Eating Disorders

2010 ◽  
pp. 347-372 ◽  
Author(s):  
Marian Tanofsky-Kraff ◽  
Denise E. Wilfley
Keyword(s):  
Anorexia Nervosa ◽  
Clinical Care ◽  
Interpersonal Psychotherapy ◽  
Future Research ◽  
Cognitive Behavior ◽  
Research Directions ◽  
Routine Clinical Care ◽  
Interpersonal Factors ◽  
Future Research Directions

Interpersonal psychotherapy (IPT) is a focused, time-limited treatment that targets interpersonal problem(s) associated with the onset and/or maintenance of EDs. IPT is supported by substantial empirical evidence documenting the role of interpersonal factors in the onset and maintenance of EDs. IPT is a viable alternative to cognitive behavior therapy for the treatment of bulimia nervosa and binge eating disorder. The effectiveness of IPT for the treatment of anorexia nervosa requires further investigation. The utility of IPT for the prevention of obesity is currently being explored. Future research directions include enhancing the delivery of IPT for EDs, increasing the availability of IPT in routine clinical care settings, exploring IPT adolescent and parent–child adaptations, and developing IPT for the prevention of eating and weight-related problems that may promote full-syndrome EDs or obesity.

scholarly journals Immunoregulation and antidepressant effect of ketamine

2021 ◽  
Vol 12 (1) ◽  
pp. 218-236
Author(s):  
Nan Zhang ◽  
Lihua Yao ◽  
Peilin Wang ◽  
Zhongchun Liu
Keyword(s):  
Disease Burden ◽  
Severe Disease ◽  
Mental Health Disorder ◽  
Antagonistic Effect ◽  
Antidepressant Effect ◽  
Future Research ◽  
Recurrence Rates ◽  
Aspartate Receptor ◽  
Antidepressant Effects ◽  
Common Mental Health Disorder

Abstract Major depressive disorder (MDD) is a common mental health disorder that brings severe disease burden worldwide. Traditional antidepressants are mainly targeted at monoamine neurotransmitters, with low remission rates and high recurrence rates. Ketamine is a noncompetitive glutamate N-methyl-d-aspartate receptor (NMDAR) antagonist, and its rapid and powerful antidepressant effects have come to light. Its antidepressant mechanism is still unclarified. Research found that ketamine had not only antagonistic effect on NMDAR but also strong immunomodulatory effect, both of which were closely related to the pathophysiology of MDD. Although there are many related studies, they are relatively heterogeneous. Therefore, this review mainly describes the immune mechanisms involved in MDD and how ketamine plays an antidepressant role by regulating peripheral and central immune system, including peripheral inflammatory cytokines, central microglia, and astrocytes. This review summarizes the related research, finds out the deficiencies of current research, and provides ideas for future research and the development of novel antidepressants.

scholarly journals Involvement of Microglia in the Pathophysiology of Intracranial Aneurysms and Vascular Malformations—A Short Overview

2021 ◽  
Vol 22 (11) ◽  
pp. 6141
Author(s):  
Teodora Larisa Timis ◽  
Ioan Alexandru Florian ◽  
Sergiu Susman ◽  
Ioan Stefan Florian
Keyword(s):  
Immune Cells ◽  
Arteriovenous Malformations ◽  
Intracranial Aneurysms ◽  
Immune Cell ◽  
Vascular Malformations ◽  
Cerebral Injury ◽  
Future Research ◽  
Mortality And Morbidity ◽  
The Central Nervous System ◽  
The Brain

Aneurysms and vascular malformations of the brain represent an important source of intracranial hemorrhage and subsequent mortality and morbidity. We are only beginning to discern the involvement of microglia, the resident immune cell of the central nervous system, in these pathologies and their outcomes. Recent evidence suggests that activated proinflammatory microglia are implicated in the expansion of brain injury following subarachnoid hemorrhage (SAH) in both the acute and chronic phases, being also a main actor in vasospasm, considerably the most severe complication of SAH. On the other hand, anti-inflammatory microglia may be involved in the resolution of cerebral injury and hemorrhage. These immune cells have also been observed in high numbers in brain arteriovenous malformations (bAVM) and cerebral cavernomas (CCM), although their roles in these lesions are currently incompletely ascertained. The following review aims to shed a light on the most significant findings related to microglia and their roles in intracranial aneurysms and vascular malformations, as well as possibly establish the course for future research.

scholarly journals Adapting a neuroscience-informed intervention to alter reward mechanisms of anorexia nervosa: a novel direction for future research

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Ann F. Haynos ◽  
Lisa M. Anderson ◽  
Autumn J. Askew ◽  
Michelle G. Craske ◽  
Carol B. Peterson
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Anxiety Disorders ◽  
Reward Processing ◽  
Future Research ◽  
Restrictive Eating ◽  
Eating Disorder Symptoms ◽  
Mood And Anxiety Disorders ◽  
Reward Responsivity ◽  
Eating Disorder Behaviors

AbstractAccumulating psychobiological data implicate reward disturbances in the persistence of anorexia nervosa (AN). Evidence suggests that individuals with AN demonstrate decision-making deficits similar to those with mood and anxiety disorders that cause them to under-respond to many conventionally rewarding experiences (e.g., eating, interacting socially). In contrast, unlike individuals with other psychiatric disorders, individuals with AN simultaneously over-respond to rewards associated with eating-disorder behaviors (e.g., restrictive eating, exercising). This pattern of reward processing likely perpetuates eating-disorder symptoms, as the rewards derived from eating-disorder behaviors provide temporary relief from the anhedonia associated with limited responsivity to other rewards. Positive Affect Treatment (PAT) is a cognitive-behavioral intervention designed to target reward deficits that contribute to anhedonia in mood and anxiety disorders, including problems with reward anticipation, experiencing, and learning. PAT has been found to promote reward responsivity and clinical improvement in mood and anxiety disorders. This manuscript will: (1) present empirical evidence supporting the promise of PAT as an intervention for AN; (2) highlight nuances in the maintaining processes of AN that necessitate adaptations of PAT for this population; and (3) suggest future directions in research on PAT and other reward-based treatments that aim to enhance clinical outcomes for AN.

scholarly journals Model predictive control for autonomous ground vehicles: a review

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Shuyou Yu ◽  
Matthias Hirche ◽  
Yanjun Huang ◽  
Hong Chen ◽  
Frank Allgöwer
Keyword(s):  
Model Predictive Control ◽  
Predictive Control ◽  
High Performance ◽  
Control Method ◽  
Theoretical Background ◽  
Future Research ◽  
Centralized Control ◽  
Ground Vehicles ◽  
Uncertain Environments ◽  
Autonomous Ground Vehicles

AbstractThis paper reviews model predictive control (MPC) and its wide applications to both single and multiple autonomous ground vehicles (AGVs). On one hand, MPC is a well-established optimal control method, which uses the predicted future information to optimize the control actions while explicitly considering constraints. On the other hand, AGVs are able to make forecasts and adapt their decisions in uncertain environments. Therefore, because of the nature of MPC and the requirements of AGVs, it is intuitive to apply MPC algorithms to AGVs. AGVs are interesting not only for considering them alone, which requires centralized control approaches, but also as groups of AGVs that interact and communicate with each other and have their own controller onboard. This calls for distributed control solutions. First, a short introduction into the basic theoretical background of centralized and distributed MPC is given. Then, it comprehensively reviews MPC applications for both single and multiple AGVs. Finally, the paper highlights existing issues and future research directions, which will promote the development of MPC schemes with high performance in AGVs.

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