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Clinical Investigations |
1 Department of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent, Belgium
2 Division of Nuclear Medicine, Ghent University Hospital, Ghent, Belgium
3 Department of Radiopharmacy, Ghent University, Ghent, Belgium
4 VUB-Cyclotron, Brussels, Belgium
Indirect estimations of brain neurotransmitters in patients with anorexia nervosa (AN) and low weight have demonstrated a reduction in brain serotonin (5-HT) turnover in general and led to hypotheses about dysfunction in the 5-HT2a receptor system. It was our aim to investigate the central 5-HT2a receptor binding index using SPECT brain imaging. Methods: The 5-HT2a receptors of low-weight patients with AN were studied by means of the highly specific radioiodinated 5-HT2a receptor antagonist 4-amino-N-[1-[3-(4-fluorophenoxy)propyl]-4-methyl-4-piperidinyl]-5-iodo-2-methoxybenzamide or 123I-5-I-R91150. Fifteen patients with clinical diagnoses of AN and 11 age-matched healthy volunteers received intravenous injections of 185 MBq 123I-5-I-R91150 and were scanned with high-resolution brain SPECT. Results: Compared with healthy volunteers, patients with AN had a significantly reduced 5-HT2a binding index in the left frontal cortex, the left and right parietal cortex, and the left and right occipital cortex. A significant left-right asymmetry was noted in the frontal cortex (left < right). Conclusion: These results are in accordance with diminished metabolic and perfusion of frontal and parietal cortices reported in recent neuroimaging studies and imply localized disturbed serotonergic function. The data are discussed in the light of possible confounding factors related to the low-weight AN status. A regional cortical reduction in 5-HT2a binding index is not likely to be caused by a general reduction in serotonergic function due to the possible confounding factors. Suggestions for further research are given.
Key Words: anorexia nervosa • serotonin • serotonin-2A receptor • SPECT
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