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Übersichtsarbeiten/Overview articles

Anorexia nervosa

Aktuelle neurowissenschaftliche Befunde

Published Online:December 23, 2013https://doi.org/10.1024/1422-4917/a000268

Abstract

Anorexia nervosa ist eine psychosomatische Erkrankung mit hoher Morbidität und Mortalität, die meist bei Mädchen und jungen Frauen auftritt. Bisher gibt es keine Hinweise auf die Überlegenheit eines bestimmten Therapieverfahrens (Herpertz et al., 2011). Während der klinische Phänotyp bislang im Fokus stand, werden immer häufiger Methoden und Ansätze verwendet, die in der Anorexieforschung bisher unterrepräsentiert waren. Diese beinhalten zum einen die Untersuchung endokrinologischer Merkmale wie z. B. Hormone und andere Mediatoren, die wichtige Vorgänge der Gewichts- und Appetitregulation beeinflussen, aber auch die Erforschung von kognitiven Veränderungen und Persönlichkeitsmerkmalen, die oft auch nach Ende der akuten Krankheitsphase noch messbar sind. Dabei ist es vor allem wichtig, prädisponierende und die Krankheit aufrechterhaltende Faktoren zu identifizieren und zu unterscheiden. Nicht zuletzt ermöglichen bildgebende Verfahren seit einigen Jahren die genauere Untersuchung von funktionellen Zusammenhängen verschiedener Gehirnareale, die diesen prädisponierenden und aufrechterhaltenden Faktoren zugrunde liegen könnten. Letztendlich ist es das Ziel, mit Hilfe dieser neurowissenschaftlichen Methoden langfristig neuropsychologische und biologische Merkmale zu ermitteln, die ein besseres Verständnis der zugrundeliegenden Mechanismen von Anorexia nervosa ermöglichen und damit zur Verbesserung der Behandlung beitragen.


Anorexia nervosa – from a neuroscience perspective

Anorexia nervosa is a frequent disorder especially among adolescent girls and young women, with high morbidity, mortality, and relapse rates. To date, no single therapeutic approach has proved to be superior to others (Herpertz et al., 2011). It remains unclear how its etiology and pathology are encoded within cognitive, neural, and endocrinological processes that modulate important mechanisms in appetitive processing and weight regulation. Yet, several trait characteristics have been identified in AN which might reflect predisposing factors. Further, altered levels of neuropeptides and hormones that regulate appetite and feeding behavior have been found during both the acute and the recovered state, pointing to dysfunctional mechanisms in AN that persist even after malnutrition has ceased. Researchers are also hoping that brain imaging techniques will allow for a more detailed investigation of the neural basis of reward and punishment sensitivity that appears to be altered in AN. The integration and extension of recent findings in these areas will hopefully provide a more comprehensive understanding of the disorder and hence enable the development of more effective treatments.

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