Table 1.
Major findings of the neurobiology of Bulimia Nervosa as it compares to drug addiction
| Bulimia Nervosa | Drug Addiction | |
|---|---|---|
| NAc Extracellular DA | Increases during bingeing[1-5] | Increases with exposure to drug[6-9] |
| Decreases during fasting[10] | Decreases during withdrawal[7, 8, 11-17] | |
| Increases during re-exposure[5] | Increases or no change during re-exposure depending on schedule of access[14, 15, 18-21] |
|
| D1 binding in NAc | Increases[2] | Increases or no change depending on method of administration[21-28] |
| D2 binding in NAc | Decreases[2, 29, 30] | Decreases for Coc, but increases for other drugs[21, 24, 26, 31] |
| D3 mRNA in the NAc | Increases[30] | Increases[21-27] |
| ΔFosB in NAc | Increases[32, 33] | Increases[34-37] |
| DA in VTA | Increases*[4] | Increases[38-42] |
| VTA DAT binding/mRNA | Increases*[43, 44] | Increases for Amph and Nic, but not Coc[45-49] |
| VTA TH | Increases*[44] | Increases for Coc and Mor, but not Meth[50, 51] |
| Raclopride (IP) | High doses decrease bingeing[52-54] | High doses attenuate relapse[55-58] |
| Low doses increase bingeing[52, 53] | Low doses stimulate reinstatement[58] | |
| SCH 23390 (IP) | Reduces sucrose and fat intake[53] | Attenuates reinstatement[55, 56, 59-63] |
| GluA1 in the NAc | Increases following restriction[64] | Increases following 30-70 d abstinence[65-68] |
| GluA2 in the NAc | No changes following restriction[64] | No changes following abstinence[65] |
| Glutamate release in NAc | Unknown* | Increases[69-71] |
| Memantine | Decreases bingeing[72-74] | No effect[75-79] |
| MTEP | Decreases bingeing[72-73] | Decreases drug-seeking[80-86] |
| PFC activity | Hypofrontality with non-disorder-related cues[87, 88] | Hypofrontality with non-drug-related cues[89-94] |
| Hyperfrontality with disorder-related cues[95-97] | Hyperfrontality with drug-related cues[98-102] | |
| μ-opioid receptor binding | Increases[2] | Increases[103] |
| Naltrexone treatment | Beneficial for bingeing of some foods*[52, 53, 104-110] | Beneficial for Alc and Hern use, but not other drugs[111-113] |
Note. DA = dopamine; VTA = ventral tegmental area; NAc = nucleus accumbens; PFC = prefrontal cortex; Amph = amphetamine; Nic = nicotine; Coc = cocaine; Mor = morphine; Meth = methamphetamine; Alc = alcohol; Hem = heroin.
More research is necessary
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