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my personal edition > psychiatry other > news
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DGDispatch
Testosterone May Help Treat Anorexia Nervosa: Presented at ENDO
By Mike Fillon
NEW ORLEANS, LA -- June 22, 2004 -- Testosterone -- a hormone that has not been widely studied in women -- may be useful in treating women with anorexia nervosa.
"Through our research, we may have identified a possible hormone treatment in women who suffer from anorexia nervosa," said lead researcher Karen K. Miller, MD, Assistant Professor of Medicine, Harvard Medical School, and Assistant in Medicine, Department of Medicine, Massachusetts General Hospital, Boston.
Results of the study were reported here June 19th in a clinical oral session at the 86th Annual Meeting of The Endocrine Society.
Anorexia nervosa -- a psychiatric disease that affects up to 1% of young women -- has a high death rate due to suicide and medical complications. Previous research using imaging techniques, such as computer tomography and magnetic resonance imaging, found abnormalities in brain structure and function in individuals with anorexia nervosa. The abnormalities in brain function have not been consistently well localized to specific areas of the brain and few specific therapies for these abnormalities have been identified.
Dr. Miller and colleagues compared 14 women with anorexia nervosa ages 20 to 27 years who were treated with a transdermal testosterone patch and 20 healthy controls of similar age. The researchers used FDG positron emission tomography (PET) to investigate regional brain glucose metabolism to identify specific brain areas that were using less glucose to fuel the brain -- a measure of brain function and a common problem in people with anorexia nervosa.
The researchers found decreased function in the following areas of the brain: posterior cingulate cortex, pregenual anterior cingulate, left middle temporal, right superior temporal, and left dorsolateral prefrontal cortex in the group with anorexia compared with controls. In the patients receiving testosterone, cerebral metabolism increased in the posterior cingulate cortex, subgenual anterior cingulate cortex, premotor cortex, right caudate and right parietal lobes. Free testosterone increased significantly in the testosterone treatment group compared with placebo, but no increase in estradiol levels was observed.
The researchers demonstrated decreased brain function in the posterior cingulate cortex in, in women with anorexia nervosa compared to controls. This is one of the brain regions that controls emotional information processing and memory. They also noticed that low-dose testosterone therapy improved brain function of this same area in the women with anorexia nervosa.
Previous studies implicated the posterior cingulate cortex in emotional information processing and memory. Dr. Miller said that there is also substantial evidence showing that dysfunction in this region plays a role in the pathophysiology of mood and anxiety disorders.
These finding appear to be attributable to testosterone and not mediated by conversion to estradiol.
"Further studies are needed to replicate these findings, to determine the significance of androgen deficiency as it related to the pathophysiology of anorexia nervosa and to more thoroughly assess the role of androgen therapy in women with eating disorders," Dr. Miller said.
[Presentation title: "Testosterone Administration Attenuates Regional Brain Hypometabolism in Women with Anorexia Nervosa." Abstract #OR44-5]
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