Pain and temporomandibular disorders in patients with eating disorders

Abstract Orofacial pain and temporomandibular dysfunction may cause chronic facial pain, which may interfere with the emotional state and food intake of patients with eating disorders (ED), such as anorexia nervosa (AN) and bulimia nervosa (BN). Sixty-four patients were assigned to four groups: Group A (AN - restricting subtype): 07; Group B (AN - purging subtype ): 19; Group C (BN): 16; and Group D (control): 22. Complaints of pain are more prevalent in individuals with eating disorders (p<0.004). There are differences between the presence of myofascial pain and the number of hospitalizations (p = 0.046) and the presence of sore throat (p=0.05). There was a higher prevalence of masticatory myofascial pain and complaints of pain in other parts of the body in ED patients; however, there was no difference between ED subgroups. There was no difference in the number of self-induced vomiting between ED patients with and without myofascial pain.

A family-based association study of the HTR1B gene in eating disorders

Objective: To explore the association of three polymorphisms of the serotonin receptor 1Dβ gene (HTR1B) in the etiology of eating disorders and their relationship with clinical characteristics. Methods: We analyzed the G861C, A-161T, and A1180G polymorphisms of the HTR1B gene through a family-based association test (FBAT) in 245 nuclear families. The sample was stratified into anorexia nervosa (AN) spectrum and bulimia nervosa (BN) spectrum. In addition, we performed a quantitative FBAT analysis of anxiety severity, depression severity, and Yale-Brown-Cornell Eating Disorders Scale (YBC-EDS) in the AN and BN-spectrum groups. Results: FBAT analysis of the A-161T polymorphism found preferential transmission of allele A-161 in the overall sample. This association was stronger when the sample was stratified by spectrums, showing transmission disequilibrium between the A-161 allele and BN spectrum (z = 2.871, p = 0.004). Quantitative trait analysis showed an association between severity of anxiety symptoms and the C861 allele in AN-spectrum participants (z = 2.871, p = 0.004). We found no associations on analysis of depression severity or preoccupation and ritual scores in AN or BN-spectrum participants. Conclusions: Our preliminary findings suggest a role of the HTR1B gene in susceptibility to development of BN subtypes. Furthermore, this gene might have an impact on the severity of anxiety in AN-spectrum patients.

Cortex insular y su rol putativo en la configuración de trastornos alimenticios / Insular Cortex and putative role in the configuration of eating disorders

El estudio neurocientífico de los desordenes alimenticios, ha experimentado importantes avances en la ultima década, posibilitando dilucidar sustratos cerebrales asociados a la configuración de diversas patologías. El lóbulo insular ha sido escasamente estudiado, trabajos de neuroimagen recientes han permitido conocer su representación anatómica, citoarquitectónica y funcional, así como su conexión con el sistema límbico y neocortex. Su activación, ha sido implicada en diversos procesos: sensomotores viscerales, somatosensoriales (incluyendo el dolor), motores, volitivos, gustativos, auditivos, vestibulares, emocionales y funciones cognitivas como el lenguaje (Ackermann, H.; Riecker, A; 2004). El presente artículo, tiene por objetivo analizar los correlatos neurofisiológicos asociados a desordenes alimenticios (obesidad, anorexia y bulimia). Sugiriendo una activación tónica diferencial en ínsula, que permitiría explicar la experiencia de saciedad y valoración afectiva a estímulos apetitivos, alterada en desordenes alimenticios.

The study neurocientífico of food disorders, has experienced significant progress in the last decade, enabling elucidate substrates brain associated with the configuration of various pathologies. The lobe island has been little studied, neuroimaging recent work has revealed his anatomical representation, citoarquitectónica and functional as well as its connection with the limbic system and neocortex. Their activation has been implicated in various processes: sensomotores visceral, somatosensory (including pain), motors, volitivo, taste, hearing, vestibular, emotional and cognitive functions such as language (Ackermann, H.; Rieck, A, 2004). This article aims to analyze the neurophysiological correlates associated with food disorders (obesity, anorexia and bulimia). Suggesting an activation pattern in differential island, which would explain the experience of satiety and valuation emotional stimuli to appetite, altered food disorders.

The use of a manual-driven group cognitive behavior therapy in a Brazilian sample of obese individuals with binge-eating disorder

OBJECTIVE: To assess the effectiveness of a manual-based cognitive behavior therapy adapted to a group format in a sample of Brazilian obese subjects with binge-eating disorder. METHOD: In an open trial, 21 obese subjects with binge-eating disorder received a group cognitive-behavioral therapy program. Changes in binge-eating frequency, weight, body shape concerns, and depressive symptoms were compared between baseline and the end of the study. RESULTS: The mean frequency of binge-eating episodes significantly decreased from baseline to post-treatment (p < 0.001), with a binge eating remission rate of 76.1 percent at the end of the trial. Depressive symptoms and body shape concern also improved (p < 0.001). In addition, weight loss was statistically and clinically significant. CONCLUSION: The use of this adapted manual-based cognitive behavior therapy in this sample resulted in a marked improvement in binge-eating, weight, body shape concern, and depressive symptoms related to binge-eating disorder.

OBJETIVO: Avaliar a efetividade da terapia cognitivo-comportamental baseada em um manual adaptado para o formato de grupo em uma amostra brasileira de obesos com transtorno da compulsão alimentar periódica. MÉTODO: Em um estudo aberto, 21 pacientes obesos com transtorno da compulsão alimentar periódica participaram de um programa da terapia cognitivo-comportamental em grupo. A freqüência da compulsão alimentar, o peso corporal, o grau de satisfação com a forma corporal e os sintomas depressivos foram avaliados no início do tratamento e no final do estudo. RESULTADOS: Houve uma redução estatisticamente significativa da freqüência média de episódios de compulsão alimentar entre a linha de base e o final do tratamento (p < 0,001), com uma taxa de remissão de episódios no final do estudo de 76,1 por cento. Foi observada, também, uma redução significativa dos sintomas depressivos e da insatisfação com a forma corporal (p < 0,001). Adicionalmente, a perda de peso foi clínica e estatisticamente significativa. CONCLUSÃO: A utilização de terapia cognitivo-comportamental baseada em um manual adaptado para o transtorno da compulsão alimentar periódica resultou em melhora significativa da compulsão alimentar, do peso corporal, da preocupação com a forma corporal e dos sintomas depressivos associados ao transtorno da compulsão alimentar periódica nessa amostra.