1.
Changes in eating behavior after deep brain stimulation for anorexia nervosa. A case study.
Manuelli, M, Franzini, A, Galentino, R, Bidone, R, Dell'Osso, B, Porta, M, Servello, D, Cena, H
Eating and weight disorders : EWD. 2020;(5):1481-1486
Abstract
PURPOSE The purpose of this study was to evaluate changes in the nutritional status, body image concerns, and eating behaviors occurring in a patient who underwent deep brain stimulation (DBS) of the bed nucleus of the stria terminalis for treatment-refractory anorexia nervosa (AN). METHODS Bilateral DBS of the bed nucleus of the stria terminalis was performed in a 37-year-old woman affected by refractory AN. Pre- and post-surgical evaluations were conducted via an array of validated testing instruments, which took into account the weight variations, body image concerns, eating behavior, quality of life, and nutritional status. RESULTS Overall, eating behavior-, body image concern-, and nutritional status-related testing instruments demonstrated improvements starting from the first post-operative month. Normal body weight was restored after 4 months of stimulation. DISCUSSION Only a few cases of DBS for AN have been conducted to determine the efficacy of surgery based upon weight variation and psychometric scales for anxiety and affective disorders. In contrast, we have designed a comprehensive approach taking into account the most important aspects of this disease. This approach should be considered in future studies dealing with the neurosurgical treatment of AN.
2.
Food Bioactive Compounds and Their Interference in Drug Pharmacokinetic/Pharmacodynamic Profiles.
Briguglio, M, Hrelia, S, Malaguti, M, Serpe, L, Canaparo, R, Dell'Osso, B, Galentino, R, De Michele, S, Dina, CZ, Porta, M, et al
Pharmaceutics. 2018;(4)
Abstract
Preclinical and clinical studies suggest that many food molecules could interact with drug transporters and metabolizing enzymes through different mechanisms, which are predictive of what would be observed clinically. Given the recent incorporation of dietary modifications or supplements in traditional medicine, an increase in potential food-drug interactions has also appeared. The objective of this article is to review data regarding the influence of food on drug efficacy. Data from Google Scholar, PubMed, and Scopus databases was reviewed for publications on pharmaceutical, pharmacokinetic, and pharmacodynamic mechanisms. The following online resources were used to integrate functional and bioinformatic results: FooDB, Phenol-Explorer, Dr. Duke's Phytochemical and Ethnobotanical Databases, DrugBank, UniProt, and IUPHAR/BPS Guide to Pharmacology. A wide range of food compounds were shown to interact with proteins involved in drug pharmacokinetic/pharmacodynamic profiles, starting from drug oral bioavailability to enteric/hepatic transport and metabolism, blood transport, and systemic transport/metabolism. Knowledge of any food components that may interfere with drug efficacy is essential, and would provide a link for obtaining a holistic view for cancer, cardiovascular, musculoskeletal, or neurological therapies. However, preclinical interaction may be irrelevant to clinical interaction, and health professionals should be aware of the limitations if they intend to optimize the therapeutic effects of drugs.
3.
Dietary Neurotransmitters: A Narrative Review on Current Knowledge.
Briguglio, M, Dell'Osso, B, Panzica, G, Malgaroli, A, Banfi, G, Zanaboni Dina, C, Galentino, R, Porta, M
Nutrients. 2018;10(5)
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Plain language summary
Neurotransmitters (NTs) are chemical messengers, found mainly within the nervous system. Common NTs are acetylcholine (ACh), glutamate, γ-aminobutyric acid (GABA), dopamine, serotonin (5-HT), and histamine. Many foods are natural sources of NTs that may influence the nervous system, and therefore mood and mental health. This review paper looked at books and studies and discusses the NT content of foods and the possible implications for human health. Acetylcholine is a NT involved in muscle movement, learning and memory. Its presence is documented in more than 50 plant species, including squash, aubergine spinach and nettles. Glutamate is the most abundant excitatory NT in the brain. Glutamic acid naturally occurs in foods with high protein content. Seaweeds, cheeses, fish sauces, soy sauces, fermented beans, and tomato showed high levels of free glutamic acid. Dried cod, salami, caviar, and instant coffee powder are other sources of this amino acid. Salts of glutamic acid, such as monosodium glutamate, are added to certain foods as flavour enhancers. GABA is a calming NT. Studies have found the highest contents of GABA in raw spinach, potato, sweet potato and cruciferous vegetables such as kale and broccoli. Shiitake mushrooms and chestnuts also contained a significant amount of GABA. Dopamine plays an essential role in the coordination of body movements, motivation, and reward. Information on the content of dopamine foods is very limited. Bananas, plantains and avocado were reported to contain high levels of dopamine. 5-HT pathways modulate behaviours, eating, and sleep, and in the gut are involved in the regulation of gastrointestinal motility. In recent years, the number of studies on the content of 5-HT in plants has increased. 5-HT appeared to be prevalent in the green bananas, with higher concentrations found in the peel compared with the flesh. 5-HT was also found in peppers, paprika, hazelnut, tomatoes, pineapple, plum, passion fruit, papaya and kiwi fruit. Histamine is involved in arousal, attention, and reactivity, as well as in local immune responses. The presence of histamine in processed foods, such as aged cheeses, contributes to characteristic flavours and textures. Wine and beer may contain a significant amount of histamine. Fermented foods contain histamine. The food industry generally aims to maintain the levels of amines in foods as low as possible; consumption of fish, cured meat products, sauerkraut, and cheese varieties such as Cheddar, Swiss, Gruyère, and Gouda have been associated with amine poisoning. The significance of dietary NTs intake needs to be further investigated, as there is little data about their bioavailability or clinical implications. New studies should consider if dietary NTs can be transported across the blood-brain barriers or act on the central nervous system via other organs. The authors suggest that in future, including or excluding particular foods containing NTs could be beneficial for patients suffering from Alzheimer’s disease or dementia (an ACh diet), epilepsy or migraines (a glutamate-free diet), anxiety or insomnia (a GABA diet), Parkinson’s disease (a dopamine diet), depressive disorders (a serotonin diet), and vascular headaches (a histamine-free diet).
Abstract
Foods are natural sources of substances that may exert crucial effects on the nervous system in humans. Some of these substances are the neurotransmitters (NTs) acetylcholine (ACh), the modified amino acids glutamate and γ-aminobutyric acid (GABA), and the biogenic amines dopamine, serotonin (5-HT), and histamine. In neuropsychiatry, progressive integration of dietary approaches in clinical routine made it necessary to discern the more about some of these dietary NTs. Relevant books and literature from PubMed and Scopus databases were searched for data on food sources of Ach, glutamate, GABA, dopamine, 5-HT, and histamine. Different animal foods, fruits, edible plants, roots, and botanicals were reported to contain NTs. These substances can either be naturally present, as part of essential metabolic processes and ecological interactions, or derive from controlled/uncontrolled food technology processes. Ripening time, methods of preservation and cooking, and microbial activity further contributes to NTs. Moreover, gut microbiota are considerable sources of NTs. However, the significance of dietary NTs intake needs to be further investigated as there are no significant data on their bioavailability, neuronal/non neuronal effects, or clinical implications. Evidence-based interventions studies should be encouraged.