Abstract
A growing body of evidence indicates that hormones play an important role in learning and memory functions as well as in mood modulation. During the acute stage of anorexia nervosa (AN), weight loss has a significant effect on serum levels of estrogen, thyroid hormones, and cortisol. Furthermore deficits in learning and memory functions are evident in patients with eating disorders during emaciation. Hormonal and neuropsychological alterations at least partly remit during weight restoration. We investigated the association between learning and memory functions as well as mood and neuroendocrinological parameters before and after weight gain in adolescent AN. Twenty-eight female subjects with AN, diagnosed according to DSM-IV, were examined before and after weight recovery. Both investigations took place while the patients were receiving hospital treatment, and the results were compared to a control group consisting of 18 age- and IQ-matched normal-weight female adolescents also tested twice within 4 months. Verbal memory and learning were assessed by a German paper–pencil-test (LGT). We performed correlation calculations between neuropsychological functions and depressive symptoms and estrogen, cortisol and free triiodothyronine (fT3) in the plasma at both time points. Compared to normal controls adolescents with AN performed worse in one subtest of the LGT which requires the verbal reproduction of figural material across both time points. Verbal learning was positively correlated with estrogen levels after weight recovery. Depressive symptoms of AN patients significantly decreased during weight rehabilitation and correlated negatively with fT3 at T 1. We did not find a relationship between cortisol levels and neuropsychological functions. We observed subtle memory impairments and depressive symptoms in subjects with adolescent AN associated with starvation-induced estrogen and triiodothyronine deficits, respectively. Normalization of body weight and resuming of menses is needed to restore learning and memory functions as well as to alleviate depressive symptoms.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders—DSM-IV, 4th edn. American Psychiatric Association, Washington, DC
Bailer UF, Kaye WH (2003) A review of neuropeptide and neuroendocrine dysregulation in anorexia and bulimia nervosa. Curr Drug Targets CNS Neurol Disord 2(1):53–59
Bauer M, London ED, Silverman DHS, Rasgon N, Kirchheiner J, Whybrow PC (2003) Thyroid, brain and mood modulation in affective disorder: insights from molecular research and functional brain imaging. Pharmacopsychiatry 36(3):S215–S221
Bäumler G (1974) Lern-und Gedächtnistest LGT-3. Verlag für Psychologie, Dr. C. Hogrefe, Göttingen
Blanz BJ, Detzner U, Lay B, Rose F, Schmidt MH (1997) The intellectual functioning of adolescents with anorexia nervosa and bulimia nervosa. Eur Child Adolesc Psychiatry 6(3):129–135
Casper RC (1998) Depression and eating disorders. Depress Anxiety 8(1):96–104
Chui HAT, Christensen BK, Zipursky RB, Richards BA, Hentratty MK, Kabani NJ, Mikulis DJ, Katzman DK (2008) Cognitive function and brain structure in females with a history of adolescent-onset anorexia nervosa. Pediatrics 122(2):e427–e437
Davis JD, Tremont G (2007) Neuropsychiatric aspects of hypothyroidism and treatment reversibility. Minerva Endocrinol 32(1):49–65
Duchesne M, Mattos P, Fontenelle LF, Veiga H, Rizo L, Appolinario JC (2004) Neuropschology of eating disorders: a systematic review of literature. Rev Bras Psiquiatr 26(2):107–117
Fichter M, Quadflieg N (2001) The structured interview of anorexic and bulimic disorders for DSM-IV and ICD-10 (SIAB-EX): reliability and validity. Eur Psychiatry 16:38–48
Galderisi S, Mucci A, Monteleone P, Sorrentino D, Piegari G, Maj M (2003) Neurocognitive functioning in subjects with eating disorders: the influence of neuroactive steroids. Biol Psychiatry 53:921–927
Hautzinger M, Kühner C, Keller F (2006) BDI-II beck-depressions-inventar. Pearson Assessment and Information GmbH, Germany
Herpertz-Dahlmann B, Salbach-Andrae H (2009) Overview of treatment modalities in adolescent anorexia nervosa. Child Adolesc Psychiatr Clin N Am 18(1):131–145
Herpertz-Dahlmann BM, Wewetzer C, Remschmidt H (1995) The predictive value of depression in anorexia nervosa. Results of a seven-year follow-up study. Acta Psychiatr Scand 91(2):114–119
Kerem NC, Katzman DK (2003) Brain structure and function in adolescents with anorexia nervosa. Adolesc Med 14(1):109–118
Kromeyer-Hauschild K, Wabitsch M, Geller F, Ziegler A, Geiß HC, Hesse V, Hippel v, Jaeger U, Johnsen D, Kiess W, Korte W, Kunze D, Menner K, Müller M, Niemann-Pilatus A, Remer Th, Schaefer F, Wittchen HU, Zabransky S, Zellner K, Hebebrand J (2001) Perzentile für den Body Mass Index für das Kindes- und Jugendalter unter Heranziehung verschiedener deutscher Stichproben. Monatsschr Kinderheilkd 149:807–818
Larisch R, Kley K, Nikolaus S, Sitte W, Franz M, Hautzel H, Tress W, Müller HW (2004) Depression and anxiety in different thyroid function states. Horm Metab Res 36:650–653
Maki PM (2005) Estrogen effects on the hippocampus and frontal lobes. Int J Fertil Womens Med 50(2):67–71
Maki PM, Rich JB, Rosenbaum RS (2002) Implicit memory varies across the menstrual cycle: estrogen effects in young women. Neuropsychologia 40:518–529
Mathias JL, Kent PS (1998) Neuropsychological consequences of extreme weight loss and dietary restriction in patients with anorexia nervosa. J Clin Exp Neuropsychol 20:548–564
Misra M, Klibanski A (2010) Neuroendocrine consequences of anorexia nervosa in adolescents. Endocr Dev 17:197–214
Neufang S, Specht K, Hausmann M, Güntürkün O, Herpertz-Dahlmann B, Fink GR, Konrad K (2009) Sex differences and the impact of steroid hormones on the developing human brain. Cereb Cortex 19(2):464–473
Nicholls D, Viner R (2005) Eating disorders and weight problems. BMJ 330(7497):950–953
Nikendei C, Funiok C, Pfüller U, Zastrow A, Aschenbrenner S, Weisbrod M, Herzog W, Friederich HC (2010) Memory performance in acute and weight-restored anorexia nervosa patients. Psychol Med 9:1–10
Petermann F, Petermann U (2008) Hamburg-Wechsler-Inteligenztest für Kinder IV (HAWIK-IV). Huber, Bern
Roberts M, Tchanturia K, Stahl D, Southgate L, Treasure J (2007) A systematic review and meta-analysis of set-shifting ability in eating disorders. Psychol Med 37:1075–1085
Ross JL, Stefanos GA, Kushner H, Bondy C, Nelson L, Zinn A, Roeltgen D (2004) The effect of genetic differences and ovarian failure: Intact cognitive function in adult women with premature ovarian failure versus turner syndrome. J Clin Endocrinol Metab 89(4):1817–1822
Seed JA, Dixon RA, McCluskey SE, Young AH (2000) Basal activity of the hypothalamic-pituitary-adrenal axis and cognitive function in anorexia nervosa. Eur Arch Psychiatry Clin Neurosci 250(1):11–15
Seed JA, McCue PM, Wesnes KA, Dahabra S, Young AH (2002) Basal activity of the HPA axis and cognitive function in anorexia nervosa. Int J Neuropsychopharmacol 5(1):17–25
Sherwin BB (2003) Estrogen and cognitive functioning in women. Endocr Rev 24(2):133–151
Sherwin BB (2007) The clinical relevance of the relationship between estrogen and cognition in women. J Steroid Biochem Mol Biol 106(1–5):151–156
Unnewehr S, Scheinder S, Magraf J (1995) Kinder DIPS—Diagnostisches Interview bei psychischen Störungen im Kindes-und Jugendalter. Springer, Heidelberg
Wolf OT (2009) Stress and memory in humans. Twelve years of progress? Brain Res 1293:142–154
Acknowledgments
The study was supported by the German Ministry of Education and Research, BMBF Nr. 01GV0602.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Buehren, K., Konrad, K., Schaefer, K. et al. Association between neuroendocrinological parameters and learning and memory functions in adolescent anorexia nervosa before and after weight recovery. J Neural Transm 118, 963–968 (2011). https://doi.org/10.1007/s00702-010-0567-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00702-010-0567-4