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Autonomic nervous system function in women with anorexia nervosa

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Abstract

Purpose

Abnormalities in autonomic function have been observed in people with anorexia nervosa. However, the majority of investigations have utilised heart rate variability as the sole assessment of autonomic activity. The current study utilised a variety of methodologies to assess autonomic nervous system function in women with a current diagnosis of anorexia, a past diagnosis of anorexia who were weight-restored, and healthy controls.

Methods

The sample included 37 participants: 10 participants with anorexia, 17 weight-restored participants (minimum body mass index > 18.5 for minimum of 12 months) and 10 controls. Assessments of autonomic function included muscle sympathetic nerve activity (MSNA) using microneurography, heart rate variability, baroreflex sensitivity, blood pressure variability, head-up tilt table test, sudomotor function and assessment of plasma catecholamines.

Results

MSNA (bursts/min) was significantly decreased in both anorexia (10.22 ± 6.24) and weight-restored (17.58 ± 1.68) groups, as compared to controls (23.62 ± 1.01, p < 0.001 and p = 0.033, respectively). Participants with anorexia had a significantly lower standard deviation in heart rate, lower blood pressure variability and decreased sudomotor function as compared to controls. Weight-restored participants demonstrated decreased baroreflex sensitivity in response to head-up tilt as compared to controls.

Conclusion

Women with a current or previous diagnosis of anorexia have significantly decreased sympathetic activity, which may reflect a physiological response to decreased energy intake. During the state of starvation, women with anorexia also displayed decreased sudomotor function. The consequences of a sustained decrease in MSNA are unknown, and future studies should investigate autonomic function in long-term weight-restored participants to determine whether activity returns to normal.

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Availability of data and material

The data sets used in the current study are available from the corresponding author on reasonable request.

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Funding

This study was conducted with funding from St. Vincent’s Hospital Research Endowment Fund and the Barbara Dicker Brain Sciences Foundation.

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Authors and Affiliations

  1. Iverson Health Innovation Research Institute and School of Health Sciences, Swinburne University of Technology, Melbourne, Australia

    Zoe M. Jenkins, Nina Eikelis, Gavin W. Lambert & Elisabeth A. Lambert

  2. Department of Mental Health, St Vincent’s Hospital Melbourne, PO Box 2900, Fitzroy, VIC, 3065, Australia

    Zoe M. Jenkins, David J. Castle & Andrea Phillipou

  3. Department of Psychiatry, University of Melbourne, Melbourne, Australia

    Zoe M. Jenkins & Andrea Phillipou

  4. Centre for Complex Interventions, Centre for Addictions and Mental Health, Toronto, Canada

    David J. Castle

  5. Department of Psychiatry, University of Toronto, Toronto, Canada

    David J. Castle

  6. Centre for Mental Health and School of Health Sciences, Swinburne University of Technology, Melbourne, Australia

    Andrea Phillipou

  7. Department of Mental Health, Austin Health, Melbourne, Australia

    Andrea Phillipou

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  1. Zoe M. Jenkins
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  2. David J. Castle
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  3. Nina Eikelis
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Correspondence to Zoe M. Jenkins.

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The authors declare no conflict of interest for this research.

Ethical approval

The research protocol was approved by the human research ethics committees at St Vincent’s Hospital, Melbourne (HREC/18/SVHM/126), Swinburne University of Technology (SHR Project 2018/183) and The Melbourne Clinic (Project 307).

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All participants provided written informed consent.

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10286_2021_836_MOESM1_ESM.tif

Supplementary file1 Supplementary Figure 1. Correlation between MSNA bursts/min and BMI across sample (grouped according to psychotropic medication treatment status; r = 0.485; p = .005). BMI: body mass index; MSNA: muscle sympathetic nerve activity. (TIF 1242 KB)

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Jenkins, Z.M., Castle, D.J., Eikelis, N. et al. Autonomic nervous system function in women with anorexia nervosa. Clin Auton Res 32, 29–42 (2022). https://doi.org/10.1007/s10286-021-00836-z

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