A preliminary report on pain thresholds in bulimia nervosa during a bulimic episode

• Published in: Comprehensive psychiatry Vol. 40; no. 3; pp. 229 - 233
• Main Authors: Raymond, Nancy C, Eckert, Elke D, Hamalainen, Michelle, Evanson, Diane, Thuras, Paul D, Hartman, Boyd K, Faris, Patricia L
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.05.1999; Elsevier
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Biological and medical sciences; Bulimia; Bulimia - complications; Bulimia - diagnosis; Disease Progression; Eating behavior disorders; Female; Humans; Medical sciences; Neurons, Afferent - physiology; Pain - diagnosis; Pain - etiology; Pain Measurement - methods; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Severity of Illness Index; Time Factors; Vagus Nerve - physiology; Bulimia; Human; Tolerance; Pain; Eating disorder
• ISSN: 0010-440X; 1532-8384
• DOI: 10.1016/S0010-440X(99)90009-3

Subjects with bulimia nervosa (BN) have been shown to exhibit abnormal satiety responses. Short-term satiety is largely mediated by afferent vagal activity. Activation of afferent vagal fibers has also been found to stimulate a descending pain inhibitory pathway that leads to elevation in somatosensory pain thresholds. Therefore, the study of pain thresholds in BN subjects may lead to a better understanding of afferent vagal function in this disorder. In this preliminary study, pressure pain thresholds were assessed in nine subjects with BN on 3 consecutive days during a binge-eating and vomiting (B/V) episode, during a normal meal, and after an overnight fast. A significant time versus condition effect was found with a significant change in the pain threshold in BN subjects under the B/V condition only. These data are consistent with the hypothesis that vagal afferent activation by a B/V episode also activates the descending pain inhibitory pathway.