A Longitudinal Magnetic Resonance Imaging Study of Brain Changes in Adolescents With Anorexia Nervosa

Altered 5-HT2A Receptor Binding after Recovery from Bulimia-Type Anorexia Nervosa: Relationships to Harm Avoidance and Drive for Thinness

“…While it is well known that ill AN subjects have reduced cortical volume (Ellison and Fong, 1998) and increased ventricular volume (Golden et al, 1996;Swayze et al, 1996;Katzman et al, 1996), it remains uncertain whether such brain volume reductions and enlargement of CSF spaces persist in the recovered state (Artmann et al, 1985;Swayze et al, 2003). Some studies showed that weightrecovered AN have significantly greater CSF volumes and smaller gray matter volumes than healthy control women Katzman et al, 1997, Krieg et al, 1988. In this study, no group differences were detected between the atrophy correction factors, across ROIs.…”

Eating disorders in adolescentsposition paper of the Society for Adolescent Medicine

“…Most of the medical complications in adolescents with an eating disorder improve with nutritional rehabilitation and recovery from the eating disorder, but some are potentially irreversible. Potentially irreversible medical complications in adolescents include: growth retardation if the disorder occurs before closure of the epiphyses [10,11,[23][24][25][26]; loss of dental enamel with chronic vomiting [27]; structural brain changes noted on cerebral tomography, magnetic resonance imaging and single-photon computerized tomography studies [28,29]; pubertal delay or arrest [30,31]; and impaired acquisition of peak bone mass [9,13,[32][33][34][35], predisposing to osteoporosis and increased fracture risk. These features underscore the importance of immediate medical management, ongoing monitoring and aggressive treatment by physicians who understand adolescent growth and development.…”

Identification and Management of Eating Disorders in Children and Adolescents

“…Brain changes may be associated with elevated cortisol concentrations related to HPA-axis dysfunction, analogous to changes now being reported in other psychiatric disorders such as posttraumatic stress disorder. 89 Cognitive impairment has been demonstrated across the wide range of neuropsychological domains but does not seem to be directly proportional to structural brain changes. 84 Functional imaging studies of the brain show decreases in both global and localized brain activity, but it is unknown whether these decreases precede or are a consequence of weight loss or whether they are reversible.…”

“…90 Normalization of white matter occurs with refeeding; however, gray matter changes seem to persist despite weight recovery. 84,89 …”