Assessment of neurobiology in adults with anorexia nervosa

Abstract

Objective: Neuroimaging and neuropsychology studies in anorexia nervosa have produced conflicting results due to confounding variables of comorbidity, psychotropic medication, age of onset, states of starvation and the absence of homogenous samples and suitable control groups. The aim of this study is to determine if consistent functional abnormalities of the brain exist in a homogeneous sample of women with anorexia nervosa compared to and controls, and to seek any association between such abnormalities and neuropsychological deficits. Methods: Eleven women with anorexia nervosa and no comorbidity underwent regional cerebral blood flow (rCBF) examination using single photon computerised tomography (SPECT) and the Eating Disorder Examination (EDE) Results were compared with those from studies on children and adolescents with AN and 11 control subjects. A battery of neuropsychometric tests (IQ, attention and memory, visuospatial and executive function) was administered to the patient group in order to examine the relationship between rCBF abnormalities and cognitive functioning. Results: Hypoperfusion was demonstrated in the anterior temporal lobe and /or caudate nuclei in 8 of 11 patients. No hypoperfusion was identified in the control group. The patient group demonstrated consistent deficits in memory tasks associated with temporal lobe function. Conclusions: The findings in this adult cohort were very similar to those in studies of children and adolescents with AN (Chowdhury et al., 2003) and significantly different from controls. Cortical involvement in the pathogenesis of anorexia nervosa is postulated and further research requirements are outlined.

Central Coherence, Organizational Strategy, and Visuospatial Memory in Children and Adolescents With Anorexia Nervosa

“…Firstly, the present study focused on children and adolescents. The vast majority of studies that have shown visuospatial ability and memory deficits in anorexia nervosa have focused on adult populations (Jones, Duncan, Brouwers, & Mirsky, 1991;Kemps, Tiggemann, Wade, Ben-Tovim, & Breyer, 2006;Key, O'Brian, Gordon, Christie, & Lask, 2006;Lopez, Tchanturia, Stahl, Booth, et al, 2008;Lopez et al, 2009;Sherman et al, 2006;Szmukler et al, 1992;Thompson, 1993). Three studies have used a mixed sample of children, adolescents, and adults (Fowler et al, 2006;Hamsher, Halmi, & Benton, 1981;Tenconi et al, 2010), while four have focused on adolescents and adults (Grunwald et al, 2001;Kingston, Szmukler, Andrewes, Tress, & Desmond, 1996;Mathias & Kent, 1998;Tokley & Kemps, 2007).…”

A Case Series Investigating Distinct Neuropsychological Profiles in Children and Adolescents with Anorexia Nervosa

“…There is an even greater body of evidence implicating executive dysfunction (Jones et al, 1991;Duchesne et al, 2004;Holliday, Tchanturia, Landau, Collier, & Treasure, 2005;Steinglass, Walsh, & Stern, 2006;Nakazato et al, 2009;Brogan, Hevey, & Pignatti, 2010;Erzegovesi et al, 2010) and visuospatial processing impairments (Jones et al, 1991;Szmukler et al, 1992;Gillberg, Gillberg, Rastam, & Johansson, 1996;Kingston, Szmukler, Andrewes, Tress, & Desmond, 1996;Mathias & Kent, 1998;Grunwald et al, 2001;Lask et al, 2005;Key et al, 2006). Two comprehensive reviews of the neuropsychological literature (Duchesne et al, 2004;Lena, Fiocco, & Leyenaar, 2004) found a lack of consensus, with no clear patterns in the neuropsychology of AN and no evidence that many of the reported deficits reverse with nutritional rehabilitation.…”

Do abnormalities in regional cerebral blood flow in anorexia nervosa resolve after weight restoration?

“…Chowdhury, Gordon, Lask, Christie, Wigley, & Watkins, 2003;Gordon, Lask, Bryant-Waugh, Christie, & Timimi, 1997) and in adults (e.g. Key, Christie, O'Brien, Gordon, & Lask, 2006;Kojima et al, 2005). Up to 70% of patients at low weight show this abnormality.…”