Implications of starvation‐induced change in right dorsal anterior cingulate volume in anorexia nervosa

Abstract

Objective Converging evidence suggests a role for the anterior cingulate cortex (ACC) in the pathophysiology of anorexia nervosa (AN). This study sought to determine whether ACC volume was affected by starvation in active AN and, if so, whether this had any clinical significance. Method Eighteen patients with active AN and age- and gender-matched normal controls underwent magnetic resonance imaging (MRI). Sixteen patients (89%) with AN had intelligence quotients (IQ) testing at intake, 14 (78%) had repeat MRIs after weight normalization, and 10 (56%) had outcome data at 1-year post-hospitalization. Results Right dorsal ACC volume was significantly reduced in active AN patients versus controls and was correlated with lower performance IQ. While ACC normalization occurred with weight restoration, smaller change in right dorsal ACC volume prospectively predicted relapse after treatment. Conclusion Reduced right dorsal ACC volume during active AN relates to deficits in perceptual organization and conceptual reasoning. The degree of right dorsal ACC normalization during treatment is related to outcome.

Altered Medial Frontal Feedback Learning Signals in Anorexia Nervosa

“…While these studies 230 suggest altered pMFC functioning in AN, the direction of group differences vary and the possible 231 interpretations range from altered conflict monitoring, excessive cognitive control and increased 232 neural efficiency. Structurally, volume reductions in the ACC (including portions of the pMFC) in 233 acutely ill AN have been related to deficits in perceptual organization and conceptual reasoning, 234 while the degree of normalization during treatment was linked to clinical outcome (54). Using SPECT, 235 reduced regional cerebral blood flow in the dACC extending into the pre-SMA was observed during 236 the acute phase of the illness and after weight recovery (55).…”

Metabolic gray matter changes of adolescents with anorexia nervosa in combined MR proton and phosphorus spectroscopy

“…More recent studies revealed selective GM reductions in AN patients [25][26][27][28][29][30][31]. Whether this reduction is reversible upon weight gain is under discussion [23,[25][26][27][28][29][30][31][32][33][34]. Voxel-based morphometry (VBM) studies reported GM decreases predominantly in the cingulate cortex and in the temporoparietal association cortex [25][26][27][28][29][30][31][32].…”

“…Early neuroimaging studies found inconsistent results of brain volume changes, reporting a decrease for the gray matter (GM) and white matter (WM) [21][22][23], or for the WM only [24]. More recent studies revealed selective GM reductions in AN patients [25][26][27][28][29][30][31]. Whether this reduction is reversible upon weight gain is under discussion [23,[25][26][27][28][29][30][31][32][33][34].…”

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

“…Studies have utilised structural [positron emission tomography (Gordon, Lask, Bryant-Waugh, Christie, & Timimi, 1997;Gordon, Dougherty, et al, 2001), single-photon emission computed tomography (Kojima et al, 2005;Lask et al, 2005) and magnetic resonance imaging (McCormick et al, 2008;Castro-Fornieles et al, 2009)] and functional imaging (Uher et al, 2005;Wagner et al, 2007;Zastrow et al, 2009). There is also a large body of positron emission tomography and single-photon emission computed tomography evidence indicating abnormal neurotransmitter systems (serotonin and dopamine) in AN (Audenaert et al, 2003;Frank et al, 2005;Bailer, Frank, Henry, Price, Meltzer, Mathis, et al, 2007;Galusca et al, 2008).…”