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. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association.