A neurodevelopmental model for anorexia nervosa

Neurobiology of anorexia and bulimia nervosa

“…Adolescence (35) is a time of profound biological, psychological and sociocultural change, and it demands a considerable degree of flexibility to successfully manage the transition into adulthood. Psychologically, change may challenge the rigidity of those at risk for AN and BN, and thus open a window of vulnerability (35). Importantly, biological changes may significantly enhance the risk of onset of an ED, particularly in women.…”

Disruption of brain white matter microstructure in women with anorexia nervosa

“…For example, the typically hyperactive hypothalamic-pituitary-adrenal axis observed in anorexia nervosa can lead to hippocampal atrophy in animal models. 3 The hippocampus has been implicated in weight-regulation processes, 55 and animal models have shown that both lesions of the hippocampus and fornix transections lead to alterations in eating behaviours. 56,57 The reward system is also intrinsically related to bodyenergy regulation.…”

“…11,12 At the same time, the major reorganization in white matter that the brain undergoes during adolescence and early adulthood is thought to be relevant to the development of some psychi atric disorders, including anorexia nervosa. 3,13 Normal maturation and organization of white matter might be affected in patients with anorexia nervosa, particularly when considering that most of the identified factors contributing to the develop ment of the disorder -including psychological, social and biological factors -have their major impact in this period. Despite all this, white matter alterations remain rather unexplored in anorexia nervosa.…”

Risk factors in the development of anorexia nervosa

“…Dalje, kod osoba sa anoreksijom nervozom umanjen je talamus, smanjena je zapremina desnog dorzalnog korteksa, poremećeno je funkcionisanje insule, prisutne su lezije u desnom frontalnom i temporalnom režnju, kortikalna atrofija i proširenje moždanih komora, smanjenje bele i sive moždane mase (zapremina sive mase smanjena je posebno u prednjem cingularnom girusu), anomalije u funkcionisanju hipotalamo-hipofiznoadrenalnog sistema stresa tokom bolesti i nakon oporavka (Connan et al, 2003).…”