Functional brain alterations in anorexia nervosa: a scoping review

Abstract

BackgroundNeuroimaging allows for the identification of brain abnormalities and alterations that are associated with anorexia nervosa (AN). We performed a scoping review to map out the extent and nature of recent research activity on functional magnetic resonance imaging (fMRI) in individuals diagnosed with, or recovered from, AN (AN-REC).Main textA literature search of PubMed, Psychinfo and Embase was conducted using the search terms “anorexia nervosa” AND “functional magnetic resonance imaging.” We included fMRI studies that involved a comparison between individuals with AN or AN-REC and healthy controls published in English language between 2010 and 2015. A total of 49 papers were included, regardless of the experimental stimuli or paradigm.ConclusionsFindings varied considerably across studies, reflecting methodological differences in study design, such as sample differences and experimental paradigms. Collectively, studies published during the past five years suggest altered activation in regions related to the fronto-striato and the limbic circuits, which are theorized to have an important role in the pathophysiology of AN.

Alterations of brain structure and functions in anorexia nervosa

“…Modern neuroimaging technologies allow e in addition to structural analyses e the investigation of functional alterations under conditions of anorexia nervosa (Table 1). Overall, functional magnetic resonance imaging (fMRI) studies indicate altered neural activity across the brain, including the frontal, parietal, temporal and occipital lobes, as well as subcortical structures such as the amygdala, striatum, thalamus and the cerebellum [34]. Despite the growing body of knowledge due to the increase in number of fMRI studies, a clear pathophysiological picture is still to be drawn.…”

“…The differentiation between alterations subsequent to the disease/malnourishment and those causally involved is still a big challenge. There are different possibilities to address this question [34], namely first, comparing patients within the first months of their disease with chronically ill patients, second, to investigate acutely ill patients compared to recovered patients, third, comparing recovered patients with healthy controls and fourth, studying patients with anorexia nervosa compared to patients with malnutrition due to any other reason. However, only few studies are available so far applying these suggested study designs.…”

“…It is also to note that results from fMRI studies are difficult to compare because of different questions, pictures shown to patients or cognitive tasks the patients are asked to perform which are mostly food-, body weight-or emotion-related in anorexia nervosa studies [34].…”

Atypical anorexia nervosa is not related to brain structural changes in newly diagnosed adolescent patients

“…Brain structural and functional alterations have also been largely reported in AN (Frank, 2015;Fuglset, Landro, Reas, & Ro, 2016;Gaudio, Wiemerslage, Brooks, & Schioth, 2016). Voxel-based morphometry (VBM) studies have however focused on adult patients, finding a reduced grey matter (GM) volume in many brain regions involved in the pathophysiology of AN.…”

Reclaiming the Lost Self in the Treatment of Bulimia Nervosa: A Neurobiological Approach to Recovery That Integrates Mind, Brain, and Body

“…As adjuncts to traditional ED treatment techniques, top-down and bottom-up "neurophysiological interventions have been shown to diminish symptoms associated with ED" [31], contradicting feelings of helplessness and fear, and facilitating a sense of empowerment [13].…”