No differences are seen in the regional cerebral blood flow in the restricting type of anorexia nervosa compared with the binge eating/purging type

Abstract

Aims: Anorexia nervosa (AN) is subdivided into the restricting type (AN-R) and the binge-eating/purging type (AN-BP), but differences in cerebral blood flow between patients with these types of AN and healthy controls have not been investigated. Methods:The present study was designed to elucidate any such differences using resting single photon emission computed tomography (SPECT) studies to compare the differences in cerebral perfusion among both types of AN and a healthy control group. Resting regional cerebral blood flow was assessed using SPECT with technetium-99m hexamethylpropyleneamine oxime in 13 female AN-R patients, 13 female AN-BP patients, and 10 healthy women as controls with 3-D stereotactic surface projections. Results:The analytic program of the SPECT images showed bilateral decreased perfusion of the subcallosal gyrus (SCG), midbrain and posterior cingulate gyrus (PCG) in both AN-R and AN-BP patients, as compared with the controls. There were no clear differences between the AN-R and AN-BP groups. There were no significant differences in cerebral blood flow between patients with AN-R and AN-BP. Conclusions:Abnormalities of the neuronal circuits containing the SCG, midbrain and PCG are possibly relevant to trait-related AN.

Cerebral perfusion differences in women currently with and recovered from anorexia nervosa

“…Five studies compared rCBF before and after weight recovery, three with primarily pediatric subjects (Kuruoglu et al, 1998; Komatsu et al, 2010; Frampton et al, 2011), and two in adults (Kojima et al, 2005; Matsumoto et al, 2006). There are four studies examining rCBF in currently-ill adult women, but the BMI for subjects in three of these studies (Naruo et al, 2001; Takano et al, 2001; Yonezawa et al, 2008) was substantially lower than in our study, leaving only one study of 11 subjects by Key et al (Key et al, 2006) containing subjects comparable to our AN-C group based on BMI and age. Similarly, there is one study by Frank et al (Frank et al, 2007), using PET to assess rCBF in 18 long-term weight recovered subjects comparable to our AN-WR group.…”

“…Six studies measured rCBF in subjects when they were underweight (Gordon et al, 1997; Naruo et al, 2001; Takano et al, 2001; Chowdhury et al, 2003; Key et al, 2006; Yonezawa et al, 2008). Six studies focused on pediatric patients (Gordon et al, 1997; Kuruoglu et al, 1998; Chowdhury et al, 2003; Lask et al, 2005; Komatsu et al, 2010; Frampton et al, 2011), and five on adult patients (Takano et al, 2001; Kojima et al, 2005; Key et al, 2006; Matsumoto et al, 2006; Frank et al, 2007; Yonezawa et al, 2008). Five studies compared rCBF before and after weight recovery, three with primarily pediatric subjects (Kuruoglu et al, 1998; Komatsu et al, 2010; Frampton et al, 2011), and two in adults (Kojima et al, 2005; Matsumoto et al, 2006).…”

“…The AN-C group examined here primarily consisted outpatients who were compared with long-term weight-recovered subjects as well as healthy subjects. In contrast, the previous adult studies (Naruo et al, 2001; Takano et al, 2001; Key et al, 2006; Yonezawa et al, 2008) examined patients with anorexia soon after initial admission for treatment, a time when symptom severity is typically highest and when both acute and chronic effects of starvation are likely, and compared these subjects with healthy women.…”

“…As such, cerebral vasculature changes may be particularly important in anorexia nervosa, and cerebral blood flow (CBF) might provide a measure of the severity of brain dysfunction occurring in patients with anorexia. Physiological brain differences in anorexia nervosa have been investigated in studies using nuclear medicine-based techniques, with largely heterogeneous results (Gordon et al, 1997; Kuruoglu et al, 1998; Naruo et al, 2001; Råstam et al, 2001; Takano et al, 2001; Chowdhury et al, 2003; Kojima et al, 2005; Lask et al, 2005; Key et al, 2006; Matsumoto et al, 2006; Frank et al, 2007; Yonezawa et al 2008; Komatsu et al, 2010; Frampton et al, 2011). A review of this literature is included in the discussion and summarized in Table 1.…”

Thinking about Eating Food Activates Visual Cortex with Reduced Bilateral Cerebellar Activation in Females with Anorexia Nervosa: An fMRI Study

“…using Positron Emission Tomography, Single Photon Emission Tomography) [34], three main regions in those with restricting AN show the most consistent dysfunctional activation: the frontal cortex (particularly the DLPFC) [70], [71], [72], [73], [74], [75], hypo-responsiveness in the left inferior parietal lobule [70], [75] and overall dysfunction in the bilateral anterior cingulate cortex [72], [73], [74], [76]. In those with binge purging AN there appears to be a similar pattern of neural dysfunction, in the frontal lobe [71], [74], [77], parietal cortex [71], [77] and bilateral anterior cingulate dysfunction [74], [78]. However, when examining neural dysfunction in AN as a whole group (without separately analysing the subtypes) a different neural profile emerges.…”