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Early‐onset anorexia nervosa: Is there evidence of limbic system imbalance?
Author(s) -
Chowdhury Uttom,
Gordon Isky,
Lask Bryan,
Watkins Beth,
Watt Hilary,
Christie Deborah
Publication year - 2003
Publication title -
international journal of eating disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.785
H-Index - 138
eISSN - 1098-108X
pISSN - 0276-3478
DOI - 10.1002/eat.10155
Subject(s) - anorexia nervosa , cerebral blood flow , psychology , frontal lobe , temporal lobe , psychopathology , context (archaeology) , eating disorders , medicine , cardiology , psychiatry , epilepsy , paleontology , biology
Objective This study, part of a continuing effort to understand the pathophysiology of the brain in early‐onset anorexia nervosa, attempts to validate findings from an earlier study of regional cerebral blood flow and to correlate any abnormalities in blood flow with eating disorder psychopathology. Method Fifteen newly referred children and adolescents with a diagnosis of anorexia nervosa (AN) underwent regional cerebral blood flow (rCBF) examination using single‐photon computerized tomography (SPECT) and the Eating Disorders Examination (EDE) for children. Results Mean age was 14 years 11 months (SD = 1.35). Mean weight for height ratio was 82.79 % (SD = 10.66). SPECT findings showed that 11 (73%) had asymmetry (hypoperfusion) of blood flow in at least one area. Regions of the brain showing hypoperfusion included the temporal lobe (n = 9), parietal lobe (n = 5), frontal lobe (n = 3), thalamus (n = 3), and the caudate nuclei (n = 1). The median EDE subscale scores were high for all four subscales. Those patients with hypoperfusion had higher median EDE subscale scores than those without hypoperfusion, although the differences were not statistically significant. Conclusions Most patients in our study had abnormal rCBF, predominantly affecting the temporal lobe, confirming our previous findings. There was no association with the EDE scores. The findings support earlier suggestions of an imbalance in neural pathways or circuits, possibly within the limbic system. This hypothesis is considered within the context of current knowledge and suggestions made with regard to how it might be tested. © 2003 by Wiley Periodicals, Inc. Int J Eat Disord 33: 388–396, 2003.