Is Anorexia Nervosa a Neuropsychological Disease (original) (raw)
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The neurobiology of anorexia nervosa: A systematic review
Australian & New Zealand Journal of Psychiatry, 2014
Objective: Recent advances in neuroimaging techniques have enabled a better understanding of the neurobiological underpinnings of anorexia nervosa (AN). The aim of this paper was to summarise our current understanding of the neurobiology of AN.
Neurobiology of Anorexia Nervosa
Anorexia nervosa is a rare, yet dangerous and often deadly disorder that primarily affects young teenage women. Individuals with anorexia are driven to starvation, refuse to maintain a minimally normal body weight, posses distorted perceptions and beliefs of oneself, and demonstrate abnormal attitudes toward food and weight. Specifically the restricting type, a subtype of anorexia that does not involve binging or purging behavior, will be the focus of this paper. Within the anorexic brain there are many chemical changes and brain abnormalities that take place including hormonal and chemical imbalances and dysfunction in the insular cortex and frontal-striatal circuits. Many of these abnormalities are believed to intensify and prolong the duration of the disorder while others are a direct result of starvation. Medications provide some relief for certain symptoms of anorexia, but the most successful treatment options include forms of CBT and family therapy.
Assessment of neurobiology in adults with anorexia nervosa
European Eating Disorders Review, 2006
Objective: Neuroimaging and neuropsychology studies in anor-exia 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 ...
2021
Anorexia Nervosa (AN) is a multifaceted disorder characterized by an inappropriate weight loss due to psychological and behavioural abnormalities. According to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), AN is defined as a failure or denial to maintain body weight >85% of which is expected for height (corresponding to body mass index (BMI), extreme fear of gaining weight, disturbed perception of body weight/shape and the occurrence of amenorrhea for a minimum of three consecutive months. However, DSM-V made three alterations in the diagnostic criteria for AN: revision of weight loss criterion, i.e., ‘A weight that is less than minimally normal or, for children and adolescents, less than that minimally expected’ (Mustelin et al., 2016); if behaviours hindering weight gain are observed then the fear of weight gain need not be verbalized and amenorrhea was now not required in the diagnosis (APA, 2013). AN has further two subtypes: (i) th...
Functional neuroimaging in anorexia nervosa: A clinical approach.
European …, 2011
AIMS: To provide a review of the available literature about the functional neuroimaging of anorexia nervosa, and to summarize the possible role of neurobiological factors in its pathogenesis. METHODS: A systematic review of the literature was performed using PubMed and Medline electronic database (1950-September 2009). Eligible studies were restricted to those involving the main parameters of cerebral activity and functional neuroimaging techniques. Findings of the reviewed studies have been grouped on a diagnostic subtype basis, and their comparison has been interpreted in terms of concordance. RESULTS: We found a high level of concordance among available studies with regard to the presence of frontal, parietal and cingulate functional disturbances in both anorexia nervosa restricting and binge/purging subtypes. Concordance among studies conducted regardless of the anorexia nervosa subtypes suggests an alteration in temporal and parietal functions and striatal metabolism. CONCLUSIONS: The most consistent alterations in anorexia nervosa cerebral activity seem to involve the dorsolateral prefrontal cortex, the inferior parietal lobule, the anterior cingulate cortex and the caudate nucleus. They may affect different neural systems such as the frontal visual system, the attention network, the arousal and emotional processing systems, the reward processing network, and the network for the body schema. Copyright © 2010 Elsevier Masson SAS. All rights reserved. PMID: 20934859 [PubMed - indexed for MEDLINE]
Neuropsychological Impairments in Anorexia Nervosa: A Spanish Sample Pilot Study
This work was aimed at obtaining a profile of neuropsychological impairments in young Spanish participants with anorexia nervosa (AN) to demonstrate that right-hemisphere and frontal capacity impairments are present not only in the acute phase but also after weight recovery in a Spanish sample compared with a healthy control group. Twelve patients with AN in the acute phase (body mass index [BMI] < 17) were compared both to 16 healthy control subjects and 12 weight-recovered AN participants (BMI ! 17) matched by age, IQ, and educational level by utilizing a wide neuropsychological battery. Differences were found between AN groups only for long-term verbal memory, which worsens as BMI increases. Among participants with AN as a group, results showed differences in speed of information processing, working memory, visual memory, and inhibition, unrelated to attentional capabilities. We cannot support the hypothesis of a specific right cerebral dysfunction in patients with AN. A general cognitive dysfunction, primarily in information processing, working memory, visual and verbal memory, as well as frontal impairments such as impulsivity and poor behavioral control, appeared unrelated to BMI. We support previous works affirming that neuropsychological impairments in AN are not a consequence of the illness but a risk factor for it to develop.
Journal of Psychiatric Research, 1999
In psychiatric patients the identi_cation of cognitive de_cits which predict a poor clinical outcome is important for the development of speci_c treatment strategies aimed at the amelioration of these impaired cognitive functions to increase the likelihood of full clinical remission[ However\ such attempts are absent in bulimia nervosa "BU#\ are scarce in anorexia nervosa "AN# and\ furthermore\ provide con~icting results[ In the present prospective study we investigated the neuropsychological demands in 01 patients with AN and in 03 patients with BU before\ during\ and after a treatment period[ At the initial testing session\ both patients samples showed similar and impaired performance levels on tasks measuring attentional demands and problem solving abilities\ while their mnemonic functions were preserved[ At the _nal testing session\ which took place 6 months thereafter\ the impaired cognitive functions had improved to a similar degree in the AN and the BU subgroups[ However\ although the eating disorder symptomatology had ameliorated in parallel\ no direct associations could be established with the initial neuropsychological demands and their recti_cation\ respectively[ On an individual level\ 00 patients initially showed obvious cognitive de_cits[ However\ the clinical characteristics of this subgroup di}ered not from that found in the 04 {good performers|[ These _ndings indicate that the cognitive functions in the acute AN and BU are similarly impaired\ but also ameliorate in a similar manner with clinical remission[ Because no associations were obvious between cognitive and clinical recti_cations\ signi_cant contributions of mediating factors "e[g[\ changes in metabolic brain turnover and in steroid hormones# are suggested[ Þ 0888 Elsevier Science Ltd[ All rights reserved[
Anorexia nervosa: towards a neurobiologically based therapy
European Journal of Pharmacology, 2003
Eating disorders, i.e. anorexia and bulimia nervosa, are disorders of eating behavior and body weight regulation. Most likely because there are few, if any, effective treatments, eating disorders are considered to be chronic disorders interrupted only by intermittent periods of shortlived remission. The neurobiology of eating, most of which explores hypothalamic mechanisms, has had no influence on the treatment of eating disorders, with the exception of psychopharmacology. However, while most patients are treated with psychoactive drugs, there is no evidence that these are effective. This may be because pharmacological attempts so far have targeted the wrong symptoms. We review the symptomatology of anorexia and bulimia and the outcome of presently used interventions. Everybody agrees that outcome must improve and to attack this clinical problem, we suggest a neurobiologically plausible framework for how the disorders develop and how they are maintained and outline a method of treatment and its results. D