Current status of functional imaging in eating disorders

Department of Child and Adolescent Psychiatry, University of Colorado Denver, Aurora, CO 80045, USA.
International Journal of Eating Disorders (Impact Factor: 3.13). 09/2012; 45(6):723-36. DOI: 10.1002/eat.22016
Source: PubMed


Eating Disorders are complex psychiatric problems that involve biologic and psychological factors. Brain imaging studies provide insights about how functionally connected brain networks may contribute to disturbed eating behavior, resulting in food refusal and altered body weight, but also body preoccupations and heightened anxiety. In this article, we review the current state of brain imaging in eating disorders, and how such techniques may help identify pathways that could be important in the treatment of those often detrimental disorders.

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Available from: Guido Frank, Aug 15, 2014
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    • "Problems with homeostasis, drive, and self-regulation are biological factors that are known to be associated with AN [1]. Although findings of magnetic resonance imaging studies of subjects with AN are inconsistent [2], other functional neuroimaging modalities, including single-photon emission tomography, positron emission tomography (PET), and functional magnetic resonance imaging (fMRI), suggest that patients with AN exhibit functional abnormalities in the frontal, parietal, and cingulate cortices [3-5]. In addition, a recent fMRI study in an adolescent population reported that activation of the medial prefrontal cortex during performance of a theory of mind task was lower in patients with AN than in controls (CTLs) [6]. "
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    ABSTRACT: Background Functional neuroimaging techniques are widely used to elucidate changes in brain activity, and various questionnaires are used to investigate psychopathological features in patients with eating disorders (ED). It is well known that social skills and interpersonal difficulties are strongly associated with the psychopathology of patients with ED. However, few studies have examined the association between brain activity and social relationships in patients with ED, particularly in patients with extremely low body weight. Methods In this study, 22-channel near-infrared spectroscopy was used to quantify regional hemodynamic changes during a letter fluency task (LFT) in 20 female patients with ED with a mean body mass index of 14.0 kg/m2and 31 female controls (CTLs). Symptoms were assessed using the Eating Disorder Inventory-2 and Beck Depression Inventory. We hypothesized that frontal activity in patients with ED would be lower than in CTLs and would show different correlations with psychopathological features compared with CTLs. Results The LFT performance and score on the social insecurity subscale of the Eating Disorder Inventory-2 were significantly higher in the ED group than in the CTL group. The mean change in oxygenated hemoglobin (oxy-Hb) in bilateral frontal regions during the LFT was significantly smaller in the ED group than in the CTL group. Social insecurity score was positively correlated with the concentration of oxy-Hb in the bilateral orbitofrontal cortex in the ED group but not in the CTL group. Conclusions These results suggest that activity of the orbitofrontal cortex is associated with social insecurity and disturbed in patients with ED. Therefore, disturbed orbitofrontal cortex activity may underlie the lack of insight and social isolation that is characteristic of patients with ED.
    Full-text · Article · Jun 2014 · BMC Psychiatry
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    • "W grupie REC AN pobudzony został obszar aktywny również u osób zdrowych, czyli boczna kora przedczołowa. Wyniki badania sugerują, iż kora przedczołowa może być odpowiedzialna za zdolność do właściwej lub niewłaściwej kontroli przyjmowania pokarmu (Frank i Kaye 2012). "
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    ABSTRACT: The purpose of this review is to illustrate the issue of new discoveries in the field of functional and anatomical changes in the brain of people suffering from anorexia. This disease destroys both the patients’ body and psyche. People struggling with anorexia nervosa are characterized by pursuit of low body weight and fear of weight gain. Increasing numbers of people, especially in Western countries, suffer from eating disorders. This trend may be explained by the influence of media on the perception of one’s own body. However, there are studies suggesting that it is not the only factor in projecting the possibility of illness. There are many theories explaining the causes of anorexia. It is generally accepted that genetic, psychological and social factors are complementary to each other and create the image of people particularly at risk of this disease. However, the developmentof brain imaging techniques allows one to locate the differences between brain functioning of a person with anorexia and a healthy one. The patients’ reward system works abnormally, and their brain responds differently to taste stimuli. According to new reports, the volume of white and gray matter in their brain is reduced, while the volume of cerebrospinal fluid is increased. Some of these changes are not permanent and disappear after treatment. The article is a review of new research concerning the functioning and anatomy of the brain of people with anorexia. These studies offer hope of deeper understanding of the nature of this disease and developing more effective therapies.
    Full-text · Article · Jan 2014 · Neuropsychiatria i Neuropsychologia
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    • "A number of systematic reviews have assessed the literature on structural imaging in ED (Van den Eynde et al., 2012) and functional neuroimaging with and without symptom provocation in AN patients (Pietrini et al., 2011; Zhu et al., 2012). In addition, there are narrative reviews on the use of neuroimaging techniques in ED (Frank, Bailer, Henry, Wagner, & Kaye, 2004; Frank & Kaye, 2012; Kaye, 2008; Kaye, Fudge, & Paulus, 2009; Kaye, Wagner, Fudge, & Paulus, 2011; Michaelides, Thanos, Volkow, & Wang, 2012). Whilst these reviews summarise findings from a variety of neuroimaging techniques including positron emission tomography and single photon emission computed tomography, the most extensive imaging data in ED arise from fMRI research. "
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    ABSTRACT: Eating disorders (ED) are chronic and sometimes deadly illnesses. Existing treatments have limited proven efficacy, especially in the case of adults with anorexia nervosa (AN). Emerging neural models of ED provide a rationale for more targeted, brain-directed interventions. This systematic review has examined the effects of neuromodulation techniques on eating behaviours and body weight and assessed their potential for therapeutic use in ED. All articles in PubMed, PsychInfo and Web of Knowledge were considered and screened against a priori inclusion/exclusion criteria. The effects of repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation, vagus nerve stimulation (VNS) and deep brain stimulation (DBS) were examined across studies in ED samples, other psychiatric and neurological disorders, and animal models. Sixty studies were identified. There is evidence for ED symptom reduction following rTMS and DBS in both AN and bulimia nervosa. Findings from studies of other psychiatric and neurological disorders and from animal studies demonstrate that increases in food intake and body weight can be achieved following DBS and that VNS has potential value as a means of controlling eating and inducing weight loss. Neuromodulation tools have potential for reducing ED symptomatology and related behaviours, and for altering food intake and body weight. In response to such findings, and emerging neural models of ED, treatment approaches are highly unlikely to remain 'brainless'. More research is required to evaluate the potential of neuromodulation procedures for improving long-term outcomes in ED. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.
    Full-text · Article · Nov 2013 · European Eating Disorders Review
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