Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-06T00:22:36.213Z Has data issue: false hasContentIssue false
  • English
  • Français

Neuropsychological and structural brain changes in anorexia nervosa before and after refeeding

Published online by Cambridge University Press:  09 July 2009

K. Kingston ,
G. Szmukler ,
D. Andrewes ,
B. Tress  and
P. Desmond
K. Kingston*
Affiliation:
Departments of Psychiatry and Radiology, Royal Melbourne Hospital and University of Melbourne, Victoria, Australia
G. Szmukler
Affiliation:
Departments of Psychiatry and Radiology, Royal Melbourne Hospital and University of Melbourne, Victoria, Australia
D. Andrewes
Affiliation:
Departments of Psychiatry and Radiology, Royal Melbourne Hospital and University of Melbourne, Victoria, Australia
B. Tress
Affiliation:
Departments of Psychiatry and Radiology, Royal Melbourne Hospital and University of Melbourne, Victoria, Australia
P. Desmond
Affiliation:
Departments of Psychiatry and Radiology, Royal Melbourne Hospital and University of Melbourne, Victoria, Australia
*
1Address for correspondence: Ms Kim Kingston, Department of Psychiatry, Royal Melbourne Hospital, c/o PO Royal Melbourne Hospital, Victoria 3050, Australia.
Get access Rights & Permissions [Opens in a new window]

Synopsis

The neuropsychological performance and Magnetic Resonance Imaging (MRI) brain appearance of a consecutive series of 46 in-patients with anorexia nervosa (AN) was compared with hat of 41 normal-weight controls. The groups were matched for sex, age, estimated pre-morbid intelligence and education. AN patients who had gained at least 10% of their body weight were retested and rescanned. Controls were retested after a similar interval. The AN group performed significantly worse than the controls on tasks measuring attention, visuospatial ability and memory. On tasks assessing flexibility and learning, no group differences were evident although an examination of deficits in individuals revealed that more anorexics were impaired on both. Following treatment, the AN group improved relative to the control group only on those tasks assessing attention. Comparison of MRI measures showed a significant proportion of anorexics had enlarged lateral ventricles and dilated sulci on both cortical and cerebellar surfaces, but no dilatation was evident for the third and fourth ventricular measures. Improvements were found after treatment on some of the radiological measures but many differences remained. Relationships between morphological brain changes and cognitive impairments were weak. Lower weight, but not duration of illness, was associated with poorer performance on tasks assessing flexibility/inhibition and memory, and with greater MRI ventricular size.

Type
Original Articles
Information
Psychological Medicine , Volume 26 , Issue 1 , January 1996 , pp. 15 - 28
Copyright
Copyright © Cambridge University Press 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn. Revised. APA: Washington, DC.Google Scholar
Artmann, H., Grau, H., Adelmann, M. & Scleiffer, R. (1985). Reversible and non-reversible enlargement of cerebrospinal fluid spaces in anorexia nervosa. Neuroradiology 27, 304–312.CrossRefGoogle ScholarPubMed
Bartko, J. J. & Carpenter, W. T. (1976). On the methods and theory of reliability. Journal of Nervous and Mental Disease 163, 307–317.CrossRefGoogle ScholarPubMed
Beck, A. T. & Steer, R. A. (1987). Beck Depression Inventory Manual. The Psychological Corporation/Harcourt Brace Jovanovich: New York.Google Scholar
Benton, A. L., Hamsher, K. de S., Varney, N. R. & Spreen, O. (1983). Contributions to Neuropsychological Assessment. Oxford University Press: New York.Google Scholar
Brennan, P. & Silman, A. (1992). Statistical methods for assessing observer variability in clinical measures. British Medical Journal 304, 1491–1494.CrossRefGoogle ScholarPubMed
Dolan, R. J., Mitchell, J. & Wakeling, A. (1988). Structural brain changes in patients with anorexia nervosa. Psychological Medicine 18, 349–353.CrossRefGoogle ScholarPubMed
Doraiswamy, P. M., Krishnan, K., Figiel, G., Husain, M., Boyko, O., Rockwell, W. & Ellinwood, E. (1990). A brain magnetic resonance imaging study of pituitary gland morphology in anorexia nervosa and bulimia. Biological Psychiatry 28, 110–116.CrossRefGoogle ScholarPubMed
Fox, C. F. (1981). Neuropsychological correlates of anorexia nervosa. International Journal of Psychiatry in Medicine 11, 285–289.CrossRefGoogle ScholarPubMed
Glaser, W. & Glaser, M. (1989). Context effects in Stroop-like word and picture processing. Journal of Experimental Psychology: General 118, 13–12.CrossRefGoogle ScholarPubMed
Golden, C. J. (1978). The Stroop Color and Word Test: A Manual for Clinical and Experimental Uses. Stoeltig: Chicago.Google Scholar
Gordon, D. P., Halmi, K. A. & Ippolito, P. M. (1984). A comparison of the psychological evaluation of adolescents with anorexia nervosa and of adolescents with conduct disorders. Journal of Adolescence 7, 245–266.CrossRefGoogle ScholarPubMed
Hamsher, K. S., Benton, A. L. & Digre, K. (1980). Serial digit learning: normative and clinical aspects. Journal of Clinical Neuropsychology 2, 39–50.CrossRefGoogle Scholar
Hamsher, K. S., Halmi, K. A. & Benton, A. L. (1981). Prediction of outcome in anorexia nervosa from neuropsychological status. Psychiatry Research 4, 79–81.CrossRefGoogle ScholarPubMed
Kohlmeyer, K., Lehmkuhl, G. & Poutska, F. (1983). Computed tomography of anorexia nervosa. American Journal of Neuroradiological Research 4, 437–438.Google ScholarPubMed
Kornreich, L., Shapira, A., Horev, G., Danziger, Y., Tyano, S. & Mimouni, M. (1991). CT and MR evaluation of the brain in patients with anorexia nervosa. American Journal of Neuroradiology 12, 1213–1216.Google Scholar
Krieg, J. C., Pirke, K. M., Lauer, C. & Backmund, H. (1988). Endocrine, metabolic, and cranial computed tomographic findings in anorexia nervosa. Biological Psychiatry 23, 377–387.CrossRefGoogle ScholarPubMed
Laessle, R. G., Krieg, J. C., Fichter, M. M. & Pirke, K. M. (1989). Cerebral atrophy and vigilance performance in patients with anorexia nervosa and bulimia nervosa. Neurobiology 21, 187–191.Google ScholarPubMed
Lankenau, H., Swigar, M. E., Bhimani, S., Luchins, D. & Quinlan, D. M. (1985). Cranial CT scans in eating disorder patients and controls. Comprehensive Psychiatry 26, 136–147.CrossRefGoogle ScholarPubMed
Maxwell, J. K., Tucker, D. M. & Townes, B. D. (1984). Asymmetric cognitive function in anorexia nervosa. International Journal of Neuroscience 24, 37–44.CrossRefGoogle ScholarPubMed
Milner, B. (1965). Visually-guided maze learning in man: effects of bilateral hippocampal, bilateral frontal, and bilateral cerebral lesions. Neuropsychologia 3, 317–338.CrossRefGoogle Scholar
Naylor, G. F. K. & Harwood, E. (1972). Interim Manual for the Naylor-Harwood Adult Intelligence Scale. Australian Council for Educational Research: Victoria.Google Scholar
Nelson, H. E. (1982). National Adult Reading Test (NART) Test Manual. NFER-Nelson: Windsor.Google Scholar
Osterrieth, P. A. (1944). Le test de copie d'une figure complex. Archives de Psychologie 30, 206–365.Google Scholar
Palazidou, E., Robinson, P. & Lishman, W. (1990). Neuroradiological and neuropsychological assessment in anorexia nervosa. Psychological Medicine 20, 521–527.CrossRefGoogle ScholarPubMed
Pendleton-Jones, B., Duncan, C. C., Brouwers, P. & Mirsky, A. F. (1991). Cognition in eating disorders. Journal of Clinical and Experimental Neuropsychology 13, 711–728.CrossRefGoogle Scholar
Reitan, R. M. (1958). Validity of the Trail Making Test as an indicator of organic brain damage. Perceptual and Motor Skills 8, 271–276.CrossRefGoogle Scholar
Ryan, C. & Butters, N. (1980). Further evidence for a continuum-of impairment encompassing male alcoholic Korsakoff patients and chronic alcoholic men. Alcoholism: Clinical and Experimental Research 4, 190–198.CrossRefGoogle ScholarPubMed
Spielberger, C. D. (1983). Manual for the State-Trait Anxiety Inventory (Form Y). Consulting Psychologists' Press: California.Google Scholar
Szmukler, G. I., Andrewes, D., Kingston, K., Chen, L., Stargatt, R. & Stanley, R. (1992). Neuropsychological impairment in anorexia nervosa: Before and after refeeding. Journal of Clinical and Experimental Neuropsychology 14, 347–352.CrossRefGoogle ScholarPubMed
Taylor, L. B. (1969). Localisation of cerebral lesions by psychological testing. Clinical Neurosurgery 16, 269–287.CrossRefGoogle ScholarPubMed
Walsh, K. W. (1985). Understanding Brain Damage: A Primer of Neuropsychological Evaluation. Churchill Livingstone: Edinburgh.Google Scholar
Weschler, D. (1981). WAIS-R Manual: Wechsler Adult Intelligence Scale – Revised. Harcourt Brace Jovanovich: New York.Google Scholar
Witt, E. D., Ryan, C. & Hsu, C. K. G. (1985). Learning deficits in adolescents with anorexia nervosa. Journal of Mental and Nervous Disease 173, 182–184.CrossRefGoogle ScholarPubMed