Brain dysfunction in anorexia nervosa : cause or consequence of under-nutrition?

Purpose of review: Imaging studies that demonstrate loss of brain substance help explain why people with anorexia nervosa have cognitive deficits and may help to elucidate the cognitive style found in many patients. It is not known whether a neurobiological vulnerability predisposes to anorexia nervosa or if this is associated with maintenance of symptoms once the illness develops. Recent findings: Evidence emerging from functional neuro-imaging studies raise the possibility of a biological abnormality that may predispose to anorexia nervosa. Studies have found abnormal functioning in the frontal, limbic, occipital, striatal and cerebellar regions that may persist after recovery. However, most recent cross-sectional and prospective studies indicate improved cerebral activity and mixed findings in regards to neurocognitve function with recovery from anorexia nervosa. Summary: The elucidation of the neurobiology of anorexia nervosa has benefited from recent advances in neuro-imaging and cognitive neuroscience. Further research is needed to examine the degree to which abnormalities are a consequence of starvation or are caused by a putative anorexia nervosa endophenotype.