Brain hypometabolism of glucose in anorexia nervosa: normalization after weight gain.
Using positron emission tomography and (18-F)-fluorodeoxyglucose, we studied cerebral glucose metabolism in 10 anorectic girls within their underweight state and after weight gain. Ten age- and sex-matched healthy volunteers were used as controls. Both groups were scanned during rest, eyes closed and with low ambient noise. In absolute values, the underweight anorectic patients, when compared to control subjects, showed a global (p = 0.002) and regional (p < or = 0.001) hypometabolism of glucose which normalized with weight gain. In relative values, no global difference could be assessed between underweight anorectic patients and controls but a trend can, nevertheless, be observed toward parietal and superior frontal cortex hypometabolism associated with a relative hypermetabolism in the caudate nuclei and in the inferior frontal cortex. After weight gain, all regions normalized for absolute and relative values, although a trend appears toward relative parietal hypometabolism and inferior frontal cortex hypermetabolism in weight gain anorectic patients. Absolute brain glucose hypometabolism might result from neuroendocrinological or morphological aspects of anorexia nervosa or might be the expression of altered neurotransmission following deficient nutritional state. As some differences exists in relative values in underweight patients and tend to persist in weight gain states, this could support a potential abnormal cerebral functioning, a different reaction to starvation within several regions of the brain or different restoration rates according to the region.
Department of Psychiatry, Hôpital Erasme, Université Libre de Bruxelles, Belgium.
V
V
Delvenne
S
S
Goldman
V
V
De Maertelaer
Y
Y
Simon
A
A
Luxen
F
F
Lotstra
D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D001786:Blood Glucose / Q000378:metabolism*; D001921:Brain / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001931:Brain Mapping; D003847:Deoxyglucose / Q000031:analogs & derivatives / Q000378:metabolism; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D010296:Parietal Lobe / Q000000981:diagnostic imaging / Q000503:physiopathology; D009435:Synaptic Transmission / Q000502:physiology; D014055:Tomography, Emission-Computed; D015430:Weight Gain / Q000502:physiology*
D001786:Blood Glucose; D019788:Fluorodeoxyglucose F18; D003847:Deoxyglucose