Implications of starvation-induced change in right dorsal anterior cingulate volume in anorexia nervosa.
OBJECTIVE
Converging evidence suggests a role for the anterior cingulate cortex (ACC) in the pathophysiology of anorexia nervosa (AN). This study sought to determine whether ACC volume was affected by starvation in active AN and, if so, whether this had any clinical significance.


METHODS
Eighteen patients with active AN and age- and gender-matched normal controls underwent magnetic resonance imaging (MRI). Sixteen patients (89%) with AN had intelligence quotients (IQ) testing at intake, 14 (78%) had repeat MRIs after weight normalization, and 10 (56%) had outcome data at 1-year posthospitalization.


RESULTS
Right dorsal ACC volume was significantly reduced in active AN patients versus controls and was correlated with lower performance IQ. While ACC normalization occurred with weight restoration, smaller change in right dorsal ACC volume prospectively predicted relapse after treatment.


CONCLUSIONS
Reduced right dorsal ACC volume during active AN relates to deficits in perceptual organization and conceptual reasoning. The degree of right dorsal ACC normalization during treatment is related to outcome.
McCormick
Laurie M
LM
Department of Psychiatry, University of Iowa, Carver College of Medicine, Iowa City, Iowa 52242, USA. laurie-mccormick@uiowa.edu
Keel
Pamela K
PK
Brumm
Michael C
MC
Bowers
Wayne
W
Swayze
Victor
V
Andersen
Arnold
A
Andreasen
Nancy
N
D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000503:physiopathology* / Q000534:rehabilitation; D001284:Atrophy; D016022:Case-Control Studies; D003071:Cognition; D005260:Female; D005500:Follow-Up Studies; D006179:Gyrus Cinguli / Q000473:pathology*; D006801:Humans; D007360:Intelligence; D008279:Magnetic Resonance Imaging; D008297:Male; D016555:Matched-Pair Analysis; D013217:Starvation / Q000503:physiopathology*; D015430:Weight Gain