title: Metabolic imaging of deep brain stimulation in anorexia nervosa: a 18F-FDG PET/CT study.
abstract: OBJECTIVE
  Anorexia nervosa (AN), a disorder of unknown etiology, has the highest mortality rate of any psychiatric disorder. Drawing the brain metabolic pattern of AN may help to target the core biological and psychological features of the disorder and to perfect the diagnosis and recovery criteria. In this study, we used 18F-FDG PET to show brain metabolic network for AN.
  
  
  METHODS
  Glucose metabolism in 6 AN patients and 12 age-matched healthy controls was studied using 18F-FDG PET. SPM2 was used to compare brain metabolism in AN patients with that in healthy controls. Four of 6 AN patients took deep brain stimulation (DBS) targeted in nucleus accumbens (NAcc). About 3 to 6 months after the surgery, the 4 AN patients took another 18F-FDG PET scan to assess the change in brain glucose metabolism.
  
  
  RESULTS
  The SPM (statistical parametric mapping ) analysis showed hypermetabolism in the frontal lobe (bilateral, BA10, BA11, BA47), the limbic lobe (bilateral, hippocampus, and amygdala), lentiform nucleus (bilateral), left insula (BA13), and left subcallosal gyrus (BA25). It also showed hypometabolism in the parietal lobe (bilateral, BA7, BA40). The hypermetabolism in frontal lobe, hippocampus, and lentiform nucleus decreased after NAcc-DBS.
  
  
  CONCLUSIONS
  The changes in brain glucose metabolism illustrated the brain metabolic pattern in AN patients. Furthermore, the pattern can be modulated by NAcc-DBS, which confirmed specificity of the pattern. The regions with altered metabolism could interconnect to form a network and integrate information related to appetite. Our study may provide information for targeting the potential candidate brain regions for understanding the pathophysiology of AN and assessing the effects of existing and future treatment approaches.
authors.affiliation: From the *PET Center, Huashan Hospital, Fudan University; and †Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University of Medicine, Shanghai, China.
authors.forename: Hui-Wei
authors.initials: HW
authors.lastname: Zhang
authors.forename: Dian-You
authors.initials: DY
authors.lastname: Li
authors.forename: Jun
authors.initials: J
authors.lastname: Zhao
authors.forename: Yi-Hui
authors.initials: YH
authors.lastname: Guan
authors.forename: Bo-Min
authors.initials: BM
authors.lastname: Sun
authors.forename: Chuan-Tao
authors.initials: CT
authors.lastname: Zuo
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000628:therapy*; D046690:Deep Brain Stimulation; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism; D006801:Humans; D008297:Male; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18; D005947:Glucose