شبکه عصبی غیر طبیعی در بی اشتهایی عصبی مورد مطالعه با I-123-IMP SPECT

Single photon emission computed tomography was used to study 14 female patients with anorexia nervosa and 8 female normal comparison subjects. Automatic voxel-based analysis of the images was carried out using statistical parametric mapping (SPM) software. Statistics across the entire brain were displayed as Z scores (threshold: P<0.05). Compared with the normal comparison subjects, the anorectic patients were characterized by hypoperfusion in the medial prefrontal cortex and the anterior cingulate gyrus, and hyperperfusion in the thalamus and the amygdala–hippocampus complex. These results suggest that a dysfunction in neuronal circuitry may be related to anorexia nervosa.

The etiology of anorexia nervosa is not yet understood but is thought to involve multifactoral, including biological substrates. A number of metabolic and endocrine abnormalities, mainly at the hypothalamic level, have been described in anorexia nervosa (Gwirtsman and Gerner, 1981 and Wakeling, 1985). Non-invasive techniques such as positron emission tomography (PET), single photon emission computed tomography (SPECT), and functional magnetic resonance imaging (fMRI) have been used to evaluate cerebral functioning in the disorder. A PET study revealed increased metabolism of the caudate nucleus in the anorexic state that returned to normal levels after realimentation (Herholz et al., 1987). In a SPECT study with [99mTc]-d,l-hexamethyl-propylene amine oxime (HM-PAO), changes in cerebral blood flow in response to food-intake stimuli were observed in the inferior frontal cortex, superior frontal cortex and occipital cortex (Nozoe et al., 1993). A recent fMRI study related activity in the anterior cingulate gyrus (ACG), the left insula, and the amygdala–hippocampus complex to calorie fear in anorexia nervosa (Ellison et al., 1998). In the present study, we used statistical parametric mapping (SPM) to compare cerebral perfusion in patients with anorexia nervosa and healthy volunteers.