Brain structure and function in adolescents with anorexia nervosa

Anorexia nervosa (AN) commonly arises during adolescence and is associated with significant medical morbidity. Abnormalities in brain structure and function are among the most common, early, and concerning physical consequences. Advances in neuroimaging technology have played an important role in delineating the structural and functional changes found in patients with AN. Studies using computed tomography and magnetic resonance imaging have demonstrated changes in brain structure in the low-weight stages of AN. In addition, functional neuroimaging techniques have demonstrated altered brain metabolism. Debate continues as to whether these brain abnormalities are fully reversible with weight restoration. Neuropsychological research has demonstrated that cognitive dysfunction is also a common feature of AN. Multiple studies have indicated deficits in various neuropsychological domains. Whether the reported cognitive deficits are reversible with weight gain remains unknown. To date, some preliminary evidence suggests that reported cognitive deficits in patients with AN may be associated with structural brain abnormalities. This chapter reviews the current literature about neuroimaging studies and cognitive function in adolescents with AN, discusses the possible underlying mechanisms causing these changes, and explores the possible association between them.