Beth Watkins

Do abnormalities in regional cerebral blood flow in anorexia nervosa resolve after weight restoration

OBJECTIVE Previous studies have demonstrated localised abnormalities of cerebral blood flow in anorexia nervosa, suggesting reduction of cerebral activity and function in specific regions. There is debate as to whether such findings are secondary to starvation or indicative of a primary abnormality predating the illness, representing an underlying biological substrate. This small study, the first in early onset anorexia nervosa, reports findings of regional cerebral blood flow (rCBF) at both baseline and follow up. METHOD Nine participants who had previously undergone rCBF studies at the start of treatment, had a repeat scan at an average of 4.2 years later. RESULTS Seven out of the nine had persisting reduced cerebral blood flow in one area of the brain, predominantly the medial temporal region. DISCUSSION These data suggest that in the majority of cases rCBF does not return to normal following weight restoration. The implications for future research are explored.

Neurobiological Status at Initial Presentation Predicts Neuropsychological Functioning in Early Onset Anorexia Nervosa at Four-Year Follow Up

This study explores whether neurobiological status (indexed by regional cerebral blood flow) at initial presentation predicts neuropsychological status at four-year follow up in a sample of children with early onset anorexia nervosa. Neuropsychological assessment was conducted on 15 females four years after their initial treatment, and matched controls. At follow up there were significant differences between subgroups (based on neurobiological status at initial presentation) and matched controls in long-term visual memory and cognitive inhibition. This study offers preliminary evidence that neurobiological abnormalities at initial presentation predict neuropsychological status at follow up, suggesting a distinct neurodevelopmental subtype of early onset anorexia nervosa.

Pattern of birth in adults with anorexia nervosa.

While women with anorexia nervosa are more likely to be born in March through June (in the northern hemisphere), there is no coherent model that explains this association. This study examined the birth pattern of adult restrictive and binge-purge anorexics and whether environmental temperature at assumed conception is a relevant factor. Retrospective analysis of the case notes of 195 adult anorexics was used to determine diagnosis, date of birth, eating attitudes, and body mass index. Meteorological records were used to determine temperature at assumed point of conception. Restrictive anorexics were significantly more likely than binge-purge anorexics to be born in April through June (i.e., conceived July through September). A higher environmental temperature at the point of assumed conception was more likely to be found in restrictive anorexics than in anorexics of the binge-purge subtype. A higher environmental temperature at the assumed point of conception was associated with more restrictive eating attitudes during adulthood, but only among the restrictive anorexics. Possible explanations and implications of these findings are discussed.

Parental perceptions of childhood feeding problems

Previous research suggests that parental report of children’s feeding corresponds with their child’s nutritional intake (Cooke et al., 2006; Ekstein et al., 2010). The current study aimed to determine whether there is a relationship between parental report of children’s feeding problems and their child’s nutritional intake in a non-clinical population and, in addition, to establish whether parental anxiety (Cooke et al., 2003) can predict whether parental report of feeding problems correspond with the child’s intake. Sixty-one parents of children aged two to seven years completed the parent report measure; the Behavioural Paediatric Feeding Assessment Scale as well as a food diary detailing their child’s intake, which was analysed using CompEAT nutritional software. They also completed the anxiety subscale of the Hospital Anxiety and Depression Scale. Previous findings of an association between parent report of feeding problems and child’s intake (Cooke et al., 2006) were not replicated. However, an association was found between parents’ anxiety and their reports of feeding problems. Parental anxiety was also found to independently predict whether parent report of feeding problems matched the child’s intake. Findings highlight the importance of a multifactorial approach to understanding childhood feeding difficulties. This requires replication with a clinical sample.