technetium-tc-99m-exametazime and Anorexia-Nervosa

Relationships of 'perceptual distortion' and 'cognitive evaluation' components of body image disturbances to brain activity were investigated. Changes in regional cerebral blood (rCBF) of nine patients with anorexia nervosa restrictive type (AN), 13 patients with bulimia nervosa purging type (BN) and 12 controls following three experiments with single photon emission computed tomography (SPECT) were compared: at rest, following a landscape video presentation (neutral stimulus), and after their filmed body image (positive stimulus) exposure. Body distortion was measured with the Silhouette test and body dissatisfaction with the Body Shape Questionnaire (BSQ). Patients with AN showed a hyperactivation of the left parietal and right superior frontal from neutral to positive stimulus. Patients with BN showed a hyperactivation of the right temporal and right occipital areas. Changes in BSQ responses were associated with changes in the right inferior frontal and right temporal rCBF, whereas changes in body distortion were related to the left parietal. The activation of the right temporal after the own body image exposure might be in accordance with the aversive events' response. Functional abnormalities in AN might be related to the storage of a distorted prototypical image of the body in the left parietal lobe.

Topics: Anorexia Nervosa; Arousal; Body Image; Bulimia Nervosa; Cerebellum; Cerebral Cortex; Dominance, Cerebral; Humans; Pattern Recognition, Visual; Perceptual Distortion; Regional Blood Flow; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Anorexia nervosa (AN) is subdivided into the restricting type (AN-R) and the binge-eating/purging type (AN-BP), but differences in cerebral blood flow between patients with these types of AN and healthy controls have not been investigated.. The present study was designed to elucidate any such differences using resting single photon emission computed tomography (SPECT) studies to compare the differences in cerebral perfusion among both types of AN and a healthy control group. Resting regional cerebral blood flow was assessed using SPECT with technetium-99m hexamethylpropyleneamine oxime in 13 female AN-R patients, 13 female AN-BP patients, and 10 healthy women as controls with 3-D stereotactic surface projections.. The analytic program of the SPECT images showed bilateral decreased perfusion of the subcallosal gyrus (SCG), midbrain and posterior cingulate gyrus (PCG) in both AN-R and AN-BP patients, as compared with the controls. There were no clear differences between the AN-R and AN-BP groups. There were no significant differences in cerebral blood flow between patients with AN-R and AN-BP.. Abnormalities of the neuronal circuits containing the SCG, midbrain and PCG are possibly relevant to trait-related AN.

Topics: Adolescent; Adult; Anorexia Nervosa; Body Mass Index; Brain; Bulimia Nervosa; Corpus Callosum; Dominance, Cerebral; Female; Gyrus Cinguli; Humans; Image Processing, Computer-Assisted; Imaging, Three-Dimensional; Mesencephalon; Reference Values; Regional Blood Flow; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

It is possible that psychopathological differences exist between the restricting and bulimic forms of anorexia nervosa. We investigated localized differences of brain blood flow of anorexia nervosa patients using SPECT image analysis with statistic parametric mapping (SPM) in an attempt to link brain blood flow patterns to neurophysiologic characteristics.. The subjects enrolled in this study included the following three groups: pure restrictor anorexics (AN-R), anorexic bulimics (AN-BP), and healthy volunteers (HV). All images were transformed into the standard anatomical space of the stereotactic brain atlas, then smoothed. After statistical analysis of each brain image, the relationships among images were evaluated.. SPM analysis of the SPECT images revealed that the blood flow of frontal area mainly containing bilateral anterior cingulate gyri (ACC) was significantly decreased in the AN-R group compared to the AN-BP and HV groups.. These findings suggest that some localized functions of the ACCare possibly relevant to the psychopathological aspects of AN-R.

Topics: Anorexia Nervosa; Blood Glucose; Body Mass Index; Bulimia; Female; Frontal Lobe; Gyrus Cinguli; Hematocrit; Humans; Regional Blood Flow; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

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.

Topics: Adolescent; Adult; Anorexia Nervosa; Brain; Brain Mapping; Case-Control Studies; Cerebrovascular Circulation; Female; Frontal Lobe; Humans; Iodine Radioisotopes; Nerve Net; Radiopharmaceuticals; Technetium Tc 99m Exametazime; Temporal Lobe; Thalamus; Tomography, Emission-Computed, Single-Photon

Eating disorders have been redefined in recent years. Brain imaging techniques are useful in demonstrating the association between the morphologic and the functional cerebral changes in these cases. We report 99mTc-HMPAO brain SPECT findings in two patients with anorexia nervosa, before and after the treatment. While the detailed neurologic and laboratory examinations, including EEG and cranial CT, were within normal limits before therapy, SPECT study revealed diffuse bilateral hypoperfusion in frontal, parietal and frontotemporal areas which was more prominent in the left hemisphere. Post-treatment SPECT studies obtained after a clinical remission period of 3 mo showed normal brain perfusion in both patients. The pre- and post-treatment SPECT studies accurately reflect the functional state of the patients, and this technique may be used to follow-up the effect of treatment and predict the clinical response to therapy in patients with eating disorders.

Topics: Adolescent; Anorexia Nervosa; Brain; Cerebrovascular Circulation; Electroencephalography; Female; Humans; Radiopharmaceuticals; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Topics: Anorexia Nervosa; Atrophy; Brain; Humans; Magnetic Resonance Imaging; Radiopharmaceuticals; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Topics: Adolescent; Adult; Anorexia Nervosa; Arousal; Cerebral Cortex; Dominance, Cerebral; Feeding Behavior; Female; Frontal Lobe; Humans; Organotechnetium Compounds; Oximes; Regional Blood Flow; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon