Eating Disorders

Question 1

Mohr et al

Answer 1

Morphed pictures. Females only tend to perceive themselves as bigger than actually are in LVF (RH)

Question 2

Keizer et al

Answer 2

Anorexic turn earlier than healthy. Door width ~2x body weight (1.5x for healthy). Supports perception being objective

Question 3

Limbic system

Answer 3

Stroke in subcortical limbic structures = change in dietary habits

Question 4

Ward et al

Answer 4

Anorexia case died in hospital. Post-mortem = abnormal white matter in R frontal lobe and cerebellum. Pituitary gland 1/2 normal weight and tumour partly in caudate nucleus

Question 5

Trummer et al (1)

Answer 5

Anorexia case. MRI = R frontal intra-cerebral lesion. Post-operation = no signs of AN

Question 6

Trummer et al (2)

Answer 6

Anorexia case. MRI = arteriovenous malformation in R middle frontal gyrus. Post-operation = weight gain, able to work (in both Trummer cases still don’t know exactly what caused improvement)

Question 7

Uher and Treasure

Answer 7

Review 54 case reports with changes in eating behaviour after subcortical lesions. Complex ED syndromes mainly after R frontal and temporal lesions

Question 8

Kaye et al

Answer 8

Link with addiction? Control and reward system imbalance?

Question 9

Levine et al (1)

Answer 9

Anorexia case. Head injury = AN ceased and insight. MRI 2 months after injury = R inferior frontal and temporal encephalomalacia

Question 10

Levine et al (2)

Answer 10

Bulimia case. MRI = mild dysplasia occipital and R temporal lobe. Temporal lobectomy = ED symptoms ceased

Question 11

Regard and Landis (1)

Answer 11

Gourmand. Haemorrhage of R middle cerebral artery inc. R internal capsule and basal ganglia

Question 12

Regard and Landis (2)

Answer 12

Haemorrhage R basal ganglia with oedema compressing R lateral ventricle. MRI 5 months later = residual bleed in R putamen, external capsule and temporal lobe.

Question 13

Cerrato et al

Answer 13

Compulsive hyperphagia after thalamic stroke. Post-operation = all signs gone

Question 14

Lipsman et al

Answer 14

Link to food addiction? Review neuroimaging AN. Related to dysfunctional limbic circuit = pathological thoughts and behaviour. Ventromedial PFC, SCC and ACC = drive extreme control

Question 15

Sheng et al

Answer 15

Cerebral perfusion significantly greater for AN group compared to recovered (control in middle). No control for medication and co-morbid disorders e.g. depression which affects CSF