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Dr. Walter H Kaye, professor of psychiatry at the University of Pittsburgh School of Medicine, is director of the eating disorders research program the Western Psychiatric Institute and Clinic at UPMC. After completing a recent study, he and colleagues say women who recovered from anorexia nervosa show vastly different patterns of brain activity compared to similar women without the eating disorder.
Studying the differences in brain function could lead to a better understanding of why some young women, who are typically worriers and perfectionists in childhood, are at greater risk of developing the disorder. Evidence also shows that such patterns of temperament persist even after recovery.
Researchers studied 13 women who had recovered from anorexia, maintaining normal weight and regular menstrual cycles for at least one year, and 13 healthy women in a control group. While playing a game on a computer screen in which a correct answer wins $2 and an incorrect guess forfeits $1, subjects were being monitored by fMRI brain imaging .
The areas being observed were the anterior ventral striatum (associated with instant emotional responses), and the caudate (involved in linking actions to outcome and planning).
“During the game, brain regions lit up in different ways for women who formerly had anorexia compared to healthy controls,” said Anglea Wagner MD, the study’s first author. “While the brain region for emotional responses showed strong differences for winning and losing in healthy women, women with a past history of anorexia showed little difference between winning and losing.
“For anorexics, then, perhaps it is difficult to appreciate immediate pleasure if it does not feel much different from a negative experience.”
The caudate regions of the former anorexics were more active than the health controls’, especially in the most anxious people, suggesting that women with a history of anorexia were more focused on the consequences of their choices, noted Dr Kaye. He added that anorexics “tend to worry about the future” and doing things right.
The Highest Mortality Rate of any Psychiatric Disorder
Dr Kaye said, “There are some positive aspects to this kind of temperament. Paying attention to detail and making sure things are done as correctly as possible are constructive traits in careers such as medicine or engineering.” Carried to extremes, however, such obsessive thinking can also be harmful.
Results of the guessing game show that healthy women responded to wins and losses by “living in the moment” and moving on to the next task, while people with a past history of anorexia had trouble letting go. “They tended to try to find patterns within the game, and were concerned about making mistakes,” said Dr Kaye.
There is no proven treament that reverses symptoms in anorexia nervosa, shich has the highest mortality rate of any psychiatric disorder. Increasing researchers’ understanding of these basic brain differences could influence future development of drugs and other treatments for the disease.
“We’re starting to understand these processes because we have better tools, such as brain imaging, and a better understanding of how the brain works because of advances in cognitive neuroscience” says Dr Kaye..
source: www.sciencedaily.com article on 12/2/07; adapted from materials provided by University of Pittsburgh Schools of the Health Sciences.
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