NEUROPSYCHOLOGICAL AND STRUCTURAL BRAIN CHANGES IN ANOREXIA-NERVOSA BEFORE AND AFTER REFEEDING

The neuropsychological performance and Magnetic Resonance Imaging (MRI ) brain appearance of a consecutive series of 46 in-patients with anor exia nervosa (AN) was compared with that of 41 normal-weight controls. The groups were matched for sex, age, estimated pre-morbid intelligen ce and education. AN patients who had gained at least 10% of their bod y weight were retested and rescanned. Controls were retested after a s imilar interval. The AN group performed significantly worse than the c ontrols on tasks measuring attention, visuospatial ability and memory. On tasks assessing flexibility and learning, no group differences wer e evident although an examination of deficits in individuals revealed that more anorexics were impaired on both. Following treatment, the AN group improved relative to the control group only on those tasks asse ssing attention. Comparison of MRI measures showed a significant propo rtion of anorexics had enlarged lateral ventricles and dilated sulci o n both cortical and cerebellar surfaces, but no dilatation was evident for the third and fourth ventricular measures. Improvements were foun d after treatment on some of the radiological measures but many differ ences remained. Relationships between morphological brain changes and cognitive impairments were weak. Lower weight, but not duration of ill ness, was associated with poorer performance on tasks assessing flexib ility/inhibition and memory, and with greater MRI ventricular size.