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Brain and Cognitive Development in Adolescents with Anorexia Nervosa: A Systematic Review of fMRI Studies

Anorexia nervosa (AN) is an eating disorder often occurring in adolescence. AN has one of the highest mortality rates amongst psychiatric illnesses and is associated with medical complications and high risk for psychiatric comorbidities, persisting after treatment. Remission rates range from 23% to...

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Autores principales: Olivo, Gaia, Gaudio, Santino, Schiöth, Helgi B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723243/
https://www.ncbi.nlm.nih.gov/pubmed/31443192
http://dx.doi.org/10.3390/nu11081907
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author Olivo, Gaia
Gaudio, Santino
Schiöth, Helgi B.
author_facet Olivo, Gaia
Gaudio, Santino
Schiöth, Helgi B.
author_sort Olivo, Gaia
collection PubMed
description Anorexia nervosa (AN) is an eating disorder often occurring in adolescence. AN has one of the highest mortality rates amongst psychiatric illnesses and is associated with medical complications and high risk for psychiatric comorbidities, persisting after treatment. Remission rates range from 23% to 33%. Moreover, weight recovery does not necessarily reflect cognitive recovery. This issue is of particular interest in adolescence, characterized by progressive changes in brain structure and functional circuitries, and fast cognitive development. We reviewed existing literature on fMRI studies in adolescents diagnosed with AN, following PRISMA guidelines. Eligible studies had to: (1) be written in English; (2) include only adolescent participants; and (3) use block-design fMRI. We propose a pathogenic model based on normal and AN-related neural and cognitive maturation during adolescence. We propose that underweight and delayed puberty—caused by genetic, environmental, and neurobehavioral factors—can affect brain and cognitive development and lead to impaired cognitive flexibility, which in turn sustains the perpetuation of aberrant behaviors in a vicious cycle. Moreover, greater punishment sensitivity causes a shift toward punishment-based learning, leading to greater anxiety and ultimately to excessive reappraisal over emotions. Treatments combining physiological and neurobehavioral rationales must be adopted to improve outcomes and prevent relapses.
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spelling pubmed-67232432019-09-10 Brain and Cognitive Development in Adolescents with Anorexia Nervosa: A Systematic Review of fMRI Studies Olivo, Gaia Gaudio, Santino Schiöth, Helgi B. Nutrients Review Anorexia nervosa (AN) is an eating disorder often occurring in adolescence. AN has one of the highest mortality rates amongst psychiatric illnesses and is associated with medical complications and high risk for psychiatric comorbidities, persisting after treatment. Remission rates range from 23% to 33%. Moreover, weight recovery does not necessarily reflect cognitive recovery. This issue is of particular interest in adolescence, characterized by progressive changes in brain structure and functional circuitries, and fast cognitive development. We reviewed existing literature on fMRI studies in adolescents diagnosed with AN, following PRISMA guidelines. Eligible studies had to: (1) be written in English; (2) include only adolescent participants; and (3) use block-design fMRI. We propose a pathogenic model based on normal and AN-related neural and cognitive maturation during adolescence. We propose that underweight and delayed puberty—caused by genetic, environmental, and neurobehavioral factors—can affect brain and cognitive development and lead to impaired cognitive flexibility, which in turn sustains the perpetuation of aberrant behaviors in a vicious cycle. Moreover, greater punishment sensitivity causes a shift toward punishment-based learning, leading to greater anxiety and ultimately to excessive reappraisal over emotions. Treatments combining physiological and neurobehavioral rationales must be adopted to improve outcomes and prevent relapses. MDPI 2019-08-15 /pmc/articles/PMC6723243/ /pubmed/31443192 http://dx.doi.org/10.3390/nu11081907 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Olivo, Gaia
Gaudio, Santino
Schiöth, Helgi B.
Brain and Cognitive Development in Adolescents with Anorexia Nervosa: A Systematic Review of fMRI Studies
title Brain and Cognitive Development in Adolescents with Anorexia Nervosa: A Systematic Review of fMRI Studies
title_full Brain and Cognitive Development in Adolescents with Anorexia Nervosa: A Systematic Review of fMRI Studies
title_fullStr Brain and Cognitive Development in Adolescents with Anorexia Nervosa: A Systematic Review of fMRI Studies
title_full_unstemmed Brain and Cognitive Development in Adolescents with Anorexia Nervosa: A Systematic Review of fMRI Studies
title_short Brain and Cognitive Development in Adolescents with Anorexia Nervosa: A Systematic Review of fMRI Studies
title_sort brain and cognitive development in adolescents with anorexia nervosa: a systematic review of fmri studies
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723243/
https://www.ncbi.nlm.nih.gov/pubmed/31443192
http://dx.doi.org/10.3390/nu11081907
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