Childhood-onset anorexia nervosa: towards identifying a biological substrate.

OBJECTIVE The etiology of anorexia nervosa is not fully understood, but is probably multifactorial, including a biological substrate. The purpose of this paper is to investigate the possible underlying biological substrate. METHOD Fifteen children and adolescents aged 8-16 years underwent regional cerebral blood blow radioisotope scans. All fulfilled DSM-IV criteria for anorexia nervosa. Three of the girls had a follow-up scan when they had regained their lost weight. RESULTS Thirteen of the 15 patients had unilateral temporal lobe hypoperfusion, 8 on the left side and 5 on the right. The abnormality persisted in the 3 girls who had a follow-up scan after weight restoration. DISCUSSION This is the first report of reduced regional cerebral blood flow in childhood-onset anorexia nervosa, and suggests an underlying primary functional abnormality.