Duchesne Monica, Mattos Paulo, Fontenelle Leonardo F, Veiga Heloisa, Rizo Luciana, Appolinario José C
Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Grupo de Obesidade e Transtornos Alimentares, Instituto Estadual de Diabetes e Endocrinologia (IEDE-RJ), RJ, Brazil.
Braz J Psychiatry. 2004 Jun;26(2):107-17. doi: 10.1590/s1516-44462004000200008. Epub 2004 Oct 27.
The pathophysiology of eating disorders is still unknown, with many factors possibly involved. The existence of a central nervous system (CNS) dysfunction is being investigated with particular interest. One of the most employed strategies to reach this goal is the evaluation of cognitive functioning of patients with eating disorders with neuropsychological tests.
To evaluate the current knowledge about the neuropsychology of ED.
We performed a review of several data bases (including MedLINE, PsychoINFO, LILACS and Cochrane Data Bank), using terms related to main theme of interest. The review comprised articles published up to January, 2004.
Anorexia Nervosa (AN) was the most studied ED from the neuropsychological point-of-view, with studies tending to elicit attentive, visuo-spatial, and visuo-constructive deficits among such patients. On the other side, patients with Bulimia Nervosa (BN) exhibited deficits in the selective aspects of attention and in executive functions. As yet, there is no study covering the neuropsychological aspects of binge-eating disorder. After successful treatment, individuals show improvement of some cognitive deficits, while other seem to persist.
The ED are possibly associated with a certain degree of neuropsychological dysfunction, even though there is no consensus with regard to which function is particularly impaired. The fact that some cognitive dysfunction tend to disappear after treatment argues in favor of the hypothesis that these are functional deficits. Other deficits, however, tend to persist, suggesting that they may precede the development of eating disorders or even contribute to their development or to a worse prognosis. The study of the neuropsychological aspects of ED may help tailoring more selective therapeutic approaches to patients suffering from these disorders.
饮食失调的病理生理学仍然未知，可能涉及许多因素。中枢神经系统（CNS）功能障碍的存在正受到特别关注。实现这一目标最常用的策略之一是通过神经心理学测试评估饮食失调患者的认知功能。
评估有关饮食失调神经心理学的现有知识。
我们使用与感兴趣的主要主题相关的术语，对几个数据库（包括医学在线数据库、心理学文摘数据库、拉丁美洲和加勒比卫生科学数据库以及考克兰数据库）进行了综述。该综述涵盖截至2004年1月发表的文章。
从神经心理学角度来看，神经性厌食症（AN）是研究最多的饮食失调症，研究倾向于发现此类患者存在注意力、视觉空间和视觉构建方面的缺陷。另一方面，神经性贪食症（BN）患者在注意力的选择性方面和执行功能方面存在缺陷。到目前为止，尚无关于暴饮暴食障碍神经心理学方面的研究。成功治疗后，个体的一些认知缺陷有所改善，而其他缺陷似乎仍然存在。
饮食失调可能与一定程度的神经心理学功能障碍有关，尽管对于哪种功能受到特别损害尚无共识。一些认知功能障碍在治疗后趋于消失这一事实支持了这些是功能性缺陷的假设。然而，其他缺陷往往持续存在，这表明它们可能在饮食失调发展之前就已存在，甚至可能导致饮食失调的发展或预后更差。对饮食失调神经心理学方面的研究可能有助于为患有这些疾病的患者量身定制更具针对性的治疗方法。
