Psychiatric Unit, Department of Neuropsychiatric Sciences, Florence University School of Medicine, Viale Morgagni 85, Florence, Italy.
Eur Psychiatry. 2011 Apr;26(3):176-82. doi: 10.1016/j.eurpsy.2010.07.011. Epub 2010 Oct 8.
To provide a review of the available literature about the functional neuroimaging of anorexia nervosa, and to summarize the possible role of neurobiological factors in its pathogenesis.
A systematic review of the literature was performed using PubMed and Medline electronic database (1950-September 2009). Eligible studies were restricted to those involving the main parameters of cerebral activity and functional neuroimaging techniques. Findings of the reviewed studies have been grouped on a diagnostic subtype basis, and their comparison has been interpreted in terms of concordance.
We found a high level of concordance among available studies with regard to the presence of frontal, parietal and cingulate functional disturbances in both anorexia nervosa restricting and binge/purging subtypes. Concordance among studies conducted regardless of the anorexia nervosa subtypes suggests an alteration in temporal and parietal functions and striatal metabolism.
The most consistent alterations in anorexia nervosa cerebral activity seem to involve the dorsolateral prefrontal cortex, the inferior parietal lobule, the anterior cingulate cortex and the caudate nucleus. They may affect different neural systems such as the frontal visual system, the attention network, the arousal and emotional processing systems, the reward processing network, and the network for the body schema.
对神经性厌食症的功能神经影像学研究文献进行综述，总结神经生物学因素在其发病机制中的可能作用。
通过 PubMed 和 Medline 电子数据库（1950 年-2009 年 9 月）进行系统的文献回顾。合格的研究仅限于涉及大脑活动主要参数和功能神经影像学技术的研究。综述研究的结果按诊断亚型进行分组，并根据一致性进行解释。
我们发现，在神经性厌食症限制型和暴食/清除型这两种亚型中，均存在额叶、顶叶和扣带回功能障碍，这方面的研究结果具有较高的一致性。无论神经性厌食症亚型如何，对这些研究进行的比较都表明颞叶和顶叶功能以及纹状体代谢存在改变。
神经性厌食症大脑活动中最一致的改变似乎涉及背外侧前额叶皮质、下顶叶小叶、前扣带皮质和尾状核。这些改变可能影响到不同的神经系统，如额眼视觉系统、注意力网络、觉醒和情绪处理系统、奖励处理网络以及身体图式网络。
