Assessment of brain function in adolescent anorexia nervosa before and after weight gain.

This study assessed brain function in 20 adolescent females with anorexia nervosa (AN) and 20 controls using event-related potentials (ERPs) and a battery of neuropsychological tests. In the AN group, N4 latencies for a nonverbal memory task were significantly longer than for a verbal task, and P3 latencies for the verbal task were significantly longer among anorexics as compared to controls. On the nonverbal task, the AN group failed to show a right > left hemispheric asymmetry for P3 amplitudes which was observed for controls. These group differences for P3 latency and amplitude were particularly pronounced in the central-parietal region of the head. Body Mass Index (BMI) in the anorexic group significantly predicted N4 amplitudes for the verbal task in the left hemisphere and P3 amplitudes for the nonverbal task in the right hemisphere. The two groups did not differ on any of the tests used to assess neuropsychological functioning. Eight nutritionally recovered patients and their matched controls were retested using the same procedures. Anorexics showed larger P3 amplitudes for the verbal as compared to the nonverbal task at follow-up. These findings provide evidence for localized brain dysfunction in anorexia nervosa that only partially normalizes with weight gain.

Energy expenditure and body composition in children with spastic quadriplegic cerebral palsy.

OBJECTIVE: To determine the relationship between resting energy expenditure and body cell mass in a group of children with spastic quadriplegic cerebral palsy (SQCP) in comparison with a group of healthy volunteers. SUBJECTS AND METHODS: Children with SQCP (n = 13) and healthy control subjects (n = 21) participated in the study. Resting energy expenditure (REE) by indirect calorimetry, as well as body composition measurements were obtained. Those included skinfold measurements, isotope dilution methods for total body water and extracellular water (2H2O or H2(18)O and NaBr, respectively), and bioelectrical impedance analysis. Intracellular water was calculated as total body water minus extracellular water. RESULTS: Overall REE in children with SQCP was significantly less than in control subjects or from predicted World Health Organization equations. There was a poor correlation between REE and weight or height for children with SQCP and those for control subjects. Children with SQCP showed a higher variance and small improvement in the correlation between REE and lean body mass or intracellular water in comparison with control subjects. Nine of the thirteen children with SQCP had significantly reduced REE per unit of lean tissue or intracellular water. Furthermore, bioelectrical impedance analysis was validated against dilution methods as a suitable technique for measuring total body water (r2 = 0.90, r = 0.95) and extracellular water (r2 = 0.84, r = 0.92) in children with SQCP. CONCLUSION: REE in children with SQCP is poorly correlated with body cell mass. We postulate that the central nervous system plays a crucial role in energy regulation. In children with SQCP, individual energy expenditure should be measured so that optimal nutritional status can be achieved. Bioelectrical impedance analysis can be used in this population to measure body water spaces.

Energy expenditure in cystic fibrosis during activities of daily living.

Energy expenditure during various activities of daily living in normally nourished female adolescents with cystic fibrosis was compared with that in matched healthy control subjects. Energy expenditure at rest, during sitting and standing, and during two levels of exercise was increased significantly in patients with cystic fibrosis (122% +/- 14%) compared with control subjects (104% +/- 10%) (p < 0.05), but incremental increases from one level of activity to another did not differ. We conclude that the various activities of daily living are not responsible for increased energy needs in female adolescents with cystic fibrosis.