Endocrine, metabolic, and brain morphological abnormalities in patients with eating disorders

In transmission computerized tomography the majority of the 50 patients examined who were suffering from anorexia nervosa displayed an enlargement of the external cerebrospinal fluid (CSF) spaces. In nearly half of the patients the morphological brain alterations were at least partially reversible after weight gain. In contrast to plasma protein, norepinephrine, triiodothyronine, and β-hydroxybutyric acid, the blood concentrations of which did not differ significantly for the groups established according to the CT finding, significantly higher plasma cortisol levels were found in those patients displaying enlarged CSF spaces. This finding may be a hint that hypercortisolism is involved in the pathogenesis of the morphological brain alterations present in patients with eating disorders, especially since according to preliminary results one fourth of the bulimic patients also display hypercortisolism as well as enlarged CSF spaces.