PGR-2 * Cerebral Atrophy in Malnutrition, the Potential for Reversal

Abstract

OBJECTIVE: There have been few cases in the literature documenting neuroanatomical changes associated with food restriction, with one case showing atrophy reversal post-treatment. This presentation will focus on a complex and diagnostically challenging case of significant cortical and cerebellar atrophy in an adolescent female patient treated for severe malnutrition. METHOD: Data from a single case study including review of records, neuroimaging study, and serial neuropsychological assessments will be reviewed for a 16-year-old female patient who presented with cognitive, motor, psychiatric, and behavioral changes following treatment in an inpatient eating disorders unit. RESULTS: Neuroimaging findings initially showed profound cortical and cerebellar atrophy, while results from her first neuropsychological assessment showed widespread cognitive deficits, including more profound processing and executive functioning impairments. She also presented with decreased balance and mild depression. The patient's cognitive and executive functioning scores improved dramatically at six-month follow-up, although residual weaknesses remained in processing speed and fine motor dexterity. Balance also improved as did her mood. Follow up neuroimaging is pending. CONCLUSIONS: The patient's speeded recovery and relatively high cognitive functioning are surprising in the context of atrophy. This case illustrates that the brain has a greater ability to recover than sometimes presumed and highlights the importance of nutrition in overall brain health.