***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Abnormalities in perception and evaluation of body shape are a hallmark of eating disorders . METHODS Brain responses to line drawings of underweight , normal weight , and overweight female bodies were measured with functional magnetic resonance imaging in 9 women with bulimia nervosa , 13 with anorexia nervosa , and 18 healthy women . Participants rated the stimuli for fear and disgust . RESULTS In the three groups , the lateral fusiform gyrus , inferior parietal cortex , and lateral prefrontal cortex were activated in response to body shapes compared with the control condition ( drawings of houses ) . The responses in the lateral fusiform gyrus and in the parietal cortex were less strong in patients with eating disorders compared with healthy control subjects . Patients with eating disorders rated the body shapes in all weight categories as more aversive than did healthy women . In the group with eating disorders , the aversion ratings correlated positively with activity in the right medial apical prefrontal cortex . CONCLUSIONS Processing of female body shapes engages a distributed neural network , parts of which are underactive in women with eating disorders . The considerable variability in subjective emotional reaction to body shapes in patients with eating disorders is associated with differential activity in the prefrontal cortex OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The Quality Index had high internal consistency ( KR-20 : 0.89 ) as did the subscales apart from external validity ( KR-20 : 0.54 ) . Test-retest ( r 0.88 ) and inter-rater ( r 0.75 ) reliability of the Quality Index were good . Reliability of the subscales varied from good ( bias ) to poor ( external validity ) . The Quality Index correlated highly with an existing , established instrument for assessing r and omised studies ( r 0.90 ) . There was little difference between its performance with non-r and omised and with r and omised studies . Raters took about 20 minutes to assess each paper ( range 10 to 45 minutes ) . CONCLUSIONS : This study has shown that it is feasible to develop a checklist that can be used to assess the method ological quality not only of r and omised controlled trials but also non-r and omised studies . It has also shown that it is possible to produce a checklist that provides a profile of the paper , alerting review ers to its particular method ological strengths and weaknesses . Further work is required to improve the checklist and the training of raters in the assessment of external validity We used single photon emission computed tomography ( SPECT ) with Tc-99m-HMPAO to examine the characteristics of regional cerebral blood flow ( rCBF ) in five patients with bulimia nervosa ( BN ) , eight patients with anorexia nervosa ( AN ) , and in nine healthy controls . The SPECT examinations were performed before and after food intake stimulus , and the values of the corrected ratio ( R ) for rCBF in 10 cerebral cortical regions before ( Rbefore ) and after eating ( Rafter ) were calculated . The asymmetry indices ( AI ) of the R values for the left and right side of each cortical region and the percent change from Rbefore to Rafter ( % change ) were computed . In comparison with the other two groups , BN patients showed significantly higher Rbefore values in the bilateral inferior frontal and left temporal regions . The AN patients showed significantly lower Rbefore values in the left parietal region than the control group . There were no significant differences in Rafter values among the three groups . The % change values in the AN group showed the greatest increase in 9 out of the 10 regions . In contrast to the positive values obtained from the 10 regions observed in the AN group , 5 out of the 10 regions in the BN group showed negative values . Among the three groups , significant differences in % change were observed on both sides of the inferior frontal , temporal , parietal , and occipital regions . These findings indicate that differences in cerebral function of BN and AN patients can be characterized through SPECT imaging OBJECTIVE To assess the functioning of mesolimbic and fronto-striatal areas involved in reward-based spatial learning in teenaged girls with bulimia nervosa ( BN ) that might be involved in the development and maintenance of maladaptive behaviors characteristic of the disorder . METHOD We compared functional magnetic resonance imaging blood oxygen level-dependent response in 27 adolescent girls with BN to that of 27 healthy , age-matched control participants during a reward-based learning task that required learning to use extra-maze cues to navigate a virtual 8-arm radial maze to find hidden rewards . We compared groups in their patterns of brain activation associated with reward-based spatial learning versus a control condition in which rewards were unexpected because they were allotted pseudo-r and omly to experimentally prevent learning . RESULTS Both groups learned to navigate the maze to find hidden rewards , but group differences in brain activity associated with maze navigation and reward processing were detected in the fronto-striatal regions and right anterior hippocampus . Unlike healthy adolescents , those with BN did not engage the right inferior frontal gyrus during maze navigation , activated the right anterior hippocampus during the receipt of unexpected rewards ( control condition ) , and deactivated the left superior frontal gyrus and right anterior hippocampus during expected reward receipt ( learning condition ) . These patterns of hippocampal activation in the control condition were significantly associated with the frequency of binge-eating episodes . CONCLUSION Adolescents with BN displayed abnormal functioning of the anterior hippocampus and fronto-striatal regions during reward-based spatial learning . These findings suggest that an imbalance in control and reward circuits may arise early in the course of BN . Clinical trial registration information-An fMRI Study of Self-Regulation in Adolescents With Bulimia Nervosa ; https:// clinical trials.gov/ ; NCT00345943 The present study is a r and omized controlled trial that aims to evaluate the efficacy of Neurofeedback compared to st and ard pharmacological intervention in the treatment of attention deficit/hyperactivity disorder ( ADHD ) . The final sample consisted of 23 children with ADHD ( 11 boys and 12 girls , 7 - 14 years old ) . Participants carried out 40 theta/beta training sessions or received methylpheni date .  Behavioral rating scales were completed by fathers , mothers , and teachers at pre- , post-treatment , two- , and six-month naturalistic follow-up . In both groups , similar significant reductions were reported in ADHD functional impairment by parents ; and in primary ADHD symptoms by parents and teachers . However , significant academic performance improvements were only detected in the Neurofeedback group . Our findings provide new evidence for the efficacy of Neurofeedback , and contribute to enlarge the range of non-pharmacological ADHD intervention choices . To our knowledge , this is the first r and omized controlled trial with a six-month follow-up that compares Neurofeedback and stimulant medication in ADHD BACKGROUND Craving or the " urge to consume " is a characteristic of bulimic eating disorders and addictions . Dysfunction of the dorsolateral prefrontal cortex ( DLPFC ) is associated with craving . We investigated whether stimulation of the DLPFC reduces food craving in people with a bulimic-type eating disorder . METHODS Thirty-eight people with bulimic-type eating disorders were r and omly allocated to receive one session of real or sham high-frequency repetitive transcranial magnetic stimulation ( rTMS ) to the left DLPFC in a double-blind procedure . Outcome measures included self-reported food craving immediately after the stimulation session and frequency of bingeing over a 24-hour follow-up period . RESULTS Compared with sham control , real rTMS was associated with decreased self-reported urge to eat and fewer binge-eating episodes over the 24 hours following stimulation . CONCLUSIONS High-frequency rTMS of the left DLPFC lowers cue-induced food cravings in people with a bulimic eating disorder and may reduce binge eating . These results provide a rationale for exploring rTMS as a treatment for bulimic eating disorders 
    Output:
    
A small number of consistent findings emerged in individuals in the acute phase of illness with BN or BED including : volume reduction and increases across a range of areas ; hypoactivity in the frontostriatal circuits ; and aberrant responses in the insula , amygdala , middle frontal gyrus and occipital cortex to a range of different stimuli or tasks ; a link between illness severity in BN and neural changes ; diminished attentional capacity and early learning ; and in SPECT studies , increased rCBF in relation to disorder-related stimuli .
One clear finding is that illness severity , exclusively defined as the frequency of binge eating or bulimic episodes , is related to greater neural changes .