The mixing of both food and non-food items within the definition of pica might confuse scientific studies. Regarding pica that occurs after acquired brain injury or in degenerative diseases little was known about the symptomatology or the neural substrates of this abnormal behavior.ĭSM-5 defines pica as a persistent eating of non-nutritive, nonfood substances, which includes a pathological eating of both food and nonfood items. However, except for ice cravings, the definite mechanisms underlying pica has not been well elucidated. Among those hypotheses, nutritional theory is the most promising one, explaining ice cravings as a result of iron deficiency anemia. Several hypotheses of pica have been proposed to explain this enigmatic behavior, including nutritional, psychological, cultural and pharmacologic theories. In spite of detailed description for centuries, the mechanism of pica has been poorly understood. Although pica was first reported in pregnant women, it also occurs in children and adults, as a result of neurodevelopmental disorders or psychiatric disorders, and in individuals with acquired brain injuries or degenerative diseases. Pica may cause digestive diseases, which sometimes require medical emergencies. These items should be avoided for patients with pica.Īmong the variety of behavioral and psychological symptoms of dementia, pica, a persistent eating of non-nutritive substances, leads to particularly high burdens for family caregivers. The most common items involved in pica are daily necessities that are easy to swallow or drink, such as lipstick or shampoo. Considering the temporal lobe involvement and semantic memory deficits for both etiologies, our findings on pica for acquired brain injury might also be applied to degenerative diseases. For degenerative diseases, case reports and our data in this article suggest that Alzheimer’s disease and semantic dementia are the two main etiologies that cause pica. Our findings suggest that semantic memory deficits as a result of temporal lobe damage are associated with pica. The brain region specific for pica in our study was the posterior part of the left middle and inferior temporal gyri. We have addressed this issue by investigating patients with acquired brain injury who presented with pica and found that semantic memory deficits are associated with pica rather than frontal release signs or changes in eating behaviors. Pica is one of the most enigmatic behaviors for human beings and its neural basis and underlying mechanisms have yet to be elucidated.
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