Brain Lesions Can Spark Cravings for Fine Food / Disorder called `gourmand syndrome'

Researchers have discovered a new kind of eating disorder in which certain kinds of brain lesions cause average eaters to become addicted to thinking about and eating gourmet food.

The new disorder, called the gourmand syndrome, was observed in 36 patients studied over three years, according to an article in the May issue of the scientific journal Neurology.

"Gourmand syndrome is a rare, benign eating disorder strongly linked to damage of the right hemisphere of the brain," said neurologist and study co-author Theodor Landis of Geneva, Switzerland, in a written statement released yesterday.

Scientists are finding more chemical links between the brain and what were once considered purely psychological dysfunctions, ranging from eating disorders such as anorexia and bulimia to obsessive-compulsive behavior such as kleptomania and pathological gambling.

But this may be one of the first studies to link behavior considered normal in places such as San Francisco, New York and Paris -- fine dining -- with damage to the brain.

The research was prompted when two men hospitalized with strokes in Switzerland displayed unusual cravings for gourmet dining as they were recovering.

One patient, a 48-year-old political journalist, became so obsessed with food after his recovery from a stroke that he became his newspaper's restaurant columnist. Prior to his hospitalization, he had no particular interest in food and ate whatever his wife brought to the table, the article said.

But as he lay recovering, he was asked by his doctors what bothered him most. "He instantly replied that he found the hospital food awful, that he felt perfectly healthy, and that he had nothing else on his mind but good, tasty food served in a nice restaurant."

While hospitalized, according to the study, he wrote in his diary: "It is time for a real hearty dinner, e.g. a good sausage with hash browns or some spaghetti Bolognese, or risotto and breaded cutlet, nicely decorated, or a scallop of game in cream sauce with 'spaetzle' (a Swiss and southern German specialty)."

The patient complained that he felt "dried up" in the hospital. "Where's the next oasis?" he wrote. "With date trees and lamb- roast or couscous and mint tea, the Moroccan way, real fresh. . ."

The second patient, a 55-year- old businessman, "had no real food preferences and preferred a tennis match to a fine dinner" before he was hospitalized with a stroke, the study said.

Five weeks after the stroke, he was asked to write down his experiences as a patient. "To our astonishment, his writing almost exclusively contained reflections about fine dining," the researchers said.

These observations led the researchers to draft a comprehensive checklist to assess present and earlier eating habits in 723 patients with known or suspected single brain lesions to determine if there were "clinical and anatomical correlates of this altered eating behavior."

Of the 723 patients studied, gourmand syndrome was observed in 36, many of whom spontaneously reported a preoccupation with eating gourmet food. Thirty- three of the patients suffered from some kind of lesions -- including strokes, tumors, hemorrhages or seizures -- in the right front area of the brain. Only two had damage on the left side, with one showing damage on both sides.

All 36 patients showed a variety of brain dysfunctions, including impairment of memory, conceptual thinking and visual perception. But the researchers described the gourmand syndrome itself as benign.

The study's authors said it was not clear why lesions on the right side caused the disorder but that other eating disorders, such as tumor-caused anorexia, also have been linked in some studies to the right hemisphere of the brain.

Studies of chemical differences between the brain's two hemispheres are rare, the article continued, but recent research suggests a chemical imbalance between the right and left sides of the brain, with levels of such neurotransmitters as serotonin higher in the right hemisphere.

"This new syndrome shows the public that addiction and compulsive disorders, even ones that aren't debilitating, can be due to damage to a limited area of the brain," said psychologist and study co-author Marianne Regard of Zurich, Switzerland, in a written statement.