title: Proton magnetic resonance spectroscopy in acute, juvenile anorexia nervosa.
abstract: Anorexia nervosa is usually associated with a shrinkage of the brain that is at least partially reversible with weight gain. The pathogenesis of this brain abnormality is unclear. The purpose of this study was to investigate potential alterations in localized proton magnetic resonance (1H MR) spectra of anorectic patients immediately after an interval of excessive weight loss. Twelve patients and seventeen control subjects were examined. Water suppressed 1H MR spectra were recorded from two voxels placed in the thalamus and in the parieto-occipital white matter. The spectra of ten patients could be evaluated. Comparing patients and control subjects, significantly higher signal intensity ratios of choline containing compounds (Cho) relative to total creatine (Cr) as well as significantly lower ratios of N-acetyl-aspartate (NAA) relative to Cho were found in the white matter region. We hypothesize that these results indicate an abnormal starvation, associated membrane turnover, which predominantly takes place in the white matter. No evidence for neuronal degeneration was found in the thalamus or in the white matter region.
authors.affiliation: Institute for Clinical Radiology Mannheim, Faculty of Medicine, University of Heidelberg, Germany. h.schlemmer@dkfz-heidelberg.de
authors.forename: H P
authors.initials: HP
authors.lastname: Schlemmer
authors.forename: R
authors.initials: R
authors.lastname: Möckel
authors.forename: A
authors.initials: A
authors.lastname: Marcus
authors.forename: F
authors.initials: F
authors.lastname: Hentschel
authors.forename: C
authors.initials: C
authors.lastname: Göpel
authors.forename: G
authors.initials: G
authors.lastname: Becker
authors.forename: J
authors.initials: J
authors.lastname: Köpke
authors.forename: F
authors.initials: F
authors.lastname: Gückel
authors.forename: M H
authors.initials: MH
authors.lastname: Schmidt
authors.forename: M
authors.initials: M
authors.lastname: Georgi
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000000981:diagnostic imaging* / Q000473:pathology; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000032:analysis; D001284:Atrophy / Q000000981:diagnostic imaging / Q000473:pathology; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology; D001923:Brain Chemistry; D002794:Choline / Q000032:analysis; D003404:Creatinine / Q000032:analysis; D005260:Female; D006801:Humans; D013788:Thalamus / Q000000981:diagnostic imaging / Q000473:pathology; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate; D003404:Creatinine; D002794:Choline