[31P-MR spectroscopy of the brain in patients with anorexia nervosa: characteristic differences in the spectra between patients and healthy control subjects].
OBJECTIVE
To investigate whether 31 P-MR spectroscopy can detect reduced concentrations of high-energy phosphates, like PCr and NTP, caused by decreased metabolic activity in the brain of patients with anorexia nervosa (AN) and, furthermore, whether any impairment of the cerebral membrane metabolism can be derived from the spectra.


METHODS
10 female patients, age range 12 - 20 years and mean BMI (body mass index) of 14.8 +/- 1.6 kg/m 2, with clinically diagnosed AN (ICD-10, F50.0) and 10 healthy control subjects, age range 12 - 21 years and mean BMI 19.0 +/- 2.1 kg/m 2, without nutritional disturbances: were investigated. 31P-MR spectroscopy was performed with a 1.5 T MRI unit using single volume selection in the frontal/prefrontal region of brain. Relative metabolic concentrations were quantified by normalizing the peak areas of the metabolites with the total area of the complete phosphorous spectrum, P tot, as well as with the peak area of beta-NTP.


RESULTS
Significant differences between the two groups were observed for the metabolic ratios PDE/P tot, PDE/beta-NTP and alpha-NTP/P tot which were lower in the patient group except for alpha-NTP/P tot. These ratios also revealed a statistically significant correlation with the BMI (r PDE/Ptot = 0.747, r PDE/beta-NTP = 0.57, r alpha-NTP/Ptot = -0.56; p </= 0.1). Reduced relative concentrations of PCr/P tot, beta-NTP/P tot or Pi/P tot were not encountered.


CONCLUSIONS
The lowered PDE/P tot ratio for patients with AN and its correlation with BMI suggests that decreased BMI induces compositional changes of the phospholipids in the brain, which decrease the fraction of mobile phospholipids.
Rzanny
R
R
Institut für Diagnostische und Interventionelle Radiologie, Klinikum der Friedrich-Schiller-Universität Jena, Germany. Reinhard.Rzanny@med.unijena.de
Freesmeyer
D
D
Reichenbach
J R
JR
Mentzel
H J
HJ
Pfleiderer
S O R
SO
Klemm
S
S
Gerhard
U J
UJ
Blanz
B
B
Kaiser
W A
WA
D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000175:diagnosis / Q000378:metabolism*; D015992:Body Mass Index; D001921:Brain / Q000378:metabolism*; D002648:Child; D016001:Confidence Intervals; D003627:Data Interpretation, Statistical; D004734:Energy Metabolism; D004952:Esters / Q000378:metabolism; D005260:Female; D005583:Fourier Analysis; D005625:Frontal Lobe / Q000378:metabolism; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008962:Models, Theoretical; D010710:Phosphates / Q000378:metabolism*; D010725:Phosphocreatine / Q000378:metabolism; D011122:Polyphosphates / Q000378:metabolism; D012984:Software; D015431:Weight Loss
D004952:Esters; D010710:Phosphates; D011122:Polyphosphates; D010725:Phosphocreatine; C005692:triphosphoric acid