A cross-sectional and follow-up voxel-based morphometric MRI study in adolescent anorexia nervosa.
The objective was to examine whether cerebral volumes are reduced, and in what regions, in adolescents with anorexia nervosa and to study changes after nutritional recovery. Twelve anorexia nervosa (DSM-IV) patients aged 11-17 consecutively admitted to an Eating Disorders Unit were assessed by means of psychopathological scales, neuropsychological battery and voxel-based morphometric (VBM) magnetic resonance imaging at admission and after 7 months' follow-up. Nine control subjects of similar age, gender and estimated intelligence level were also studied. The two groups showed differences in gray matter (F=22.2; p<0.001) and cerebrospinal fluid (CSF) (F=21.2; p<0.001) but not in white matter volumes. In anorexic patients, gray matter volume correlated negatively with the copy time from the Rey Complex Figure Test. In the regional VBM study several temporal and parietal gray matter regions were reduced. During follow-up there was a greater global increase in gray matter (F=10.7; p=0.004) and decrease in CSF (F=22.1; p=0.001) in anorexic patients. The increase in gray matter correlated with a decrease in cortisol (Spearman correlation=-0.73; p=0.017). At follow-up there were no differences in global gray matter (F=2.1; p=0.165), white matter (F=0.02, p=0.965) or CSF (F=1.8; p=0.113) volumes between both groups. There were still some smaller areas, in the right temporal and both supplementary motor area, showing differences between them in the regional VBM study. In conclusion, in adolescent anorexic patients gray matter is more affected than white matter and mainly involves the posterior regions of the brain. Overall gray matter alterations are reversible after nutritional recovery.
Castro-Fornieles
Josefina
J
Department of Child and Adolescent Psychiatry and Psychology, Institute Clinic of Neurosciences, Hospital Clinic, University of Barcelona, Centro de Investigación Biomédica en Red de Salud Mental (CIBER-SAM), Barcelona, Spain. jcastro@clinic.ub.es
Bargalló
Nuria
N
Lázaro
Luisa
L
Andrés
Susana
S
Falcon
Carles
C
Plana
Maria Teresa
MT
Junqué
Carme
C
D000293:Adolescent; D000704:Analysis of Variance; D000856:Anorexia Nervosa / Q000134:cerebrospinal fluid / Q000523:psychology* / Q000628:therapy; D015992:Body Mass Index; D001921:Brain / Q000473:pathology* / Q000503:physiopathology*; D002552:Cerebral Ventricles / Q000473:pathology / Q000503:physiopathology; D002648:Child; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D044623:Nutrition Therapy; D011569:Psychiatric Status Rating Scales; D011863:Radioimmunoassay; D013997:Time Factors; D016896:Treatment Outcome; D014284:Triiodothyronine / Q000097:blood
D014284:Triiodothyronine; D007334:Insulin-Like Growth Factor I; D006854:Hydrocortisone