title: Morphological changes in the brain of acutely ill and weight-recovered patients with anorexia nervosa. A meta-analysis and qualitative review.
abstract: OBJECTIVE
  Acute anorexia nervosa (AN) leads to reduced gray (GM) and white matter (WM) volume in the brain, which however improves again upon restoration of weight. Yet little is known about the extent and clinical correlates of these brain changes, nor do we know much about the time-course and completeness of their recovery.
  
  
  METHODS
  We conducted a meta-analysis and a qualitative review of all magnetic resonance imaging studies involving volume analyses of the brain in both acute and recovered AN.
  
  
  RESULTS
  We identified structural neuroimaging studies with a total of 214 acute AN patients and 177 weight-recovered AN patients. In acute AN, GM was reduced by 5.6% and WM by 3.8% compared to healthy controls (HC). Short-term weight recovery 2-5 months after admission resulted in restitution of about half of the GM aberrations and almost full WM recovery. After 2-8 years of remission GM and WM were nearly normalized, and differences to HC (GM: -1.0%, WM: -0.7%) were no longer significant, although small residual changes could not be ruled out. In the qualitative review some studies found GM volume loss to be associated with cognitive deficits and clinical prognosis.
  
  
  CONCLUSIONS
  GM and WM were strongly reduced in acute AN. The completeness of brain volume rehabilitation remained equivocal.
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, <location>Germany</location>
authors.forename: Jochen
authors.initials: J
authors.lastname: Seitz
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, <location>Germany</location>
authors.forename: Katharina
authors.initials: K
authors.lastname: Bühren
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, <location>Germany</location>
authors.forename: Georg G
authors.initials: GG
authors.lastname: von Polier
authors.affiliation: Department of Medical Statistics, University Hospital RWTH Aachen, <location>Germany</location>
authors.forename: Nicole
authors.initials: N
authors.lastname: Heussen
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, <location>Germany</location>
authors.forename: Beate
authors.initials: B
authors.lastname: Herpertz-Dahlmann
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, <location>Germany</location>
authors.forename: Kerstin
authors.initials: K
authors.lastname: Konrad
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000473:pathology* / Q000628:therapy*; D001921:Brain / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009474:Neurons / Q000473:pathology; D009929:Organ Size / Q000502:physiology; D010343:Patient Admission; D020127:Recovery of Function; D012016:Reference Values; D013223:Statistics as Topic; D015430:Weight Gain / Q000502:physiology; D055815:Young Adult
keywords: Anorexia Nervosa; Gehirnvolumen; Meta-Analyse; anorexia nervosa; brain volume; gewichts-rehabilitiert; meta-analysis; morphologische Veränderungen; morphometric changes; recovered