title: Disruption of brain white matter microstructure in women with anorexia nervosa.
abstract: BACKGROUND
  The etiology of anorexia nervosa is still unknown. Multiple and distributed brain regions have been implicated in its pathophysiology, implying a dysfunction of connected neural circuits. Despite these findings, the role of white matter in anorexia nervosa has been rarely assessed. In this study, we used diffusion tensor imaging (DTI) to characterize alterations of white matter microstructure in a clinically homogeneous sample of patients with anorexia nervosa.
  
  
  METHODS
  Women with anorexia nervosa (restricting subtype) and healthy controls underwent brain DTI. We used tract-based spatial statistics to compare fractional anisotropy (FA) and mean diffusivity (MD) maps between the groups. Furthermore, axial (AD) and radial diffusivity (RD) measures were extracted from regions showing group differences in either FA or MD.
  
  
  RESULTS
  We enrolled 19 women with anorexia nervosa and 19 healthy controls in our study. Patients with anorexia nervosa showed significant FA decreases in the parietal part of the left superior longitudinal fasciculus (SLF; p(FWE) < 0.05), with increased MD and RD but no differences in AD. Patients with anorexia nervosa also showed significantly increased MD in the fornix (p(FWE) < 0.05), accompanied by decreased FA and increased RD and AD.
  
  
  CONCLUSIONS
  Limitations include our modest sample size and cross-sectional design.
  
  
  CONCLUSIONS
  Our findings support the presence of white matter pathology in patients with anorexia nervosa. Alterations in the SLF and fornix might be relevant to key symptoms of anorexia nervosa, such as body image distortion or impairments in body-energy-balance and reward processes. The differences found in both areas replicate those found in previous DTI studies and support a role for white matter pathology of specific neural circuits in individuals with anorexia nervosa.
authors.affiliation: Bellvitge University Hospital, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), and the Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Via
authors.affiliation: Melbourne Neuropsychiatry Centre, The University of Melbourne, Melbourne, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Zalesky
authors.affiliation: Bellvitge University Hospital, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Sánchez
authors.affiliation: Bellvitge University Hospital, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL),and the and the CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Carlos III, University of Barcelona, Barcelona, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Forcano
authors.affiliation: Melbourne Neuropsychiatry Centre, The University of Melbourne, Melbourne, Australia.
authors.forename: Ben J
authors.initials: BJ
authors.lastname: Harrison
authors.affiliation: MRI Research Unit, CRC Mar, Hospital de Mar, Barcelona, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Pujol
authors.affiliation: Bellvitge University Hospital, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), and the Department of Clinical Sciences, School of Medicine, and the CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Carlos III, University of Barcelona, Barcelona, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Fernández-Aranda
authors.affiliation: Bellvitge University Hospital, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), the Department of Clinical Sciences, School of Medicine, and the CIBER Salud Mental (CIBERSAM), Instituto Carlos III, University of Barcelona, Barcelona, Spain.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Menchón
authors.affiliation: Bellvitge University Hospital, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), the CIBER Salud Mental (CIBERSAM), Instituto Carlos III, Barcelona, Spain.
authors.forename: Carles
authors.initials: C
authors.lastname: Soriano-Mas
authors.affiliation: Bellvitge University Hospital, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), the Department of Clinical Sciences, School of Medicine, and the CIBER Salud Mental (CIBERSAM), Instituto Carlos III, University of Barcelona, Barcelona, Spain.
authors.forename: Narcís
authors.initials: N
authors.lastname: Cardoner
authors.affiliation: Monash Clinical and Imaging Neuroscience, School of Psychology and Psychiatry & Monash Biomedical Imaging, Monash University, Clayton, Australia.
authors.forename: Alex
authors.initials: A
authors.lastname: Fornito
mesh_terms: D000293:Adolescent; D000328:Adult; D016880:Anisotropy; D000856:Anorexia Nervosa / Q000188:drug therapy / Q000473:pathology*; D001921:Brain / Q000473:pathology*; D003430:Cross-Sectional Studies; D038524:Diffusion Magnetic Resonance Imaging; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D009434:Neural Pathways / Q000473:pathology; D066127:White Matter / Q000473:pathology*; D055815:Young Adult