title: Global cortical thinning in acute anorexia nervosa normalizes following long-term weight restoration.
abstract: BACKGROUND
  Anorexia nervosa (AN) is a serious eating disorder characterized by self-starvation, extreme weight loss, and alterations in brain structure. Structural magnetic resonance imaging studies have documented brain volume reductions in acute AN, but it is unclear whether they are 1) regionally specific, or 2) reversible following weight restoration. Here, we measured cortical thickness (CT) for the first time in AN.
  
  
  METHODS
  Structural magnetic resonance imaging data were acquired from adolescent and young adult female patients with acute AN (n = 40), recovered patients following long-term weight restoration (n = 34), and an equal number of age-matched healthy control subjects. Group differences in CT were tested with well-validated procedures implemented in FreeSurfer. The mediating role of clinical variables including body mass index and drive for thinness were explored. For completeness, we also used FreeSurfer's subcortical segmentation stream to test group differences in volumes of select gray matter regions of interest.
  
  
  RESULTS
  Vertex-wise analyses revealed significant thinning of over 85% of the cortical surface in patients with acute AN and CT normalization in recovered patients following long-term weight restoration, although normal age-related trajectories were absent in the disorder. This pattern of results was largely mirrored in subcortical volumes. We also observed a strong negative correlation between CT and drive for thinness in extrastriate regions involved in body perception.
  
  
  CONCLUSIONS
  Structural brain anomalies in AN as expressed in CT and subcortical volume are primarily the consequence of malnutrition and unlikely to reflect premorbid trait markers or permanent scars, but longitudinal data are needed.
authors.affiliation: Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: King
authors.affiliation: Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden.
authors.forename: Daniel
authors.initials: D
authors.lastname: Geisler
authors.affiliation: Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden.
authors.forename: Franziska
authors.initials: F
authors.lastname: Ritschel
authors.affiliation: Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden.
authors.forename: Ilka
authors.initials: I
authors.lastname: Boehm
authors.affiliation: Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden.
authors.forename: Maria
authors.initials: M
authors.lastname: Seidel
authors.affiliation: Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Roschinski
authors.affiliation: Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden.
authors.forename: Laura
authors.initials: L
authors.lastname: Soltwedel
authors.affiliation: Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden.
authors.forename: Johannes
authors.initials: J
authors.lastname: Zwipp
authors.affiliation: Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden; Department of Psychology, University of Tromsø, Tromsø, Norway.
authors.forename: Gerit
authors.initials: G
authors.lastname: Pfuhl
authors.affiliation: Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Marxen
authors.affiliation: Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden.
authors.forename: Veit
authors.initials: V
authors.lastname: Roessner
authors.affiliation: Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden; Massachusetts General Hospital/Massachusetts Institute of Technology /Harvard Medical School Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown; Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts. Electronic address: transden.lab@gmail.com.
authors.forename: Stefan
authors.initials: S
authors.lastname: Ehrlich
mesh_terms: D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000473:pathology* / Q000628:therapy*; D001835:Body Weight; D002540:Cerebral Cortex / Q000473:pathology*; D002648:Child; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009929:Organ Size; D016896:Treatment Outcome; D055815:Young Adult
keywords: Anorexia nervosa; Cerebral cortex; Cortical thickness; FreeSurfer; MRI; Subcortical structures