title: Structural hippocampal alterations, perceived stress, and coping deficiencies in patients with anorexia nervosa.
abstract: OBJECTIVE
  Anorexia nervosa (AN) is a severe mental illness that mainly affects young females. Studies have found a reduction of the hippocampus-amygdala formation in people with AN, a brain region that is especially vulnerable to stress. In addition, patients with AN were found to perceive higher stress levels and to have more coping deficiencies than healthy controls. No prior study has considered a connection between stress, coping, and the hippocampal volume in AN. Therefore, the purpose of our study was to analyze the volume of hippocampal substructures, and its relation to stress and coping.
  
  
  METHODS
  We tested 21 females currently affected by AN and 21 age-matched normal controls (NC). Demographic and behavioral data were assessed. A magnetic resonance (MR) scanner was used to collect data reflecting volume of cortical structures. We performed comparisons between groups and calculated correlations between the hippocampal volume and coping strategies or stress.
  
  
  RESULTS
  The results showed a significant reduction of the hippocampal fimbria and a significant enlargement of the hippocampal fissure in patients with AN compared to the NC. In addition, patients with AN were found to report higher stress levels and to have more coping deficiencies than healthy controls. The hippocampal volume showed a trend-level association with stress in patients with AN.
  
  
  CONCLUSIONS
  In sum, our study provides the first-available evidence that perceived stress in patients with AN could be related to hippocampal volume. Our results may contribute to a better understanding of the pathophysiology of AN and, therefore, help to improve the treatment.
authors: Medical University Graz, Institute of Social Medicine and Epidemiology, Graz, Austria.
authors: Nathalie T
authors: NT
authors: Burkert
authors: Karl-Franzens-University Graz, Institute of Psychology, Graz, Austria.
authors: Karl
authors: K
authors: Koschutnig
authors: General Hospital Graz, Clinic of Neuroradiology, Graz, Austria.
authors: Franz
authors: F
authors: Ebner
authors: Medical University Graz, Institute of Social Medicine and Epidemiology, Graz, Austria.
authors: Wolfgang
authors: W
authors: Freidl
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000856:Anorexia Nervosa / Q000473:pathology* / Q000523:psychology*; D001921:Brain / Q000473:pathology*; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D013315:Stress, Psychological / Q000473:pathology; D055815:Young Adult
keywords: MRI measurement; anorexia nervosa; coping strategies; hippocampal subfields; stress; volume