title: Gyrification brain abnormalities as predictors of outcome in anorexia nervosa.
abstract: Gyrification brain abnormalities are considered a marker of early deviations from normal developmental trajectories and a putative predictor of poor outcome in psychiatric disorders. The aim of this study was to explore cortical folding morphology in patients with anorexia nervosa (AN). A MRI brain study was conducted on 38 patients with AN, 20 fully recovered patients, and 38 healthy women. Local gyrification was measured with procedures implemented in FreeSurfer. Vertex-wise comparisons were carried out to compare: (1) AN patients and healthy women; (2) patients with a full remission at a 3-year longitudinal follow-up assessment and patients who did not recover. AN patients exhibited significantly lower gyrification when compared with healthy controls. Patients with a poor 3-year outcome had significantly lower baseline gyrification when compared to both healthy women and patients with full recovery at follow-up, even after controlling for the effects of duration of illness and gray matter volume. No significant correlation has been found between gyrification, body mass index, amount of weight loss, onset age, and duration of illness. Brain gyrification significantly predicted outcome at follow-up even after controlling for the effects of duration of illness and other clinical prognostic factors. Although the role of starvation in determining our findings cannot be excluded, our study showed that brain gyrification might be a predictor of outcome in AN. Further studies are needed to understand if brain gyrification abnormalities are indices of early neurodevelopmental alterations, the consequence of starvation, or the interaction between both factors.
authors.affiliation: Department of Neurosciences, University of Padova, Italy.|Centro Neuroscienze Cognitive, University of Padova, Italy.|Neuroradiology Unit, IRCSS San Camillo, Venice, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Favaro
authors.affiliation: Department of Neurosciences, University of Padova, Italy.|Centro Neuroscienze Cognitive, University of Padova, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Tenconi
authors.affiliation: Department of Neurosciences, University of Padova, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Degortes
authors.affiliation: Department of Medicine, University of Salerno, Italy.|Neuroradiology Unit, IRCSS San Camillo, Venice, Italy.
authors.forename: Renzo
authors.initials: R
authors.lastname: Manara
authors.affiliation: Department of Neurosciences, University of Padova, Italy.|Centro Neuroscienze Cognitive, University of Padova, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Santonastaso
mesh_terms: D017668:Age of Onset; D000856:Anorexia Nervosa / Q000175:diagnosis*; D001921:Brain / Q000473:pathology*; D001931:Brain Mapping; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D009010:Monte Carlo Method; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D013223:Statistics as Topic
keywords: MRI; anorexia nervosa; brain gyrification; cortical folding; outcome