title: White matter microstructural changes in adolescent anorexia nervosa including an exploratory longitudinal study.
abstract: Anorexia nervosa (AN) often begins in adolescence, however, the understanding of the underlying pathophysiology at this developmentally important age is scarce, impeding early interventions. We used diffusion tensor imaging (DTI) to investigate microstructural white matter (WM) brain changes including an experimental longitudinal follow-up.
  
  
  
  We acquired whole brain diffusion-weighted brain scans of 22 adolescent female hospitalized patients with AN at admission and nine patients longitudinally at discharge after weight rehabilitation. Patients (10-18 years) were compared to 21 typically developing controls (TD). Tract-based spatial statistics (TBSS) were applied to compare fractional anisotropy (FA) across groups and time points. Associations between average FA values of the global WM skeleton and weight as well as illness duration parameters were analyzed by multiple linear regression.
  
  
  
  We observed increased FA in bilateral frontal, parietal and temporal areas in AN patients at admission compared to TD. Higher FA of the global WM skeleton at admission was associated with faster weight loss prior to admission. Exploratory longitudinal analysis showed this FA increase to be partially normalized after weight rehabilitation.
  
  
  
  Our findings reveal a markedly different pattern of WM microstructural changes in adolescent AN compared to most previous results in adult AN. This could signify a different susceptibility and reaction to semi-starvation in the still developing brain of adolescents or a time-dependent pathomechanism differing with extend of chronicity. Higher FA at admission in adolescents with AN could point to WM fibers being packed together more closely.
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital, RWTH Aachen University, Neuenhofer Weg 21, 52074 Aachen, Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Vogel
authors.affiliation: Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
authors.forename: Inge
authors.initials: I
authors.lastname: Timmers
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany; JARA-Translational Brain Medicine (The Jülich Aachen Research Alliance), Forschungszentrum Jülich GmbH, 52425 Jülich, Germany.
authors.forename: Vinod
authors.initials: V
authors.lastname: Kumar
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany; JARA-Translational Brain Medicine (The Jülich Aachen Research Alliance), Forschungszentrum Jülich GmbH, 52425 Jülich, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Nickl-Jockschat
authors.affiliation: Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands; Oxford Centre for Functional MRI of the Brain, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom.
authors.forename: Matteo
authors.initials: M
authors.lastname: Bastiani
authors.affiliation: Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
authors.forename: Alard
authors.initials: A
authors.lastname: Roebroek
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital, RWTH Aachen University, Neuenhofer Weg 21, 52074 Aachen, Germany.
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 University, Neuenhofer Weg 21, 52074 Aachen, Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Konrad
authors.affiliation: Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
authors.forename: Rainer
authors.initials: R
authors.lastname: Goebel
authors.affiliation: Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital, RWTH Aachen University, Neuenhofer Weg 21, 52074 Aachen, Germany; Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. Electronic address: jseitz@ukaachen.de.
authors.forename: Jochen
authors.initials: J
authors.lastname: Seitz
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D016880:Anisotropy; D000856:Anorexia Nervosa / Q000473:pathology*; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D001931:Brain Mapping; D002648:Child; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008137:Longitudinal Studies; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D066127:White Matter / Q000000981:diagnostic imaging*
keywords: Adolescence; Anorexia nervosa; DTI; Fractional anisotropy; TBSS