title: Mammillary body volume abnormalities in anorexia nervosa.
abstract: Several case reports of Wernicke's Encephalopathy in anorexia nervosa (AN) caused by thiamine deficiency have described mammillary body (MB) injury, but systematic studies are lacking. Here we evaluated whether underweight and weight-restored individuals with AN demonstrate evidence of abnormal MB morphology, via retrospective examination of a previously collected data set.
  
  
  
  Using standard-resolution T1-weighted magnetic resonance imaging at 3 Tesla, we measured MB volume and fornix area in a cross-sectional study of 12 underweight AN, 20 weight-restored AN, and 30 age- and sex-matched healthy comparisons. Because of the small size of these structures, a manual tracing approach was necessary to obtain accurate measurements. A blinded expert rater manually traced MB and fornix structures in each participant.
  
  
  
  We observed significantly smaller MB volumes in the underweight AN group. However, the weight-restored AN group exhibited significantly larger MB volumes. The right fornix was smaller in the weight-restored AN group only.
  
  
  
  These findings suggest the possibility that MB volume and fornix area could represent potential biomarkers of acute weight loss and restoration, respectively. Verification of this finding through prospective studies evaluating MB morphology, cognition, and thiamine levels longitudinally across individual illness trajectories might be warranted. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:920-929).
authors.affiliation: Laureate Institute for Brain Research, Tulsa, Oklahoma, 74136. skhalsa@laureateinstitute.org.|Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma, 74104. skhalsa@laureateinstitute.org.
authors.forename: Sahib S
authors.initials: SS
authors.lastname: Khalsa
authors.affiliation: Department of Anesthesiology, University of California at Los Angeles, Los Angeles, California, 90095.|Brain Research Institute, University of California at Los Angeles, Los Angeles, California.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, 90095.
authors.forename: Vandan
authors.initials: V
authors.lastname: Patel
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, 90095.
authors.forename: Michael
authors.initials: M
authors.lastname: Strober
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, 90095.
authors.forename: Jamie D
authors.initials: JD
authors.lastname: Feusner
mesh_terms: D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000000981:diagnostic imaging / Q000473:pathology*; D015415:Biomarkers; D001823:Body Composition; D003430:Cross-Sectional Studies; D005260:Female; D020712:Fornix, Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008326:Mammillary Bodies / Q000000981:diagnostic imaging / Q000473:pathology*; D012189:Retrospective Studies; D013851:Thinness / Q000000981:diagnostic imaging / Q000473:pathology; D015431:Weight Loss; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: Wernicke's encephalopathy; anorexia nervosa; fornix; mammillary body; structural MRI; thiamine deficiency