Preserved white matter microstructure in adolescent patients with atypical anorexia nervosa

Olivo, Gaia; Swenne, Ingemar; Zhukovsky, Christina; Tuunainen, Anna-Kaisa; Saaid, Avista; Salonen-Ros, Helena; Larsson, Elna‐Marie; Brooks, Samantha; Schiöth, Helgi B.

doi:10.1002/eat.23012

Cited by 14 publications

(11 citation statements)

References 51 publications

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“…Small‐scale studies of brain structure and function have pointed to potential pathogenetic differences between AN and AAN. For example, in contrast to AN, alterations in gray and white matter microstructure do not appear to be common features of AAN; however, this may reflect less severe undernutrition in AAN (Olivo et al, 2018; Olivo et al, 2019). Moreover, food‐related neural responses in AAN may differ from what is typically seen in AN (Olivo et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Identifying research priorities for the study of atypical anorexia nervosa: A Delphi study

Strand

Zvrskovec

Hübel

et al. 2020

Intl J Eating Disorders

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Objective: Individuals meeting all criteria for anorexia nervosa (AN) except that weight falls within or above the normal range despite significant weight loss are categorized as having atypical AN (AAN). Existing research has provided mixed evidence concerning the diagnostic demarcation of AN and AAN. The aim of the present study was to identify research priorities for furthering the understanding of AN and AAN as diagnostic entities. Method: Employing the Delphi methodology, experts in the field were invited to suggest research questions that need to be explored in the demarcation of AN from AAN. This yielded 24 research areas, that were presented in subsequent rounds where panelists were asked to prioritize areas of primary interest. Results: Fifty-three panelists completed all three Delphi rounds. Consensus was only reached on three items considered to be of primary interest: medical, neurobiological, and neurological factors; epidemiology and natural course; and treatment response in AAN compared to AN. In contrast, questions of premorbid weight and determining the need for and nature of a body mass index cutoff differentiating between AAN and AN were seen as being of low priority. Discussion: These findings reveal a relatively low degree of consensus on the demarcation of AN from AAN in the field of eating disorders. A reason could be that the definition and use of the AAN category vary in research and clinical practice. In order to achieve further diagnostic clarity, research on the demarcation of AAN and AN should focus on the identified prioritized research areas.

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Section: Introductionmentioning

confidence: 99%

Identifying research priorities for the study of atypical anorexia nervosa: A Delphi study

Strand

Zvrskovec

Hübel

et al. 2020

Intl J Eating Disorders

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“…Most studies report lower FA in widespread WM regions, including the corpus callosum (CC) (Frieling et al, 2012;Frank et al, 2013;Shott et al, 2016;Gaudio et al, 2017;Phillipou et al, 2018;von Schwanenflug et al, 2019), fornix fibers (Kazlouski et al, 2011;Frank et al, 2013;Gaudio et al, 2017), thalamus (Frieling et al, 2012;Hu et al, 2017), cingulum (Kazlouski et al, 2011;Frank et al, 2013), posterior thalamic radiation (PTR) (Phillipou et al, 2018), superior longitudinal fasciculus (SLF) (Via et al, 2014), fronto-occipital fasciculus (FOF) (Kazlouski et al, 2011;Via et al, 2014), corona radiation (Shott et al, 2016;Phillipou et al, 2018) and cerebellum (Nagahara et al, 2014;Shott et al, 2016). Five studies, however, observed no significant FA differences between AN patients and HC (Yau et al, 2013;Cha et al, 2016;Pfuhl et al, 2016;Bang et al, 2018;Olivo and Swenne, 2019). Two studies also reported higher FA in corona radiation, SLF, FOF, PTR, and CC (Frank et al, 2013;Vogel et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

White Matter Abnormalities in Anorexia Nervosa: Psychoradiologic Evidence From Meta-Analysis of Diffusion Tensor Imaging Studies Using Tract Based Spatial Statistics

Zhang

Wang

et al. 2020

Front. Neurosci.

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Background: Anorexia nervosa (AN) is a debilitating illness whose neural basis remains unclear. Studies using tract-based spatial statistics (TBSS) with diffusion tensor imaging (DTI) have demonstrated differences in white matter (WM) microarchitecture in AN, but the findings are inconclusive and controversial. Objectives: To identify the most consistent WM abnormalities among previous TBSS studies of differences in WM microarchitecture in AN. Methods: By systematically searching online databases, a total of 11 datasets were identified, including 245 patients with AN and 246 healthy controls (HC). We used Seed-based d Mapping to analyze fractional anisotropy (FA) differences between AN patients and HC, and performed meta-regression analysis to explore the effects of clinical characteristics on WM abnormalities in AN. Results: The pooled results of all AN patients showed robustly lower FA in the corpus callosum (CC) and the cingulum compared to HC. These two regions preserved significance in the sensitivity analysis as well as in all subgroup analyses. Fiber tracking showed that the WM tracts primarily involved were the body of the CC and the cingulum bundle. Meta-regression analysis revealed that the body mass index and mean age were not linearly correlated with the lower FA. Conclusions: The most consistent WM microstructural differences in AN were in the interhemispheric connections and limbic association fibers. These common "targets" advance our understanding of the complex neural mechanisms underlying the puzzling symptoms of AN, and may help in developing early treatment approaches.

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“…Further, methodological differences between tract-based spatial statistics (TBSS) and voxel-based analysis (VBA) could account for heterogeneity in WM findings, as TBSS seems to be more sensitive to FA reductions (29). Concerning body mass index (BMI) differences, an interesting study of Olivo et al (30) compared 25 adolescents with atypical AN with 25 HC, who did not differ with respect to BMI. They did not find WM differences and discussed weight-related WM abnormalities as most likely in other studies.…”

Section: Introductionmentioning

confidence: 99%

White Matter Abnormalities in the Corpus Callosum in Acute and Recovered Anorexia Nervosa Patients—A Diffusion Tensor Imaging Study

et al. 2019

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Objective: Severe malnutrition in patients with anorexia nervosa (AN) as well as possible trait-related aberrations lead to pronounced structural brain changes whose reversibility after recovery is currently unclear. Previous diffusion tensor imaging (DTI) studies investigating white matter (WM) microstructure alterations in AN are inconsistent. Methods: In this so far largest DTI study in adults, we investigated 33 AN patients, 20 recovered (REC), and 33 healthy women. DTI data were processed using the “DTI and Fiber tools,” and the Computational Anatomy Toolbox. WM integrity, both in terms of fractional anisotropy (FA) and mean diffusivity (MD), was assessed. Results: We found a significant FA decrease in the corpus callosum (body) and an MD decrease in the posterior thalamic radiation in the AN group. The REC group displayed FA decrease in the corpus callosum in comparison to HC, whereas there were no MD differences between the REC and HC groups. Conclusion: Despite prolonged restoration of weight in the REC group, no significant regeneration of WM integrity in terms of FA could be observed. Transient changes in MD likely represent a reversible consequence of the acute state of starvation or result from dehydration. Reduction of FA either may be due to WM damage resulting from malnutrition or may be considered a pre-morbid marker.

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Preserved white matter microstructure in adolescent patients with atypical anorexia nervosa

Cited by 14 publications

References 51 publications

Identifying research priorities for the study of atypical anorexia nervosa: A Delphi study

Identifying research priorities for the study of atypical anorexia nervosa: A Delphi study

White Matter Abnormalities in Anorexia Nervosa: Psychoradiologic Evidence From Meta-Analysis of Diffusion Tensor Imaging Studies Using Tract Based Spatial Statistics

White Matter Abnormalities in the Corpus Callosum in Acute and Recovered Anorexia Nervosa Patients—A Diffusion Tensor Imaging Study

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