Proton magnetic resonance spectroscopy in acute, juvenile anorexia nervosa

Schlemmer, Heinz Peter; Möckel, Regina; Marcus, Alexander; Hentschel, Frank; Göpel, Christopher; Becker, Georg; Köpke, Julian; Gückel, F.; Schmidt, Martin H.; Georgi, M

doi:10.1016/s0925-4927(98)00019-5

Cited by 31 publications

(13 citation statements)

References 22 publications

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“…In detail, in patients with acute AN significantly higher concentrations of tCho, tCr and Glx were found, while low levels of NAA, Glx, and mI were detected in the frontal cortex, with a tendency to normalize after weight restoration [ 15 , 54 ]. Finally, using metabolite ratios in order to evaluate alterations, a significantly higher Cho-Cr ratio and lower NAA-Cho ratio were pointed out in the WM of the parietal-occipital region of patients [ 55 ].…”

Section: Resultsmentioning

confidence: 99%

Neuroimaging Findings in Adolescents and Young Adults with Anorexia Nervosa: A Systematic Review

et al. 2021

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Background: Anorexia nervosa (AN) is a serious, multifactorial mental disorder affecting predominantly young females. This systematic review examines neuroimaging findings in adolescents and young adults up to 24 years old, in order to explore alterations associated with disease pathophysiology. Methods: Eligible studies on structural and functional brain neuroimaging were sought systematically in PubMed, CENTRAL and EMBASE databases up to October 05, 2020. Results: Thirty-three studies were included, investigating a total of 587 patients with a current diagnosis of AN and 663 healthy controls (HC). Global and regional grey matter (GM) volume reduction as well as white matter (WM) microstructure alterations were detected. The mainly affected regions were the prefrontal, parietal and temporal cortex, hippocampus, amygdala, insula, thalamus and cerebellum as well as various WM tracts such as corona radiata and superior longitudinal fasciculus (SLF). Regarding functional imaging, alterations were pointed out in large-scale brain networks, such as default mode network (DMN), executive control network (ECN) and salience network (SN). Most findings appear to reverse after weight restoration. Specific limitations of neuroimaging studies in still developing individuals are also discussed. Conclusions: Structural and functional alterations are present in the early course of the disease, most of them being partially or totally reversible. Nonetheless, neuroimaging findings have been open to many biological interpretations. Thus, more studies are needed to clarify their clinical significance.

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Section: Resultsmentioning

confidence: 99%

Neuroimaging Findings in Adolescents and Young Adults with Anorexia Nervosa: A Systematic Review

et al. 2021

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“…Decreased concentrations of NAA indicate a loss of neuronal cells. Although NAA signal differences have been reported in various studies on AN, the results were inconsistent regarding a diminished or elevated NAA level [9][10][11][12][13] (see Table 1).…”

Section: Introductionmentioning

confidence: 93%

Insular Cell Integrity Markers Linked to Weight Concern in Anorexia Nervosa—An MR-Spectroscopy Study

Maier

Nickel

Perlov

et al. 2020

JCM

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Objective: An insular involvement in the pathogenesis of anorexia nervosa (AN) has been suggested in many structural and functional neuroimaging studies. This magnetic resonance spectroscopy (MRS) study is the first to investigate metabolic signals in the anterior insular cortex in patients with AN and recovered individuals (REC). Method: The MR spectra of 32 adult women with AN, 21 REC subjects and 33 healthy controls (HC) were quantified for absolute N-acetylaspartate (NAA), glutamate + glutamine (Glx), total choline, myo-inositol, creatine concentrations (mM/L). After adjusting the metabolite concentrations for age and partial gray/white matter volume, group differences were tested using one-way multivariate analyses of variance (MANOVA). Post-hoc analyses of variance were applied to identify those metabolites that showed significant group effects. Correlations were tested for associations with psychometric measures (eating disorder examination), duration of illness, and body mass index. Results: The MANOVA exhibited a significant group effect. The NAA signal was reduced in the AN group compared to the HC group. The REC and the HC groups did not differ in metabolite concentrations. In the AN group, lower NAA and Glx signals were related to increased weight concern. Discussion: We interpret the decreased NAA availability in the anterior insula as a signal of impaired neuronal integrity or density. The association of weight concern, which is a core feature of AN, with decreased NAA and Glx indicates that disturbances of glutamatergic neurotransmission might be related to core psychopathology in AN. The absence of significant metabolic differences between the REC and HC subjects suggests that metabolic alterations in AN represent a state rather than a trait phenomenon.

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“…Animal studies support the idea that set shifting is associated with glutamatergic neurotransmission (for example, with N -methyl- d -aspartate (NMDA) receptor function) [16,19-21]. MRS studies of people with AN [14,15,22,23] have shown heterogenous findings possibly due to methodological factors.…”

Section: Introductionmentioning

confidence: 99%

Serum glutamine, set-shifting ability and anorexia nervosa

et al. 2010

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BackgroundSet-shifting is impaired in people with anorexia nervosa (AN), but the underlying physiological and biochemical processes are unclear. Animal studies have established that glutamatergic pathways in the prefrontal cortex play an important role in set-shifting ability. However, it is not yet understood whether levels of serum glutamatergic amino acids are associated with set-shifting performance in humans. The aim of this study was to determine whether serum concentrations of amino acids related to glutamatergic neurotransmission (glutamine, glutamate, glycine, l-serine, d-serine) are associated with set-shifting ability in people with acute AN and those after recovery.MethodsSerum concentrations of glutamatergic amino acids were measured in 27 women with current AN (AN group), 18 women recovered from AN (ANRec group) and 28 age-matched healthy controls (HC group). Set-shifting was measured using the Wisconsin Card Sorting Test (WCST) and the Trail Making Task (TMT). Dimensional measures of psychopathology were used, including the Eating Disorder Examination Questionnaire (EDEQ), the Maudsley Obsessive-Compulsive Inventory (MOCI) and the Hospital Anxiety and Depression Scale (HADS).ResultsSerum glutamine concentrations in the AN group (1,310.2 ± 265.6 μM, mean ± SD) were significantly higher (by approximately 20%) than those in the HC group (1,102.9 ± 152.7 μM, mean ± SD) (F(2, 70) = 6.3, P = 0.003, 95% CI 61.2 to 353.4). Concentrations of serum glutamine were positively associated with markers of the illness severity: a negative correlation was present between serum glutamine concentrations and body mass index (BMI) and lowest BMI and a positive correlation was found between duration of illness and EDEQ. The AN group showed significantly impaired set shifting in the WCST, both total errors, and perseverative errors. In the AN group, there were no correlations between serum glutamine concentrations and set shifting.ConclusionsSerum concentrations of glutamine may be a biomarker of illness severity in people with AN. It does not appear to be directly associated with changes in executive function.

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Proton magnetic resonance spectroscopy in acute, juvenile anorexia nervosa

Cited by 31 publications

References 22 publications

Neuroimaging Findings in Adolescents and Young Adults with Anorexia Nervosa: A Systematic Review

Neuroimaging Findings in Adolescents and Young Adults with Anorexia Nervosa: A Systematic Review

Insular Cell Integrity Markers Linked to Weight Concern in Anorexia Nervosa—An MR-Spectroscopy Study

Serum glutamine, set-shifting ability and anorexia nervosa

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