Sulcal characteristics patterns and gyrification gradient at different stages of Anorexia Nervosa: A structural MRI evaluation

Collantoni, Enrico; Madan, Christopher R.; Meregalli, Valentina; Meneguzzo, Paolo; Marzola, Enrica; Panero, Matteo; D’Agata, Federico; Abbate-Daga, Giovanni; Tenconi, Elena; Manara, Renzo; Favaro, Angela

doi:10.1016/j.pscychresns.2021.111350

Cited by 12 publications

(5 citation statements)

References 34 publications

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“…Notably, only one study (3.70%) mentioned the implementation of a motivational interview before admission [ 38 ], despite the recognition that poor motivation is associated with treatment dropout and negative outcomes [ 80 , 81 ]. This points to a gap in the practice, given that motivation in AN is influenced by both psychological and biological factors inherent to the illness [ 82 , 83 ]. Also, motivation should be regarded as a pivotal factor, given its direct correlation with the severity of the condition.…”

Section: Discussionmentioning

confidence: 99%

Inpatient treatments for adults with anorexia nervosa: a systematic review of literature

Toppino,

Martini,

Longo

et al. 2024

Eat Weight Disord

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Purpose Anorexia nervosa (AN) is a mental disorder for which hospitalization is frequently needed in case of severe medical and psychiatric consequences. We aim to describe the state-of-the-art inpatient treatment of AN in real-world reports. Methods A systematic review of the literature on the major medical databases, spanning from January 2011 to October 2023, was performed, using the keywords: “inpatient”, “hospitalization” and “anorexia nervosa”. Studies on pediatric populations and inpatients in residential facilities were excluded. Results Twenty-seven studies (3501 subjects) were included, and nine themes related to the primary challenges faced in hospitalization settings were selected. About 81.48% of the studies detailed the clinical team, 51.85% cited the use of a psychotherapeutic model, 25.93% addressed motivation, 100% specified the treatment setting, 66.67% detailed nutrition and refeeding, 22.22% cited pharmacological therapy, 40.74% described admission or discharge criteria and 14.81% follow-up, and 51.85% used tests for assessment of the AN or psychopathology. Despite the factors defined by international guidelines, the data were not homogeneous and not adequately defined on admission/discharge criteria, pharmacological therapy, and motivation, while more comprehensive details were available for treatment settings, refeeding protocols, and psychometric assessments. Conclusion Though the heterogeneity among the included studies was considered, the existence of sparse criteria, objectives, and treatment modalities emerged, outlining a sometimes ambiguous report of hospitalization practices. Future studies must aim for a more comprehensive description of treatment approaches. This will enable uniform depictions of inpatient treatment, facilitating comparisons across different studies and establishing guidelines more grounded in scientific evidence. Level of evidence Level I, systematic review.

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Section: Discussionmentioning

confidence: 99%

Inpatient treatments for adults with anorexia nervosa: a systematic review of literature

Toppino,

Martini,

Longo

et al. 2024

Eat Weight Disord

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“…Sulcal information has proven to be useful in the study of a wide range of conditions; for example, in Alzheimer's disease (Maciej Plocharski and Lasse Riis Østergaard, 2016 ; Mateos et al, 2020 ), Parkinson's disease (Wang et al, 2011 ), and anorexia (Collantoni et al, 2021 ; Wagner et al, 2003 ). Schizophrenia has a rich and well‐replicated literature establishing patterns of cortical change (Liu et al, 2020 ; Palaniyappan et al, 2018 ; Sallet et al, 2003 ; Zhang et al, 2012 ).…”

Section: Introductionmentioning

confidence: 99%

Machine learning in small sample neuroimaging studies: Novel measures for schizophrenia analysis

Jimenez‐Mesa,

Ramirez,

et al. 2024

Human Brain Mapping

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Novel features derived from imaging and artificial intelligence systems are commonly coupled to construct computer‐aided diagnosis (CAD) systems that are intended as clinical support tools or for investigation of complex biological patterns. This study used sulcal patterns from structural images of the brain as the basis for classifying patients with schizophrenia from unaffected controls. Statistical, machine learning and deep learning techniques were sequentially applied as a demonstration of how a CAD system might be comprehensively evaluated in the absence of prior empirical work or extant literature to guide development, and the availability of only small sample datasets. Sulcal features of the entire cerebral cortex were derived from 58 schizophrenia patients and 56 healthy controls. No similar CAD systems has been reported that uses sulcal features from the entire cortex. We considered all the stages in a CAD system workflow: preprocessing, feature selection and extraction, and classification. The explainable AI techniques Local Interpretable Model‐agnostic Explanations and SHapley Additive exPlanations were applied to detect the relevance of features to classification. At each stage, alternatives were compared in terms of their performance in the context of a small sample. Differentiating sulcal patterns were located in temporal and precentral areas, as well as the collateral fissure. We also verified the benefits of applying dimensionality reduction techniques and validation methods, such as resubstitution with upper bound correction, to optimize performance.

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“…The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), identifies two subtypes of AN: the restricting type (AN-R), where weight loss is achieved through dieting, fasting, and/or excessive exercise, and the binge–purging type (AN-BP), which includes episodes of binge eating and/or purging behavior, such as self-induced vomiting or the misuse of laxatives or diuretics [ 3 ]. AN profoundly disrupts cognitive, emotional, and social functioning and leads to severe medical complications across multiple systems, including cardiovascular, gastrointestinal, endocrine, and cerebral [ 4 , 5 ]. It also frequently presents comorbidity with mood, anxiety, and personality disorders [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Nasogastric Tube Feeding in Anorexia Nervosa: A Propensity Score-Matched Analysis on Clinical Efficacy and Treatment Satisfaction

Martini,

Longo,

Di Benedetto

et al. 2024

Nutrients

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The choice of a refeeding strategy is essential in the inpatient treatment of Anorexia Nervosa (AN). Oral nutrition is usually the first choice, but enteral nutrition through the use of a Nasogastric Tube (NGT) often becomes necessary in hospitalized patients. The literature provides mixed results on the efficacy of this method in weight gain, and there is a scarcity of studies researching its psychological correlates. This study aims to analyze the effectiveness of oral versus enteral refeeding strategies in inpatients with AN, focusing on Body Mass Index (BMI) increase and treatment satisfaction, alongside assessing personality traits. We analyzed data from 241 inpatients, comparing a group of treated vs. non-treated individuals, balancing confounding factors using propensity score matching, and applied regression analysis to matched groups. The findings indicate that enteral therapy significantly enhances BMI without impacting treatment satisfaction, accounting for the therapeutic alliance. Personality traits showed no significant differences between patients undergoing oral or enteral refeeding. The study highlights the clinical efficacy of enteral feeding in weight gain, supporting its use in severe AN cases when oral refeeding is inadequate without adversely affecting patient satisfaction or being influenced by personality traits.

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Sulcal characteristics patterns and gyrification gradient at different stages of Anorexia Nervosa: A structural MRI evaluation

Cited by 12 publications

References 34 publications

Inpatient treatments for adults with anorexia nervosa: a systematic review of literature

Inpatient treatments for adults with anorexia nervosa: a systematic review of literature

Machine learning in small sample neuroimaging studies: Novel measures for schizophrenia analysis

Nasogastric Tube Feeding in Anorexia Nervosa: A Propensity Score-Matched Analysis on Clinical Efficacy and Treatment Satisfaction

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