Anorexia nervosa (AN) is a mental health disorder of complex aetiology. Previous neuroimaging studies have found consistent global reductions in global grey matter volume of underweight girls with AN; however, differences in regional grey matter volumes are less consistent. The aims of this study were to investigate grey matter regional volumes of adolescent girls with AN before and after weight recovery and the relationship of any changes with clinical characteristics. We collected high-resolution T1-weighted images from 26 underweight girls with AN before weight gain and 20 healthy control volunteers. Clinical features were assessed using the Eating Disorder Examination Questionnaire. AN subjects displayed reduced grey matter volumes in the insula, amygdala, prefrontal, hippocampal and cingulate cortices and the precuneus, relative to healthy controls. In a subset of 10 AN subjects who were followed after weight recovery, grey matter volumes increased to near-control levels in the orbito- and medial prefrontal, insular, left hippocampal and mid- and posterior cingulate cortices and precuneus. The recovery of the right anterior thalamus and the left orbitofrontal cortex was correlated with improvements in eating concerns and shape concerns, respectively. However, large parts of the anterior cingulate cortex, caudate nuclei and right hippocampus did not display any grey matter recovery following a short-term of treatment. These results show that in adolescents with AN, some brain regions display marked recovery in grey matter volume following weight recovery, whereas others do not, considering grey mater recovery possibly linked to symptom improvement.
AIM:To identify findings concerning white matter (WM) fibre microstructural alterations in anorexia nervosa (AN). METHODS:A systematic electronic search was undertaken in several databases up to April 2015. The search strategy aimed to locate all studies published in English or Spanish that included participants with AN and which investigated WM using diffusion tensor imaging (DTI). Trials were assessed for quality assessment according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist and a published quality index guideline. RESULTS:A total of 6 studies met the inclusion criteria, four of people in the acute state of the illness, one included both recovered and unwell participants, and one included people who had recovered. Participants were female with ages ranging from 14 to 29 years. All studies but one measured a range of psychopathological features. Fractional anisotropy and mean diffusivity were the main DTI correlates reported. Alterations were reported in a range of WM structures of the limbic SYSTEMATIC REVIEWS Core tip: The present systematic review identifies the latest research on white matter (WM) brain alterations in anorexia nervosa (AN). The WM architecture has been poorly understood due to its structure forming deep parts of the brain. It transmits information between cortical and subcortical structures. New advances in imaging methods with diffusion tensor imaging, allow its characterization and integrity analysis. Alterations in areas of fornix, cingulum, corpus callosum, cerebellum, superior longitudinal fasciculus and thalamus have been found in AN. They could be related to symptoms like anxiety, body image perception, reward processing and cognitive abilities.Martin Monzon B, Hay P, Foroughi N, Touyz S. White matter alterations in anorexia nervosa: A systematic review of diffusion tensor imaging studies.
El objetivo del presente estudio fue investigar las diferencias de edad, estado nutricional (Índice de Masa Corporal o IMC), ansiedad, depresión e insatisfacción corporal en pacientes con trastornos de la conducta alimentaria (TCA.), con una autoestima baja, media y alta. Además, intentamos distinguir las discrepancias entre el estado nutricional real y el estado nutricional deseado. Se evaluaron un total de 146 mujeres con TCA (Anorexia nerviosa y Bulimia nerviosa según el DSM-IV-TR). Los cuestionarios utilizados fueron el Body Shape Questionnaire (BSQ), el Hospital Anxiety and Depression Scale (HADS) y la Rosenberg Self-Esteem Scale (RSES). Los resultados reflejan diferencias significativas entre los tres subtipos de pacientes de baja, media y alta autoestima en cuanto a la ansiedad, depresión, insatisfacción corporal, IMC deseado y la relación dentro de IMC real y el IMC deseado. Estos hallazgos indican que las mujeres de baja autoestima presentan altos niveles en insatisfacción corporal, ansiedad y depresión en comparación con los otros grupos. Además, los pacientes con TCA con baja autoestima mostraban un mayor IMC deseado. Sugerimos que se incluyan técnicas de autoestima en la prevención y el tratamiento relacionados con programas de TCA para disminuir los síntomas de ansiedad y depresión.
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