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BackgroundAnorexia nervosa (AN) often begins in adolescence, however, the understanding of the underlying pathophysiology at this developmentally important age is scarce, impeding early interventions. We used diffusion tensor imaging (DTI) to investigate microstructural white matter (WM) brain changes including an experimental longitudinal follow-up.MethodsWe acquired whole brain diffusion-weighted brain scans of 22 adolescent female hospitalized patients with AN at admission and nine patients longitudinally at discharge after weight rehabilitation. Patients (10–18 years) were compared to 21 typically developing controls (TD). Tract-based spatial statistics (TBSS) were applied to compare fractional anisotropy (FA) across groups and time points. Associations between average FA values of the global WM skeleton and weight as well as illness duration parameters were analyzed by multiple linear regression.ResultsWe observed increased FA in bilateral frontal, parietal and temporal areas in AN patients at admission compared to TD. Higher FA of the global WM skeleton at admission was associated with faster weight loss prior to admission. Exploratory longitudinal analysis showed this FA increase to be partially normalized after weight rehabilitation.ConclusionsOur findings reveal a markedly different pattern of WM microstructural changes in adolescent AN compared to most previous results in adult AN. This could signify a different susceptibility and reaction to semi-starvation in the still developing brain of adolescents or a time-dependent pathomechanism differing with extend of chronicity. Higher FA at admission in adolescents with AN could point to WM fibers being packed together more closely.

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Falkmer T, Vogel K, Gregersen NP. The Test of Visual Perceptual Skills (non -motor) Upper Le×el is not a ×alid predictor for the outcome of dri×er education. Scand J Occup Ther 2001; 8: 72 -78. In order to reduce the monetary and personal costs of driver training for persons with cerebral palsy, it is of interest to nd a predictor that is able to select potential license holders. Previous research has shown that such a predictor could be one that assesses visual perception. In the present study, the Test of Visual Perceptual Skills (non-motor) Upper Level, was validated for predicting the outcome of driver education. It was found that using the test for this purpose could not be recommended. The ndings of the present study were not in accordance with the results of other studies on the predictive value of perceptual tests regarding the ability to drive, owing to the use of different methods. Future studies should focus on cross-validation of perceptual tests for different types of independent variables, such as driving license or not, accident involvement and driving ability.

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