Normal white matter microstructure in women long‐term recovered from anorexia nervosa: A diffusion tensor imaging study

Abstract

Objectives: Studies point to white matter (WM) microstructure alterations in both adolescent and adult patients with anorexia nervosa (AN). These include reduced fractional anisotropy in several WM fiber tracts, suggesting reduced WM integrity. The extent to which these alterations are reversible with recovery from AN is unclear. There is a paucity of research investigating the presence of WM microstructure alterations in recovered AN patients, and results are inconsistent. This study aimed to investigate the presence of WM microstructure alterations in women long-term recovered from AN.Method: Twenty-one adult women who were recovered from AN for at least 1 year were compared to 21 adult comparison women. Participants were recruited via user-organizations for eating disorders, local advertisements, and online forums. Diffusion tensor imaging was used to compare WM microstructure between groups. Correlations between WM microstructure and clinical characteristics were also explored.Results: There were no statistically significant between-group differences in WM microstructure.These null findings remained when employing liberal alpha level thresholds. Furthermore, there were no statistically significant correlations between WM microstructure and clinical characteristics. Discussion: Our findings showed normal WM microstructure in long-term recovered patients, indicating the alterations observed during the acute phase are reversible. Given the paucity of research and inconsistent findings, future studies are warranted to determine the presence of WM microstructure alterations following recovery from AN. K E Y W O R D Sanorexia nervosa, diffusion tensor imaging, magnetic resonance imaging, neurobiology, white matter microstructure

Anorexia nervosa and diffusion weighted imaging: An open methodological question raised by a systematic review and a fractional anisotropy anatomical likelihood estimation meta‐analysis

“…It has been demonstrated that it does not merely coincide with an increase in weight: cognitive impairments and psychopathological signatures, such as obsessive thoughts and body image concerns may persist (Steinhausen, ; Zipfel et al, ). In our review, four articles out of six showed no difference in FA between recovered AN and HC (Bang, Ro, & Enderstad, ; Miles, Kaplan, French, & Voineskos, ; Pfuhl et al, ; Yau et al, ). Zhang et al (), too, showed no differences between weight‐restored AN patients and HC.…”

“…Although most of the studies focused on acutely ill patients, some of them involved patients who had recovered from AN, in order to determine whether the DTI findings reflected state or trait characteristics of the disorder. These studies used comparable samples in terms of age and BMI and, while one of them showed the presence of some FA alterations in recovered AN patients compared to HC (Shott et al, ), the other ones showed no between‐group differences (Bang et al, ; Pfuhl et al, ; Yau et al, ; Zhang et al, ). Interestingly, these results are in line with the findings of other studies that investigated WM volumes by means of different methodological approaches (i.e., VBM; Seitz et al, ).…”

White matter microstructure in anorexia nervosa

“…Studies in recovered AN patients have reported no differences in DWI parameters (Bang, Rø, & Endestad, 2018;Yau et al, 2013). The current study assessed individuals with a diagnosis of AN based on DSM-IV criteria, with the exception of the amenorrhea criterion.…”

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

“…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).…”