Structural hippocampal alterations, perceived stress, and coping deficiencies in patients with anorexia nervosa

Burkert, Nathalie Tatjana; Koschutnig, Karl; Ebner, Franz; Freidl, Wolfgang

doi:10.1002/eat.22397

Cited by 26 publications

(33 citation statements)

References 25 publications

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“…Here we find that this pattern remains after weight restoration. While hippocampal volume abnormalities have been demonstrated in AN (Burkert, Koschutnig, Ebner, & Freidl, 2015), such abnormalities may not be associated with changes in cognitive function (Connan et al, 2006). Thus a host of neural changes may accompany AN, but it is critical to link neural changes to relevant cognition and behavior.…”

Section: Discussionmentioning

confidence: 99%

Decreased feedback learning in anorexia nervosa persists after weight restoration

Foerde

Steinglass

2017

Intl J Eating Disorders

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Objective Anorexia Nervosa (AN) is a serious disorder, with a mortality rate the highest of any psychiatric illness. It is notoriously challenging to treat and mechanisms of illness are not well understood. Reward system abnormalities have been proposed across theoretical models of the persistence of AN. Feedback learning is an important component of how reward systems shape behavior and we hypothesized that individuals with AN would show poorer learning from feedback. Method We administered the Acquired Equivalence Task to measure both learning from incremental feedback and generalization of that learning to novel stimuli. Participants were individuals with AN (n=36) before and after intensive weight restoration treatment and healthy controls (HC, n=26) tested twice. Performance was assessed as accuracy during the Learning and Test phases, for both trained and novel stimuli. The relationship between task performance and eating disorder severity at baseline was also assessed. Results Both before and after treatment, individuals with AN showed reduced learning from feedback in the Learning phase (F3,180=2.75, p=0.048) and lower accuracy during the Test phase (F1,60=4.29, p=0.043), as compared with HC. Individuals with AN did not differ from HC in accuracy for novel stimuli (F1,60=1.04, p=0.312), indicating no deficit in generalization. Decreased acquisition of feedback learning was associated with longer illness duration and with greater eating disorder symptom severity at baseline. Discussion Individuals with AN show reduced learning from feedback or reinforcement, which may contribute to difficulties in changing maladaptive behaviors.

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Section: Discussionmentioning

confidence: 99%

Decreased feedback learning in anorexia nervosa persists after weight restoration

Foerde

Steinglass

2017

Intl J Eating Disorders

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“…To our knowledge, only one previous study has investigated HS in AN patients (Burkert et al, 2015). Adult AN patients who had been ill for several years were found to have a significant reduction in the fimbriaa white matter bundle projecting along the anterior-posterior axis of the hippocampus (Burkert et al, 2015), and an increase in the size of the hippocampal fissure -the "ventricle" of the hippocampus.…”

Section: Introductionmentioning

confidence: 96%

“…Volume reduction of the hippocampus formation has been reported in several studies in both adults (Burkert et al, 2015;Chui et al, 2008;Connan et al, 2006;King et al, 2015;Mainz et al, 2012). The formation of the hippocampus is well known for its involvement in learning and memory, but also plays an important role in emotional regulation (Fanselow and Dong, 2010).…”

Section: Introductionmentioning

confidence: 97%

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Hippocampal subfields in adolescent anorexia nervosa

Myrvang

Vangberg

Stedal

et al. 2018

Psychiatry Research: Neuroimaging

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Patients with anorexia nervosa (AN) exhibit volume reduction in cerebral gray matter (GM), and several studies report reduced hippocampus volume. The hippocampal subfields (HS) are functionally and structurally distinct, and appear to respond differently to neuropathology. The aim of this study was to investigate HS volumes in adolescent females with restrictive AN compared to a healthy age-matched control group (HC). The FreeSurfer v6.0 package was used to extract brain volumes, and segment HS in 58 female adolescents (AN=30, HC=28). We investigated group differences in GM, white matter (WM), whole hippocampus and 12 HS volumes. AN patients had significantly lower total GM and total hippocampal volume. No group difference was found in WM. Volume reduction was found in 11 of the 12 HS, and most results remained significant when adjusting for global brain volume reduction. Investigations of clinical covariates revealed statistically significant relationships between the whole hippocampus, several HS and scores on depression and anxiety scales in AN. Results from this study show that young AN patients exhibit reduced volume in most subfields of the hippocampus, and that this reduction may be more extensive than the observed global cerebral volume loss.

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“…Due to its complexity, the neurobiology of anorexia nervosa is unknown, but studies using magnetic resonance imaging showed hippocampal volume reduction [3–6]. The hippocampus is involved in spatial learning, cognition, and regulation of anxiety [7].…”

Section: Introductionmentioning

confidence: 99%

Anorexia Reduces GFAP+ Cell Density in the Rat Hippocampus

et al. 2016

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Anorexia nervosa is an eating disorder observed primarily in young women. The neurobiology of the disorder is unknown but recently magnetic resonance imaging showed a volume reduction of the hippocampus in anorexic patients. Dehydration-induced anorexia (DIA) is a murine model that mimics core features of this disorder, including severe weight loss due to voluntary reduction in food intake. The energy supply to the brain is mediated by astrocytes, but whether their density is compromised by anorexia is unknown. Thus, the aim of this study was to estimate GFAP+ cell density in the main regions of the hippocampus (CA1, CA2, CA3, and dentate gyrus) in the DIA model. Our results showed that GFAP+ cell density was significantly reduced (~20%) in all regions of the hippocampus, except in CA1. Interestingly, DIA significantly reduced the GFAP+ cells/nuclei ratio in CA2 (−23%) and dentate gyrus (−48%). The reduction of GFAP+ cell density was in agreement with a lower expression of GFAP protein. Additionally, anorexia increased the expression of the intermediate filaments vimentin and nestin. Accordingly, anorexia increased the number of reactive astrocytes in CA2 and dentate gyrus more than twofold. We conclude that anorexia reduces the hippocampal GFAP+ cell density and increases vimentin and nestin expression.

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Structural hippocampal alterations, perceived stress, and coping deficiencies in patients with anorexia nervosa

Abstract: In sum, our study provides the first-available evidence that perceived stress in patients with AN could be related to hippocampal volume. Our results may contribute to a better understanding of the pathophysiology of AN and, therefore, help to improve the treatment.

Cited by 26 publications

References 25 publications

Decreased feedback learning in anorexia nervosa persists after weight restoration

Decreased feedback learning in anorexia nervosa persists after weight restoration

Hippocampal subfields in adolescent anorexia nervosa

Anorexia Reduces GFAP+ Cell Density in the Rat Hippocampus

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