Structural Magnetic Resonance Imaging in Eating Disorders: A Systematic Review of Voxel‐Based Morphometry Studies

Eynde, Fréderique Van den; Suda, Masashi; Broadbent, Hannah; Guillaume, Sébastien; Eynde, Magali Van den; Steiger, Howard; Israël, Mimi; Berlim, Marcelo T.; Giampietro, Vincent; Simmons, Andrew; Treasure, Janet; Campbell, Iain C.; Schmidt, Ulrike

doi:10.1002/erv.1163

Cited by 117 publications

(67 citation statements)

References 62 publications

(116 reference statements)

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“…Healthy controls were in the expected range for the DASS-21 subscales (0-7), but the group with anxiety scored in the moderate-severe range for anxiety (7)(8)(9)(10)(11)(12) and in the moderate range for stress and depression (6)(7)(8)(9). The AN outpatients scored 'severe' on all three subscales (8)(9)(10)(11)(12)(13)(14)(15)(16)) and the inpatient group had scores that assessed them as 'severe-extremely severe' for depression (11-14+) and 'extremely severe' for stress and anxiety (> 10 and > 17, respectively).…”

Section: Eating Disorders Examination-questionnaire and Depression Anmentioning

confidence: 99%

“…The AN outpatients scored 'severe' on all three subscales (8)(9)(10)(11)(12)(13)(14)(15)(16)) and the inpatient group had scores that assessed them as 'severe-extremely severe' for depression (11-14+) and 'extremely severe' for stress and anxiety (> 10 and > 17, respectively). Table 20).…”

Section: Eating Disorders Examination-questionnaire and Depression Anmentioning

confidence: 99%

“…premorbid feeding problems, obsessive compulsive and anxious traits, high levels of exercising and overinvolved parenting). 6,7 Research on the genetic, epigenetic and neurobiological underpinnings of eating disorder (ED) psychopathology [8][9][10][11][12][13] has identified neurocognitive and social cognitive biomarkers, such as impaired set-shifting, poor central coherence or emotion processing impairments, including poor theory of mind, [14][15][16][17][18] which have the potential to inform predictions of treatment outcome and prognosis. A key challenge is to utilise all this knowledge to develop targeted treatments.…”

Section: Introductionmentioning

confidence: 99%

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Treatment of anorexia nervosa: a multimethod investigation translating experimental neuroscience into clinical practice

Schmidt

Sharpe

Bartholdy

et al. 2017

Programme Grants Appl Res

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BackgroundAnorexia nervosa (AN) is a severe psychiatric condition and evidence on how to best treat it is limited.ObjectivesThis programme consists of seven integrated work packages (WPs) and aims to develop and test disseminable and cost-effective treatments to optimise management for people with AN across all stages of illness.MethodsWP1a used surveys, focus groups and a pre–post trial to develop and evaluate a training programme for school staff on eating disorders (EDs). WP1b used a randomised controlled trial (RCT) [International Standard Randomised Controlled Trial Number (ISRCTN) 42594993] to evaluate a prevention programme for EDs in schools. WP2a evaluated an inpatient treatment for AN using case reports, interviews and a quasi-experimental trial. WP2b used a RCT (ISRCTN67720902) to evaluate two outpatient psychological therapies for AN. WP3 used a RCT (ISRCTN06149665) to evaluate an intervention for carers of inpatients with AN. WP4 used actimetry, self-report and endocrine assessment to examine physical activity (PA) in AN. WP5 conducted a RCT (ISRCTN18274621) of an e-mail-guided relapse prevention programme for inpatients with AN. WP6 analysed cohort data to examine the effects of maternal EDs on fertility and their children’s diet and growth. WP7a examined clinical case notes to explore how access to specialist ED services affects care pathways and user experiences. Finally, WP7b used data from this programme and the British Cohort Study (1970) to identify the costs of services used by people with AN and to estimate annual costs of AN for England.ResultsWP1a: a brief training programme improved knowledge, attitudes and confidence of school staff in managing EDs in school. WP1b: a teacher-delivered intervention was feasible and improved risk factors for EDs in adolescent girls. WP2a: both psychological therapies improved outcomes in outpatients with AN similarly, but patients preferred one of the treatments. WP2b: the inpatient treatment (Cognitive Remediation and Emotional Skills Training) was acceptable with perceived benefits by patients, but showed no benefits compared with treatment as usual (TAU). WP3: compared with TAU, the carer intervention improved a range of patient and carer outcomes, including carer burden and patient ED symptomatology. WP4: drive to exercise is tied to ED pathology and a desire to improve mood in AN patients. PA was not increased in these patients. WP5: compared with TAU, the e-mail-guided relapse prevention programme resulted in higher body mass index and lower distress in patients at 12 months after discharge. WP6: women with an ED had impaired fertility and their children had altered dietary and growth patterns compared with the children of women without an ED. WP7a: direct access to specialist ED services was associated with higher referral rates, lower admission rates, greater consistency of care and user satisfaction. WP7b: the annual costs of AN in England are estimated at between £45M and £230M for 2011.ConclusionsThis programme has produced evidence to inform future intervention development and has developed interventions that can be disseminated to improve outcomes for individuals with AN. Directions for future research include RCTs with longer-term outcomes and sufficient power to examine mediators and moderators of change.Trial registrationCurrent Controlled Trials ISRCTN42594993, ISRCTN67720902, ISRCTN06149665 and ISRCTN18274621.FundingThis project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full inProgramme Grants for Applied Research; Vol. 5, No. 16. See the NIHR Journals Library website for further project information.

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Section: Eating Disorders Examination-questionnaire and Depression Anmentioning

confidence: 99%

Section: Eating Disorders Examination-questionnaire and Depression Anmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Treatment of anorexia nervosa: a multimethod investigation translating experimental neuroscience into clinical practice

Schmidt

Sharpe

Bartholdy

et al. 2017

Programme Grants Appl Res

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“…Imaging studies showed that in the acute phase of AN, patients have a reduced brain volume and enlargement of the cortical sulci and the ventricles [62-64]. Alterations in activity in the insula and the prefrontal, orbitofrontal, temporal, parietal and anterior cingulate cortices and the VS at rest and during symptom provocation were found [65-71].…”

Section: Reviewmentioning

confidence: 99%

Is deep brain stimulation a treatment option for anorexia nervosa?

et al. 2013

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Anorexia nervosa (AN) is a severe psychiatric disorder with high rates of morbidity, comorbidity and mortality, which in a subset of patients (21%) takes on a chronic course. Since an evidence based treatment for AN is scarce, it is crucial to investigate new treatment options, preferably focused on influencing the underlying neurobiological mechanisms of AN. The objective of the present paper was to review the evidence for possible neurobiological correlates of AN, and to hypothesize about potential targets for Deep brain stimulation (DBS) as a treatment for chronic, therapy-refractory AN. One avenue for exploring new treatment options based on the neurobiological correlates of AN, is the search for symptomatologic and neurobiologic parallels between AN and other compulsivity- or reward-related disorders. As in other compulsive disorders, the fronto-striatal circuitry, in particular the insula, the ventral striatum (VS) and the prefrontal, orbitofrontal, temporal, parietal and anterior cingulate cortices, are likely to be implicated in the neuropathogenesis of AN. In this paper we will review the few available cases in which DBS has been performed in patients with AN (either as primary diagnosis or as comorbid condition). Given the overlap in symptomatology and neurocircuitry between reward-related disorders such as obsessive compulsive disorder (OCD) and AN, and the established efficacy of accumbal DBS in OCD, we hypothesize that DBS of the nucleus accumbens (NAc) and other areas associated with reward, e.g. the anterior cingulated cortex (ACC), might be an effective treatment for patients with chronic, treatment refractory AN, providing not only weight restoration, but also significant and sustained improvement in AN core symptoms and associated comorbidities and complications. Possible targets for DBS in AN are the ACC, the ventral anterior limb of the capsula interna (vALIC) and the VS. We suggest conducting larger efficacy studies that also explore the functional effects of DBS in AN.

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“…Volumetric brain imaging studies have been used to study GM and WM volume abnormalities in underweight adolescent and adult people with AN [10] . Several have reported loss of global and regional GM and often WM volume.…”

Section: Introductionmentioning

confidence: 99%

White matter alterations in anorexia nervosa: A systematic review of diffusion tensor imaging studies

Monzón¹,

Hay²,

Foroughi³

et al. 2016

WJP

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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.

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Structural Magnetic Resonance Imaging in Eating Disorders: A Systematic Review of Voxel‐Based Morphometry Studies

Cited by 117 publications

References 62 publications

Treatment of anorexia nervosa: a multimethod investigation translating experimental neuroscience into clinical practice

Treatment of anorexia nervosa: a multimethod investigation translating experimental neuroscience into clinical practice

Is deep brain stimulation a treatment option for anorexia nervosa?

White matter alterations in anorexia nervosa: A systematic review of diffusion tensor imaging studies

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