White matter microstructural differences in underweight adolescents with anorexia nervosa and a preliminary longitudinal investigation of change following short-term weight restoration

Griffiths, Kristi R.; Monzón, Beatriz Martín; Madden, Sloane; Kohn, Michael; Touyz, Stephen; Sachdev, Perminder S.; Clarke, Simon; Foroughi, Nasim; Hay, Phillipa

doi:10.1007/s40519-020-01041-z

Cited by 6 publications

(9 citation statements)

References 47 publications

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“…A vast body of knowledge concerning genetic and neurobiological mechanisms in AN has accumulated in recent years, and there is increasing support for genetic, temperamental, neurobiological as well as psychosocial processes as influential factors for the onset of AN (Zipfel, Giel, Bulik, Hay, & Schmidt, 2015). Neuroimaging studies have shown brain atrophy in both young and older patients with AN, and it is unclear whether these reductions in brain tissue fully restore after recovery (Griffiths et al., 2020).…”

Section: Introductionmentioning

confidence: 99%

Research Review: Neuropsychological functioning in young anorexia nervosa: A meta‐analysis

Stedal

Scherer

Touyz

et al. 2021

Child Psychology Psychiatry

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Background: Cognitive inflexibility and compulsive behaviours are commonly observed in patients with anorexia nervosa (AN) and are often considered to be caused by impairments in executive functioning and visuospatial processing. Despite an increasing number of young individuals presenting with AN, there is a lack of meta-analytic evidence on the neuropsychological functioning in this population. Our primary aim was to review and synthesize the differences in neuropsychological test performance between young people with AN and healthy controls, and to explore potential moderators. Methods: A database search following PRISMA guidelines of MEDLINE, PsycINFO, ISI Web of Science and Epistemonikos was conducted. Hedges' g served as an effect size indicating the standardized mean differences. We utilized mixed-effects meta-regression and machine learning meta-analyses to identify relevant moderators. Results: Sixteen studies met the inclusion criteria with a total of 1333 participants (665 with AN) and 59 effect sizes. Random-effects meta-analyses demonstrated a small and insignificant difference between young individuals with AN and controls (g = −0.144, 95% CI [−0.328, 0.041]) in overall neuropsychological functioning. However, the difference was significant for the cognitive domains of memory, working memory and visuospatial abilities. Moderator and machine-learning analyses revealed a stronger negative effect in older participants and moderator effects of country and assessment quality. Conclusions: Our findings highlight the significant impact of age on neuropsychological test performance in patients with AN. There is a need for a more widespread inclusion of potentially confounding variables in primary studies as well as instruments specifically targeted at younger populations.

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Section: Introductionmentioning

confidence: 99%

Research Review: Neuropsychological functioning in young anorexia nervosa: A meta‐analysis

Stedal

Scherer

Touyz

et al. 2021

Child Psychology Psychiatry

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“…There was no significant correlation between body mass index (BMI) and reduced FA (Zhang et al, 2020). Investigations focusing on MD in the corpus callosum are heterogeneous and reported both increased (Griffiths et al, 2020;Miles et al, 2020) and decreased (Nagahara et al, 2014) MD in patients compared to HC. Due to the scarcity of longitudinal DTI studies, it currently remains unclear whether the white matter alterations in patients with AN are inherent, occur during the course of the disease, or, whether these changes are completely reversibly after remission (Barona et al, 2019).…”

Section: Introductionmentioning

confidence: 94%

“…There was no significant correlation between body mass index (BMI) and reduced FA (Zhang et al., 2020). Investigations focusing on MD in the corpus callosum are heterogeneous and reported both increased (Griffiths et al., 2020; Miles et al., 2020) and decreased (Nagahara et al., 2014) MD in patients compared to HC.…”

Section: Introductionmentioning

confidence: 99%

Reduced structural connectivity in the corpus callosum in patients with anorexia nervosa

Maier

Joos

Elst

et al. 2022

Euro Eating Disorders Rev

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Objective Previous diffusion tensor imaging studies reported a reduced fractional anisotropy in the body of the corpus callosum in patients with anorexia nervosa, which may indicate impaired white matter integrity in interhemispheric connections. The aim of the current study was to investigate whether structural connectivity is affected in patients with anorexia nervosa. Method To this end, we compared the number of streamlines (a model of the white matter fibre tracts) and the total volume filled by these streamlines in different subsections of the corpus callosum in 33 women with and 33 without anorexia nervosa as well as in 20 recovered individuals. Results The volume of streamlines in the anterior and mid‐anterior subsection of the corpus callosum was reduced in women with, but not in those who had recovered from anorexia nervosa. No differences in number of streamlines was detected in the corpus callosum between patients with anorexia nervosa, healthy controls and recovered patients. Conclusions Alterations of the corpus callosum have been repeatedly reported in anorexia nervosa. Since the recovered group did not differ from the healthy control group, the reported alterations in acute patients appear to represent a state and not a trait marker.

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“…These results have been relatively inconsistent and may arise from differences in subject characteristics (e.g., duration of illness), methodological approaches and neurodevelopmental factors (e.g., age) [12,[14][15][16][17][18][19][20][21]. Among previous research groups that longitudinally assessed axonal integrity in acutely ill AN patients, altered FA were most consistently found in WM tracts of the cingulate gyrus, the corpus callosum and the fornix, as well as the superior longitudinal fasciculus [13,22], which restored after therapy to varying degrees [5,22,23], or remained impaired [24][25][26]. Alterations in MD measures are typically negatively correlated with FA [27,28] and thought to be suggestive of inflammation or atrophy by representing water content or extracellular fluid [29].…”

Section: Introductionmentioning

confidence: 99%

“…They found that the unresolved category was related to reduced FA values in the inferior fronto-occipital longitudinal fasciculus and the splenium of the corpus callosum [45]. Although some research groups have previously demonstrated WM microstructure changes from pre-to post-therapy [5,22,23], research on underlying psychological factors associated with these changes has only recently begun. Whereas psychological components such as symptoms of anxiety or depression were not related to gray (GM) and white matter changes in AN patients [5], Lenhart et al [4] demonstrated in a recently published study that attachment trauma is associated with GM alterations in adolescent AN.…”

Section: Introductionmentioning

confidence: 99%

Attachment Trauma Is Associated with White Matter Fiber Microstructural Alterations in Adolescents with Anorexia Nervosa before and after Exposure to Psychotherapeutic and Nutritional Treatment

Gander,

Lenhart,

Steiger

et al. 2023

Brain Sciences

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In the present study, we explore the role of attachment for microstructural white matter (WM) changes in adolescents with anorexia nervosa (AN) before and after exposure to short-term and nutritional treatment. The case sample consisted of 22 female adolescent inpatients with AN (mean age: 15.2 ± 1.2 years) and the control sample were 18 gender-matched healthy adolescents (mean age: 16.8 ± 0.9 years). We performed a 3T MRI in the patient group during the acute state of AN and after weight restoration (duration: 2.6 ± 1 months) and compared the data to a healthy control group. To classify attachment patterns, we used the Adult Attachment Projective Picture System. In the patient sample, over 50% were classified with an attachment trauma/unresolved attachment status. Prior to treatment exposure, fractional anisotropy (FA) reductions and concordant mean diffusivity (MD) increases were evident in the fornix, the corpus callosum and WM regions of the thalamus, which normalized in the corpus callosum and the fornix post-therapy in the total patient sample (p < 0.002). In the acute state, patients with an attachment trauma demonstrated significant FA decreases compared to healthy controls, but no MD increases, in the corpus callosum and cingulum bilaterally, which remained decreased after therapy. Attachment patterns seem to be associated with region-specific changes of WM alterations in AN.

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White matter microstructural differences in underweight adolescents with anorexia nervosa and a preliminary longitudinal investigation of change following short-term weight restoration

Cited by 6 publications

References 47 publications

Research Review: Neuropsychological functioning in young anorexia nervosa: A meta‐analysis

Research Review: Neuropsychological functioning in young anorexia nervosa: A meta‐analysis

Reduced structural connectivity in the corpus callosum in patients with anorexia nervosa

Attachment Trauma Is Associated with White Matter Fiber Microstructural Alterations in Adolescents with Anorexia Nervosa before and after Exposure to Psychotherapeutic and Nutritional Treatment

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