Esther Via1, Andrew Zalesky2, Isabel Sánchez3, Laura Forcano4, Ben J Harrison2, Jesús Pujol5, Fernando Fernández-Aranda6, José Manuel Menchón7, Carles Soriano-Mas8, Narcís Cardoner7, Alex Fornito9. 1. Bellvitge University Hospital, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), and the Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain. 2. Melbourne Neuropsychiatry Centre, The University of Melbourne, Melbourne, Australia. 3. Bellvitge University Hospital, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain. 4. Bellvitge University Hospital, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL),and the and the CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Carlos III, University of Barcelona, Barcelona, Spain. 5. MRI Research Unit, CRC Mar, Hospital de Mar, Barcelona, Spain. 6. Bellvitge University Hospital, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), and the Department of Clinical Sciences, School of Medicine, and the CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Carlos III, University of Barcelona, Barcelona, Spain. 7. Bellvitge University Hospital, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), the Department of Clinical Sciences, School of Medicine, and the CIBER Salud Mental (CIBERSAM), Instituto Carlos III, University of Barcelona, Barcelona, Spain. 8. Bellvitge University Hospital, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), the CIBER Salud Mental (CIBERSAM), Instituto Carlos III, Barcelona, Spain. 9. Monash Clinical and Imaging Neuroscience, School of Psychology and Psychiatry & Monash Biomedical Imaging, Monash University, Clayton, Australia.
Abstract
BACKGROUND: The etiology of anorexia nervosa is still unknown. Multiple and distributed brain regions have been implicated in its pathophysiology, implying a dysfunction of connected neural circuits. Despite these findings, the role of white matter in anorexia nervosa has been rarely assessed. In this study, we used diffusion tensor imaging (DTI) to characterize alterations of white matter microstructure in a clinically homogeneous sample of patients with anorexia nervosa. METHODS: Women with anorexia nervosa (restricting subtype) and healthy controls underwent brain DTI. We used tract-based spatial statistics to compare fractional anisotropy (FA) and mean diffusivity (MD) maps between the groups. Furthermore, axial (AD) and radial diffusivity (RD) measures were extracted from regions showing group differences in either FA or MD. RESULTS: We enrolled 19 women with anorexia nervosa and 19 healthy controls in our study. Patients with anorexia nervosa showed significant FA decreases in the parietal part of the left superior longitudinal fasciculus (SLF; p(FWE) < 0.05), with increased MD and RD but no differences in AD. Patients with anorexia nervosa also showed significantly increased MD in the fornix (p(FWE) < 0.05), accompanied by decreased FA and increased RD and AD. LIMITATIONS: Limitations include our modest sample size and cross-sectional design. CONCLUSION: Our findings support the presence of white matter pathology in patients with anorexia nervosa. Alterations in the SLF and fornix might be relevant to key symptoms of anorexia nervosa, such as body image distortion or impairments in body-energy-balance and reward processes. The differences found in both areas replicate those found in previous DTI studies and support a role for white matter pathology of specific neural circuits in individuals with anorexia nervosa.
BACKGROUND: The etiology of anorexia nervosa is still unknown. Multiple and distributed brain regions have been implicated in its pathophysiology, implying a dysfunction of connected neural circuits. Despite these findings, the role of white matter in anorexia nervosa has been rarely assessed. In this study, we used diffusion tensor imaging (DTI) to characterize alterations of white matter microstructure in a clinically homogeneous sample of patients with anorexia nervosa. METHODS:Women with anorexia nervosa (restricting subtype) and healthy controls underwent brain DTI. We used tract-based spatial statistics to compare fractional anisotropy (FA) and mean diffusivity (MD) maps between the groups. Furthermore, axial (AD) and radial diffusivity (RD) measures were extracted from regions showing group differences in either FA or MD. RESULTS: We enrolled 19 women with anorexia nervosa and 19 healthy controls in our study. Patients with anorexia nervosa showed significant FA decreases in the parietal part of the left superior longitudinal fasciculus (SLF; p(FWE) < 0.05), with increased MD and RD but no differences in AD. Patients with anorexia nervosa also showed significantly increased MD in the fornix (p(FWE) < 0.05), accompanied by decreased FA and increased RD and AD. LIMITATIONS: Limitations include our modest sample size and cross-sectional design. CONCLUSION: Our findings support the presence of white matter pathology in patients with anorexia nervosa. Alterations in the SLF and fornix might be relevant to key symptoms of anorexia nervosa, such as body image distortion or impairments in body-energy-balance and reward processes. The differences found in both areas replicate those found in previous DTI studies and support a role for white matter pathology of specific neural circuits in individuals with anorexia nervosa.
Authors: Victor W Swayze; Arnold E Andersen; Nancy C Andreasen; Stephan Arndt; Yutaka Sato; Steve Ziebell Journal: Int J Eat Disord Date: 2003-01 Impact factor: 4.861
Authors: Stephen M Smith; Mark Jenkinson; Mark W Woolrich; Christian F Beckmann; Timothy E J Behrens; Heidi Johansen-Berg; Peter R Bannister; Marilena De Luca; Ivana Drobnjak; David E Flitney; Rami K Niazy; James Saunders; John Vickers; Yongyue Zhang; Nicola De Stefano; J Michael Brady; Paul M Matthews Journal: Neuroimage Date: 2004 Impact factor: 6.556
Authors: Demitry Kazlouski; Michael D H Rollin; Jason Tregellas; Megan E Shott; Leah M Jappe; Jennifer O Hagman; Tamara Pryor; Tony T Yang; Guido K W Frank Journal: Psychiatry Res Date: 2011-04-17 Impact factor: 3.222
Authors: Guido K W Frank; Megan E Shott; Jennifer O Hagman; Tony T Yang Journal: J Am Acad Child Adolesc Psychiatry Date: 2013-08-27 Impact factor: 8.829
Authors: Mark Mühlau; Christian Gaser; Rüdiger Ilg; Bastian Conrad; Carl Leibl; Marian H Cebulla; Herbert Backmund; Monika Gerlinghoff; Peter Lommer; Andreas Schnebel; Afra M Wohlschläger; Claus Zimmer; Sabine Nunnemann Journal: Am J Psychiatry Date: 2007-12 Impact factor: 18.112
Authors: Jiook Cha; Jaime S Ide; F Dubois Bowman; Helen B Simpson; Jonathan Posner; Joanna E Steinglass Journal: Hum Brain Mapp Date: 2016-11 Impact factor: 5.038
Authors: Andrea Phillipou; Sean P Carruthers; Maria A Di Biase; Andrew Zalesky; Larry A Abel; David J Castle; Caroline Gurvich; Susan L Rossell Journal: Hum Brain Mapp Date: 2018-07-02 Impact factor: 5.038
Authors: Gerit Pfuhl; Joseph A King; Daniel Geisler; Benjamin Roschinski; Franziska Ritschel; Maria Seidel; Fabio Bernardoni; Dirk K Müller; Tonya White; Veit Roessner; Stefan Ehrlich Journal: Hum Brain Mapp Date: 2016-11 Impact factor: 5.038
Authors: Royce Lee; Konstantinos Arfanakis; Arnold M Evia; Jennifer Fanning; Sarah Keedy; Emil F Coccaro Journal: Neuropsychopharmacology Date: 2016-05-20 Impact factor: 7.853