TY - JOUR
T1 - Brain Structure in Acutely Underweight and Partially Weight-Restored Individuals With Anorexia Nervosa
T2 - A Coordinated Analysis by the ENIGMA Eating Disorders Working Group
AU - Walton, Esther
AU - Bernardoni, Fabio
AU - Batury, Victoria Luise
AU - Bahnsen, Klaas
AU - Larivière, Sara
AU - Abbate-Daga, Giovanni
AU - Andres-Perpiña, Susana
AU - Bang, Lasse
AU - Bischoff-Grethe, Amanda
AU - Brooks, Samantha J.
AU - Campbell, Iain C.
AU - Cascino, Giammarco
AU - Castro-Fornieles, Josefina
AU - Collantoni, Enrico
AU - D'Agata, Federico
AU - Dahmen, Brigitte
AU - Danner, Unna N.
AU - Favaro, Angela
AU - Feusner, Jamie D.
AU - Frank, Guido K.W.
AU - Friederich, Hans Christoph
AU - Graner, John L.
AU - Herpertz-Dahlmann, Beate
AU - Hess, Andreas
AU - Horndasch, Stefanie
AU - Kaplan, Allan S.
AU - Kaufmann, Lisa Katrin
AU - Kaye, Walter H.
AU - Khalsa, Sahib S.
AU - LaBar, Kevin S.
AU - Lavagnino, Luca
AU - Lazaro, Luisa
AU - Manara, Renzo
AU - Miles, Amy E.
AU - Milos, Gabriella F.
AU - Monteleone, Alessio Maria
AU - Monteleone, Palmiero
AU - Mwangi, Benson
AU - O'Daly, Owen
AU - Pariente, Jose
AU - Roesch, Julie
AU - Schmidt, Ulrike H.
AU - Seitz, Jochen
AU - Shott, Megan E.
AU - Simon, Joe J.
AU - Smeets, Paul A.M.
AU - Tamnes, Christian K.
AU - Tenconi, Elena
AU - Thomopoulos, Sophia I.
AU - van Elburg, Annemarie A.
AU - Voineskos, Aristotle N.
AU - von Polier, Georg G.
AU - Wierenga, Christina E.
AU - Zucker, Nancy L.
AU - Jahanshad, Neda
AU - King, Joseph A.
AU - Thompson, Paul M.
AU - Berner, Laura A.
AU - Ehrlich, Stefan
PY - 2022/11
Y1 - 2022/11
N2 - Background: The pattern of structural brain abnormalities in anorexia nervosa (AN) is still not well understood. While several studies report substantial deficits in gray matter volume and cortical thickness in acutely underweight patients, others find no differences, or even increases in patients compared with healthy control subjects. Recent weight regain before scanning may explain some of this heterogeneity. To clarify the extent, magnitude, and dependencies of gray matter changes in AN, we conducted a prospective, coordinated meta-analysis of multicenter neuroimaging data. Methods: We analyzed T1-weighted structural magnetic resonance imaging scans assessed with standardized methods from 685 female patients with AN and 963 female healthy control subjects across 22 sites worldwide. In addition to a case-control comparison, we conducted a 3-group analysis comparing healthy control subjects with acutely underweight AN patients (n = 466) and partially weight-restored patients in treatment (n = 251). Results: In AN, reductions in cortical thickness, subcortical volumes, and, to a lesser extent, cortical surface area were sizable (Cohen's d up to 0.95), widespread, and colocalized with hub regions. Highlighting the effects of undernutrition, these deficits were associated with lower body mass index in the AN sample and were less pronounced in partially weight-restored patients. Conclusions: The effect sizes observed for cortical thickness deficits in acute AN are the largest of any psychiatric disorder investigated in the ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis) Consortium to date. These results confirm the importance of considering weight loss and renutrition in biomedical research on AN and underscore the importance of treatment engagement to prevent potentially long-lasting structural brain changes in this population.
AB - Background: The pattern of structural brain abnormalities in anorexia nervosa (AN) is still not well understood. While several studies report substantial deficits in gray matter volume and cortical thickness in acutely underweight patients, others find no differences, or even increases in patients compared with healthy control subjects. Recent weight regain before scanning may explain some of this heterogeneity. To clarify the extent, magnitude, and dependencies of gray matter changes in AN, we conducted a prospective, coordinated meta-analysis of multicenter neuroimaging data. Methods: We analyzed T1-weighted structural magnetic resonance imaging scans assessed with standardized methods from 685 female patients with AN and 963 female healthy control subjects across 22 sites worldwide. In addition to a case-control comparison, we conducted a 3-group analysis comparing healthy control subjects with acutely underweight AN patients (n = 466) and partially weight-restored patients in treatment (n = 251). Results: In AN, reductions in cortical thickness, subcortical volumes, and, to a lesser extent, cortical surface area were sizable (Cohen's d up to 0.95), widespread, and colocalized with hub regions. Highlighting the effects of undernutrition, these deficits were associated with lower body mass index in the AN sample and were less pronounced in partially weight-restored patients. Conclusions: The effect sizes observed for cortical thickness deficits in acute AN are the largest of any psychiatric disorder investigated in the ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis) Consortium to date. These results confirm the importance of considering weight loss and renutrition in biomedical research on AN and underscore the importance of treatment engagement to prevent potentially long-lasting structural brain changes in this population.
KW - BMI
KW - Cortical thickness
KW - MRI
KW - Subcortical volume
KW - Surface area
U2 - 10.1016/j.biopsych.2022.04.022
DO - 10.1016/j.biopsych.2022.04.022
M3 - Article
AN - SCOPUS:85136665057
SN - 0006-3223
VL - 92
SP - 730
EP - 738
JO - Biological Psychiatry
JF - Biological Psychiatry
IS - 9
ER -