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Ravanfar P, Rushmore RJ, Lyall AE, Cropley V, Makris N, Desmond P, Velakoulis D, Shenton ME, Bush AI, Rossell SL, Pantelis C, Syeda WT, Phillipou A. Investigation of brain iron in anorexia nervosa, a quantitative susceptibility mapping study. J Eat Disord 2023; 11:142. [PMID: 37605216 PMCID: PMC10441741 DOI: 10.1186/s40337-023-00870-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 08/14/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Anorexia nervosa (AN) is a potentially fatal psychiatric condition, associated with structural brain changes such as gray matter volume loss. The pathophysiological mechanisms for these changes are not yet fully understood. Iron is a crucial element in the development and function of the brain. Considering the systemic alterations in iron homeostasis in AN, we hypothesized that brain iron would be altered as a possible factor associated with structural brain changes in AN. METHODS In this study, we used quantitative susceptibility mapping (QSM) magnetic resonance imaging to investigate brain iron in current AN (c-AN) and weight-restored AN compared with healthy individuals. Whole-brain voxel wise comparison was used to probe areas with possible group differences. Further, the thalamus, caudate nucleus, putamen, nucleus accumbens, hippocampus, and amygdala were selected as the regions of interest (ROIs) for ROI-based comparison of mean QSM values. RESULTS Whole-brain voxel-wise and ROI-based comparison of QSM did not reveal any differences between groups. Exploratory analyses revealed a correlation between higher regional QSM (higher iron) and lower body mass index, higher illness severity, longer illness duration, and younger age at onset in the c-AN group. CONCLUSIONS This study did not find evidence of altered brain iron in AN compared to healthy individuals. However, the correlations between clinical variables and QSM suggest a link between brain iron and weight status or biological processes in AN, which warrants further investigation.
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Affiliation(s)
- Parsa Ravanfar
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Royal Melbourne Hospital, Level 3, Alan Gilbert Building, 161 Barry ST, Carlton South, VIC, 3053, Australia.
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | - R Jarrett Rushmore
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Center for Morphometric Analysis (CMA), Massachusetts General Hospital, Charlestown, MA, USA
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | - Amanda E Lyall
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Vanessa Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Royal Melbourne Hospital, Level 3, Alan Gilbert Building, 161 Barry ST, Carlton South, VIC, 3053, Australia
| | - Nikos Makris
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Center for Morphometric Analysis (CMA), Massachusetts General Hospital, Charlestown, MA, USA
| | - Patricia Desmond
- Department of Radiology, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia
| | - Dennis Velakoulis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Royal Melbourne Hospital, Level 3, Alan Gilbert Building, 161 Barry ST, Carlton South, VIC, 3053, Australia
- Neuropsychiatry, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
| | - Ashley I Bush
- Melbourne Dementia Research Centre, The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Susan L Rossell
- Centre for Mental Health and Brain Sciences, Swinburne University, Hawthorn, VIC, Australia
- Department of Mental Health, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Royal Melbourne Hospital, Level 3, Alan Gilbert Building, 161 Barry ST, Carlton South, VIC, 3053, Australia
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Warda T Syeda
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Royal Melbourne Hospital, Level 3, Alan Gilbert Building, 161 Barry ST, Carlton South, VIC, 3053, Australia
| | - Andrea Phillipou
- Department of Mental Health, St Vincent's Hospital, Melbourne, VIC, Australia
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
- Department of Mental Health, Austin Health, Melbourne, Australia
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Gander M, Lenhart L, Steiger R, Buchheim A, Mangesius S, Birkl C, Haid-Stecher N, Fuchs M, Libal A, Dabkowska-Mika A, Gizewski ER, Sevecke K. Attachment Trauma Is Associated with White Matter Fiber Microstructural Alterations in Adolescents with Anorexia Nervosa before and after Exposure to Psychotherapeutic and Nutritional Treatment. Brain Sci 2023; 13:brainsci13050798. [PMID: 37239270 DOI: 10.3390/brainsci13050798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
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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Affiliation(s)
- Manuela Gander
- Institute of Psychology, Leopold-Franzens-University of Innsbruck, 6020 Innsbruck, Austria
- Department of Child and Adolescent Psychiatry, Tirol Kliniken, 6060 Hall in Tirol, Austria
| | - Lukas Lenhart
- Department of Neuroradiology, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Ruth Steiger
- Department of Neuroradiology, Medical University of Innsbruck, 6020 Innsbruck, Austria
- Neuroimaging Research Core Facility, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Anna Buchheim
- Institute of Psychology, Leopold-Franzens-University of Innsbruck, 6020 Innsbruck, Austria
| | - Stephanie Mangesius
- Department of Neuroradiology, Medical University of Innsbruck, 6020 Innsbruck, Austria
- Neuroimaging Research Core Facility, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Christoph Birkl
- Department of Neuroradiology, Medical University of Innsbruck, 6020 Innsbruck, Austria
- Neuroimaging Research Core Facility, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Nina Haid-Stecher
- Department of Child and Adolescent Psychiatry, Tirol Kliniken, 6060 Hall in Tirol, Austria
| | - Martin Fuchs
- Department of Child and Adolescent Psychiatry, Tirol Kliniken, 6060 Hall in Tirol, Austria
| | - Anna Libal
- Department of Child and Adolescent Psychiatry, Tirol Kliniken, 6060 Hall in Tirol, Austria
| | - Agnieszka Dabkowska-Mika
- Department of Neuroradiology, Medical University of Innsbruck, 6020 Innsbruck, Austria
- Neuroimaging Research Core Facility, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Elke Ruth Gizewski
- Department of Neuroradiology, Medical University of Innsbruck, 6020 Innsbruck, Austria
- Neuroimaging Research Core Facility, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Kathrin Sevecke
- Department of Child and Adolescent Psychiatry, Tirol Kliniken, 6060 Hall in Tirol, Austria
- Department of Child and Adolescent Psychiatry, Medical University of Innsbruck, 6020 Innsbruck, Austria
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3
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Murray SB, Cabeen RP, Jann K, Tadayonnejad R, Strober M, Feusner JD. White matter microstructure in habit and reward circuits in anorexia nervosa: Insights from a neurite orientation dispersion and density imaging study. Acta Psychiatr Scand 2023; 147:134-144. [PMID: 36376250 PMCID: PMC9852024 DOI: 10.1111/acps.13521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/04/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Behavioral features of anorexia nervosa (AN) suggest abnormalities in reward and habit. Neuroimaging evidence suggests morphometric and functional perturbations within these circuits, although fewer studies have assessed white matter characteristics in AN, and no studies to date have assessed white matter microstructure in AN. METHODS In this brain imaging study, 29 female adolescents with partially or fully weight-restored AN and 27 healthy controls, all between 10 and 19 years, underwent whole-brain multi-shell diffusion tensor imaging. Utilizing neurite orientation dispersion and density imaging methods, we investigated group differences in white matter neurite density, orientation dispersion, and myelin density in tracts between prominent nodes of the reward circuit (ventral tegmental area (VTA) to nucleus accumbens (NAcc)) and the habit circuit (sensory motor area [SMA] to putamen). RESULTS Findings revealed reduced neurite (F = 5.20, p = 0.027) and myelin density (F = 5.39, p = 0.025) in the left VTA-NAcc tract, and reduced orientation dispersion in the left (F = 7.00, p = 0.011) and right (F = 6.77, p = 0.012) VTA-NAcc tract. There were no significant group differences in the SMA-putamen tract. Significant relationships, after corrections, were not evident between tract microstructure and reward responsiveness, compulsive behaviors, illness duration, or BMI. CONCLUSIONS Adolescents with AN exhibit less dense, undermyelinated, and less dispersed white matter tracts connecting prominent reward system nodes, which could potentially signify underutilization of this part of the reward circuit. These results provide a detailed examination of white matter microstructure in tracts underlying instrumental behavioral phenotypes contributing to illness in AN.
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Affiliation(s)
- Stuart B. Murray
- Department of Psychiatry & Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - Ryan P. Cabeen
- Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Kay Jann
- Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Reza Tadayonnejad
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA,Computation & Neural Systems program, California Institute of Technology, Pasadena, CA, USA
| | - Michael Strober
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jamie D. Feusner
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA,Department of Psychiatry, University of Toronto, Toronto, ON, Canada,Centre for Addiction and Mental Health, Toronto, ON, Canada,Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden,Corresponding author: Jamie Feusner, 250 College St. #645, Toronto, ON M5V 3W5, Canada, Phone: +1-416-535-8501 x33436,
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4
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Vo M, Golden N. Medical complications and management of atypical anorexia nervosa. J Eat Disord 2022; 10:196. [PMID: 36522787 PMCID: PMC9756584 DOI: 10.1186/s40337-022-00720-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Atypical anorexia nervosa (AAN) is a new diagnosis in the 5th edition of the Diagnostic and Statistical Manual. Patients with AAN have been recognized to have similar, if not more severe, medical and psychological complications compared with patients with typical Anorexia Nervosa; yet studies on medical complications and optimal treatment of AAN are lacking. Here we review what is known regarding medical presentation and management of patients with AAN.
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Affiliation(s)
- Megen Vo
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University School of Medicine, 750 Welch Road Suite 210, Palo Alto, CA, 94304, USA.
| | - Neville Golden
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University School of Medicine, 750 Welch Road Suite 210, Palo Alto, CA, 94304, USA
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5
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Maier S, Joos A, Tebartz van Elst L, Ebert D, Endres D, Domschke K, Lahmann C, Zeeck A, Runge K, Denzel D, Reisert M, Nickel K. Reduced structural connectivity in the corpus callosum in patients with anorexia nervosa. EUROPEAN EATING DISORDERS REVIEW 2022; 30:341-352. [DOI: 10.1002/erv.2894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 02/19/2022] [Accepted: 02/21/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Simon Maier
- Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Andreas Joos
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Ludger Tebartz van Elst
- Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Dieter Ebert
- Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Dominique Endres
- Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
- Center for Basics in Neuromodulation, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Claas Lahmann
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Almut Zeeck
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Kimon Runge
- Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Dominik Denzel
- Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Marco Reisert
- Department of Radiology, Medical Physics, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Kathrin Nickel
- Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany
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6
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Laczkovics C, Nenning KH, Wittek T, Schmidbauer V, Schwarzenberg J, Maurer ES, Wagner G, Seidel S, Philipp J, Prayer D, Kasprian G, Karwautz A. White matter integrity is disrupted in adolescents with acute anorexia nervosa: A diffusion tensor imaging study. Psychiatry Res Neuroimaging 2022; 320:111427. [PMID: 34952446 DOI: 10.1016/j.pscychresns.2021.111427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 12/09/2021] [Accepted: 12/10/2021] [Indexed: 11/30/2022]
Abstract
Anorexia nervosa (AN) is a highly debilitating mental illness with multifactorial etiology. It oftentimes begins in adolescence, therefore understanding the pathophysiology in this period is important. Few studies investigated the possible impact of the acute state of illness on white matter (WM) tissue properties in the developing adolescent brain. The present study expands our understanding of the implications of AN and starvation on WM integrity. 67 acutely ill adolescent patients suffering from AN restricting type were compared with 32 healthy controls using diffusion tensor imaging assessing fractional anisotropy (FA) and mean diffusivity (MD). We found widespread alterations in the vast majority of the WM regions with significantly decreased FA and increased MD in the AN group. In this highly selective sample in the acute stage of AN, the alterations are likely to be the consequence of starvation. Still, we cannot rule out that some of the affected regions might play a key role in AN-specific psychopathology.
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Affiliation(s)
- Clarissa Laczkovics
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Austria.
| | - Karl-Heinz Nenning
- Computational Imaging Research Lab, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - Tanja Wittek
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Austria
| | - Victor Schmidbauer
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - Julia Schwarzenberg
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Austria
| | - Elisabeth Sophie Maurer
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Austria
| | - Gudrun Wagner
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Austria
| | - Stefan Seidel
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - Julia Philipp
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Austria
| | - Daniela Prayer
- Department of Neurology, Medical University of Vienna, Austria
| | - Gregor Kasprian
- Department of Neurology, Medical University of Vienna, Austria
| | - Andreas Karwautz
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Austria
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7
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Pappaianni E, Borsarini B, Doucet GE, Hochman A, Frangou S, Micali N. Initial evidence of abnormal brain plasticity in anorexia nervosa: an ultra-high field study. Sci Rep 2022; 12:2589. [PMID: 35173174 PMCID: PMC8850617 DOI: 10.1038/s41598-022-06113-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 01/05/2022] [Indexed: 11/09/2022] Open
Abstract
Anorexia Nervosa has been associated with white matter abnormalities implicating subcortical abnormal myelination. Extending these findings to intracortical myelin has been challenging but ultra-high field neuroimaging offers new methodological opportunities. To test the integrity of intracortical myelin in AN we used 7 T neuroimaging to acquire T1-weighted images optimized for intracortical myelin from seven females with AN (age range: 18-33) and 11 healthy females (age range: 23-32). Intracortical T1 values (inverse index of myelin concentration) were extracted from 148 cortical regions at ten depth-levels across the cortical ribbon. Across all cortical regions, these levels were averaged to generate estimates of total intracortical myelin concentration and were clustered using principal component analyses into two clusters; the outer cluster comprised T1 values across depth-levels ranging from the CSF boundary to the middle of the cortical regions and the inner cluster comprised T1 values across depth-levels ranging from the middle of the cortical regions to the gray/white matter boundary. Individuals with AN exhibited higher T1 values (i.e., decreased intracortical myelin concentration) in all three metrics. It remains to be established if these abnormalities result from undernutrition or specific lipid nutritional imbalances, or are trait markers; and whether they may contribute to neurobiological deficits seen in AN.
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Affiliation(s)
- Edoardo Pappaianni
- Department of Psychiatry, Faculty of Medicine, University of Geneva, 2 Rue Verte, 1205, Geneva, Switzerland
| | - Bianca Borsarini
- Department of Psychiatry, Faculty of Medicine, University of Geneva, 2 Rue Verte, 1205, Geneva, Switzerland
| | | | - Ayelet Hochman
- Department of Psychology, St. John's University, Queens, NY, USA
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Nadia Micali
- Department of Psychiatry, Faculty of Medicine, University of Geneva, 2 Rue Verte, 1205, Geneva, Switzerland. .,Great Ormond Street Institute of Child Health, University College London, London, UK. .,Department of Pediatrics, Gynecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
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8
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Gao Y, Meng X, Bai Z, Liu X, Zhang M, Li H, Ding G, Liu L, Booth JR. Left and Right Arcuate Fasciculi Are Uniquely Related to Word Reading Skills in Chinese-English Bilingual Children. NEUROBIOLOGY OF LANGUAGE (CAMBRIDGE, MASS.) 2022; 3:109-131. [PMID: 37215330 PMCID: PMC10158580 DOI: 10.1162/nol_a_00051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 07/10/2021] [Indexed: 05/24/2023]
Abstract
Whether reading in different writing systems recruits language-unique or language-universal neural processes is a long-standing debate. Many studies have shown the left arcuate fasciculus (AF) to be involved in phonological and reading processes. In contrast, little is known about the role of the right AF in reading, but some have suggested that it may play a role in visual spatial aspects of reading or the prosodic components of language. The right AF may be more important for reading in Chinese due to its logographic and tonal properties, but this hypothesis has yet to be tested. We recruited a group of Chinese-English bilingual children (8.2 to 12.0 years old) to explore the common and unique relation of reading skill in English and Chinese to fractional anisotropy (FA) in the bilateral AF. We found that both English and Chinese reading skills were positively correlated with FA in the rostral part of the left AF-direct segment. Additionally, English reading skill was positively correlated with FA in the caudal part of the left AF-direct segment, which was also positively correlated with phonological awareness. In contrast, Chinese reading skill was positively correlated with FA in certain segments of the right AF, which was positively correlated with visual spatial ability, but not tone discrimination ability. Our results suggest that there are language universal substrates of reading across languages, but that certain left AF nodes support phonological mechanisms important for reading in English, whereas certain right AF nodes support visual spatial mechanisms important for reading in Chinese.
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Affiliation(s)
- Yue Gao
- State Key Laboratory of Cognitive Neuroscience and Learning, and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Xiangzhi Meng
- School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behavioral and Mental Health, Peking University, Beijing, China
- PekingU-PolyU Center for Child Development and Learning, Beijing, China
| | - Zilin Bai
- State Key Laboratory of Cognitive Neuroscience and Learning, and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Xin Liu
- Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
| | - Manli Zhang
- Department of Cognitive Neuroscience and Maastricht Brain Imaging Center, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Hehui Li
- State Key Laboratory of Cognitive Neuroscience and Learning, and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Guosheng Ding
- State Key Laboratory of Cognitive Neuroscience and Learning, and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Li Liu
- State Key Laboratory of Cognitive Neuroscience and Learning, and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - James R. Booth
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
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9
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Geisler D, King JA, Bahnsen K, Bernardoni F, Doose A, Müller DK, Marxen M, Roessner V, van den Heuvel M, Ehrlich S. Altered White Matter Connectivity in Young Acutely Underweight Patients With Anorexia Nervosa. J Am Acad Child Adolesc Psychiatry 2022; 61:331-340. [PMID: 33989747 DOI: 10.1016/j.jaac.2021.04.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 04/07/2021] [Accepted: 04/30/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Reductions of gray matter volume and cortical thickness in anorexia nervosa (AN) are well documented. However, findings regarding the integrity of white matter (WM) as studied via diffusion weighted imaging (DWI) are remarkably heterogeneous, and WM connectivity has been examined only in small samples using a limited number of regions of interest. The present study investigated whole-brain WM connectivity for the first time in a large sample of acutely underweight patients with AN. METHOD DWI data from predominantly adolescent patients with acute AN (n = 96, mean age = 16.3 years) and age-matched healthy control participants (n = 96, mean age = 17.2 years) were analyzed. WM connectivity networks were generated from fiber-tractography-derived streamlines connecting 233 cortical/subcortical regions. To identify group differences, network-based statistic was used while taking head motion, WM, and ventricular volume into account. RESULTS Patients with AN were characterized by 6 WM subnetworks with abnormal architecture, as indicated by increased fractional anisotropy located primarily in parietal-occipital regions and accompanied by reduced radial diffusivity. Group differences based on number of streamlines reached only nominal significance. CONCLUSION Our study reveals pronounced alterations in the WM connectome in young patients with AN. In contrast to known reductions in gray matter in the acutely underweight state of AN, this pattern does not necessarily indicate a deterioration of the WM network. Future studies using advanced MRI sequences will have to clarify interrelations with axonal packing or myelination, and whether the changes should be considered a consequence of undernutrition or a vulnerability for developing or maintaining AN.
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Affiliation(s)
- Daniel Geisler
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Joseph A King
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Klaas Bahnsen
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Fabio Bernardoni
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Arne Doose
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Dirk K Müller
- Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Michael Marxen
- Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Veit Roessner
- Child and Adolescent Psychiatry, University Hospital C. G. Carus, Technische Universität Dresden, Dresden, Germany
| | - Martijn van den Heuvel
- Connectome Lab, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; Eating Disorder Treatment and Research Center, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
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10
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Simultaneous confidence bands for functional data using the Gaussian Kinematic formula. J Stat Plan Inference 2022; 216:70-94. [DOI: 10.1016/j.jspi.2021.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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11
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Mishima R, Isobe M, Noda T, Tose K, Kawabata M, Noma S, Murai T. Structural brain changes in severe and enduring anorexia nervosa: A multimodal magnetic resonance imaging study of gray matter volume, cortical thickness, and white matter integrity. Psychiatry Res Neuroimaging 2021; 318:111393. [PMID: 34670165 DOI: 10.1016/j.pscychresns.2021.111393] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 10/20/2022]
Abstract
Whole-brain T1-weighted imaging and diffusion tensor imaging was performed in 35 adult women with anorexia nervosa (AN) and 35 healthy controls. We conducted voxel-based group comparisons for gray matter volume (GMV), cortical thickness (CT), and fractional anisotropy (FA) values, using age and total intracranial volume as nuisance covariates. We then conducted the same group comparisons for these three measures, but this time also controlled for the following global pathological measures: total GMV, mean CT across the whole brain, and mean FA across the entire white matter skeleton. Compared with the healthy controls, AN patients had lower GMV and CT in widespread cortical regions, and smaller FA values in widespread white matter regions. After controlling for global parameters, almost all of the differences between the two groups disappeared, except for higher CT in the medial orbital gyrus and parietal operculum in the AN group. Structural brain changes in AN are likely to be composed of both global and region-specific changes. The former changes are likely to have a dominant impact, while the latter changes might in part explain the disease-specific pathophysiology of AN.
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Affiliation(s)
- Ryo Mishima
- Department of Psychiatry, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto, Japan
| | - Masanori Isobe
- Department of Psychiatry, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto, Japan.
| | - Tomomi Noda
- Department of Psychiatry, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto, Japan
| | - Keima Tose
- Department of Psychiatry, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto, Japan
| | - Michiko Kawabata
- Department of Psychiatry, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto, Japan
| | - Shun'ichi Noma
- Department of Psychiatry, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto, Japan; Noma Kokoro Clinic, 5-322-1 Fukakusa-Sujikaibashi, Fushimi-ku, Kyoto, Japan
| | - Toshiya Murai
- Department of Psychiatry, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto, Japan
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12
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Bruckert L, Travis KE, Mezer AA, Ben-Shachar M, Feldman HM. Associations of Reading Efficiency with White Matter Properties of the Cerebellar Peduncles in Children. THE CEREBELLUM 2021; 19:771-777. [PMID: 32642932 DOI: 10.1007/s12311-020-01162-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Reading in children has been associated with microstructural properties of the cerebellar peduncles, the white matter pathways connecting the cerebellum to the cerebrum. In this study, we used two independent neuroimaging modalities to assess which features of the cerebellar peduncles would be associated with reading. Twenty-three 8-year-old children were evaluated on word reading efficiency and imaged using diffusion MRI (dMRI) and quantitative T1 relaxometry (qT1). We segmented the superior (SCP), middle, and inferior cerebellar peduncles and extracted two metrics: fractional anisotropy (FA) from dMRI and R1 from qT1. Tract-FA was significantly correlated with tract-R1 in left and right SCPs (left: rP(21) = .63, right: rP(21) = .76, p ≤ .001) suggesting that FA of these peduncles, at least in part, indexed myelin content. Tract-FA and tract R1 were not correlated in the other cerebellar peduncles. Reading efficiency negatively correlated with tract-FA of the left (rP(21) = - .43, p = .040) and right SCP (rP(21) = - .37, p = .079). Reading efficiency did not correlate with tract-R1 in the SCPs. The negative association of reading efficiency with tract-FA and the lack of association of reading efficiency with tract-R1 implicate properties other than myelin content as relevant to the information flow between the cerebellum and the cerebrum for individual differences in reading skills in children.
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Affiliation(s)
- Lisa Bruckert
- Developmental-Behavioral Pediatrics, Stanford School of Medicine, Stanford, CA, USA
| | - Katherine E Travis
- Developmental-Behavioral Pediatrics, Stanford School of Medicine, Stanford, CA, USA
| | - Aviv A Mezer
- Edmond and Lily Safra Center for Brain Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Michal Ben-Shachar
- Department of English Literature and Linguistics, Bar Ilan University, Ramat Gan, Israel.,The Gonda Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, Israel
| | - Heidi M Feldman
- Developmental-Behavioral Pediatrics, Stanford School of Medicine, Stanford, CA, USA. .,Medical School Office Building, 1265 Welch Road, Room X163, Stanford, CA, 94305, USA.
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13
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Wang D, Zhuo K, Sun Y, Xiang Q, Guo X, Wang J, Xu Y, Liu D, Li Y. Middle temporal corpus callosum impairment as a predictor of eight-week treatment outcome of drug-naïve first-episode psychosis patients: A pilot longitudinal study. Schizophr Res 2021; 232:95-97. [PMID: 34029947 DOI: 10.1016/j.schres.2021.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 05/01/2021] [Accepted: 05/02/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Danni Wang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Kaiming Zhuo
- First-episode Schizophrenia and Early Psychosis Program, Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Yu Sun
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, Zhejiang University, Zhejiang 310052, China; Department of Radiology, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Zhejiang 310052, China
| | - Qiong Xiang
- First-episode Schizophrenia and Early Psychosis Program, Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Xiaoyun Guo
- First-episode Schizophrenia and Early Psychosis Program, Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Jinhong Wang
- Department of Medical Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Yifeng Xu
- First-episode Schizophrenia and Early Psychosis Program, Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Institute of Mental Health, Fudan University, Shanghai 200030, China
| | - Dengtang Liu
- First-episode Schizophrenia and Early Psychosis Program, Division of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; Institute of Mental Health, Fudan University, Shanghai 200030, China.
| | - Yao Li
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China.
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Kappou K, Ntougia M, Kourtesi A, Panagouli E, Vlachopapadopoulou E, Michalacos S, Gonidakis F, Mastorakos G, Psaltopoulou T, Tsolia M, Bacopoulou F, Sergentanis TN, Tsitsika A. Neuroimaging Findings in Adolescents and Young Adults with Anorexia Nervosa: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2021; 8:137. [PMID: 33673193 PMCID: PMC7918703 DOI: 10.3390/children8020137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Anorexia nervosa (AN) is a serious, multifactorial mental disorder affecting predominantly young females. This systematic review examines neuroimaging findings in adolescents and young adults up to 24 years old, in order to explore alterations associated with disease pathophysiology. METHODS Eligible studies on structural and functional brain neuroimaging were sought systematically in PubMed, CENTRAL and EMBASE databases up to 5 October 2020. RESULTS Thirty-three studies were included, investigating a total of 587 patients with a current diagnosis of AN and 663 healthy controls (HC). Global and regional grey matter (GM) volume reduction as well as white matter (WM) microstructure alterations were detected. The mainly affected regions were the prefrontal, parietal and temporal cortex, hippocampus, amygdala, insula, thalamus and cerebellum as well as various WM tracts such as corona radiata and superior longitudinal fasciculus (SLF). Regarding functional imaging, alterations were pointed out in large-scale brain networks, such as default mode network (DMN), executive control network (ECN) and salience network (SN). Most findings appear to reverse after weight restoration. Specific limitations of neuroimaging studies in still developing individuals are also discussed. CONCLUSIONS Structural and functional alterations are present in the early course of the disease, most of them being partially or totally reversible. Nonetheless, neuroimaging findings have been open to many biological interpretations. Thus, more studies are needed to clarify their clinical significance.
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Affiliation(s)
- Kalliopi Kappou
- MSc “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (K.K.); (M.N.); (A.K.); (E.P.); (T.P.); (M.T.); (T.N.S.)
| | - Myrto Ntougia
- MSc “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (K.K.); (M.N.); (A.K.); (E.P.); (T.P.); (M.T.); (T.N.S.)
| | - Aikaterini Kourtesi
- MSc “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (K.K.); (M.N.); (A.K.); (E.P.); (T.P.); (M.T.); (T.N.S.)
| | - Eleni Panagouli
- MSc “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (K.K.); (M.N.); (A.K.); (E.P.); (T.P.); (M.T.); (T.N.S.)
| | - Elpis Vlachopapadopoulou
- Department of Endocrinology-Growth and Development, “P. & A. Kyriakou” Children’s Hospital, 115 27 Athens, Greece; (E.V.); (S.M.)
| | - Stefanos Michalacos
- Department of Endocrinology-Growth and Development, “P. & A. Kyriakou” Children’s Hospital, 115 27 Athens, Greece; (E.V.); (S.M.)
| | - Fragiskos Gonidakis
- First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 115 28 Athens, Greece;
| | - Georgios Mastorakos
- Unit of Endocrinology, Diabetes Mellitus and Metabolism, Aretaieion Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece;
| | - Theodora Psaltopoulou
- MSc “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (K.K.); (M.N.); (A.K.); (E.P.); (T.P.); (M.T.); (T.N.S.)
- Department of Clinical Therapeutics, “Alexandra” Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Maria Tsolia
- MSc “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (K.K.); (M.N.); (A.K.); (E.P.); (T.P.); (M.T.); (T.N.S.)
| | - Flora Bacopoulou
- Center for Adolescent Medicine and UNESCO Chair Adolescent Health Care, First Department of Pediatrics, “Agia Sophia” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece;
| | - Theodoros N. Sergentanis
- MSc “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (K.K.); (M.N.); (A.K.); (E.P.); (T.P.); (M.T.); (T.N.S.)
- Department of Clinical Therapeutics, “Alexandra” Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Artemis Tsitsika
- MSc “Strategies of Developmental and Adolescent Health”, 2nd Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece; (K.K.); (M.N.); (A.K.); (E.P.); (T.P.); (M.T.); (T.N.S.)
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15
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Luckhoff HK, du Plessis S, Scheffler F, Phahladira L, Kilian S, Buckle C, Smit R, Chiliza B, Asmal L, Emsley R. Fronto-limbic white matter fractional anisotropy and body mass index in first-episode schizophrenia spectrum disorder patients compared to healthy controls. Psychiatry Res Neuroimaging 2020; 305:111173. [PMID: 32896691 DOI: 10.1016/j.pscychresns.2020.111173] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 08/27/2020] [Accepted: 08/31/2020] [Indexed: 12/18/2022]
Abstract
In this diffusion tensor imaging study, we explored the associations of body mass index (BMI) with white matter microstructure in first-episode schizophrenia spectrum disorder patients (n = 69) versus healthy controls (n = 93). We focused on fractional anisotropy (FA) measures for fronto-limbic white matter tracts known to connect brain regions which form part of a "core eating network". Secondary objectives included the associations of body mass with global illness severity, psychopathology and depressive symptoms. In a multivariate analysis of covariance (MANCOVA) model, there was a significant interaction between BMI and group (patient versus control) across the fronto-limbic white matter tracts of interest (F(1,155)= 4.91, p = 0.03). In a sub-analysis, BMI was significantly inversely correlated with FA measures for the genu and body of the corpus callosum, left and right tapetum, and left superior fronto-occipital fasciculus in controls. In patients, BMI was significantly positively correlated with white matter FA for the genu of the corpus callosum and left tapetum. Lower BMI was significantly correlated with more severe negative symptoms, as was earlier age of illness onset. Body mass may be differentially associated with fronto-limbic white matter microstructure in first-episode schizophrenia spectrum disorder compared to controls.
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Affiliation(s)
- H K Luckhoff
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape 7500, South Africa.
| | - S du Plessis
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape 7500, South Africa
| | - F Scheffler
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape 7500, South Africa
| | - L Phahladira
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape 7500, South Africa
| | - S Kilian
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape 7500, South Africa
| | - C Buckle
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape 7500, South Africa
| | - R Smit
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape 7500, South Africa
| | - B Chiliza
- Department of Psychiatry, Nelson R Mandela School of Medicine, University of Kwazulu-Natal, Durban, South Africa
| | - L Asmal
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape 7500, South Africa
| | - R Emsley
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape 7500, South Africa
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16
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Dubner SE, Rose J, Bruckert L, Feldman HM, Travis KE. Neonatal white matter tract microstructure and 2-year language outcomes after preterm birth. NEUROIMAGE-CLINICAL 2020; 28:102446. [PMID: 33035964 PMCID: PMC7554644 DOI: 10.1016/j.nicl.2020.102446] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 09/18/2020] [Accepted: 09/20/2020] [Indexed: 01/04/2023]
Abstract
Preterm infant white matter tracts uniquely predict later toddler language. Neonatal medical history moderates posterior corpus callosum–language relations. Different associations by tract may relate to brain maturation and medical history.
Aim To determine whether variability in diffusion MRI (dMRI) white matter tract metrics, obtained in a cohort of preterm infants prior to neonatal hospital discharge, would be associated with language outcomes at age 2 years, after consideration of age at scan and number of major neonatal complications. Method 30 children, gestational age 28.9 (2.4) weeks, underwent dMRI at mean post menstrual age 36.4 (1.4) weeks and language assessment with the Bayley Scales of Infant Development–III at mean age 22.2 (1.7) months chronological age. Mean fractional anisotropy (FA) and mean diffusivity (MD) were calculated for 5 white matter tracts. Hierarchical linear regression assessed associations between tract FA, moderating variables, and language outcomes. Results FA of the left inferior longitudinal fasciculus accounted for 17% (p = 0.03) of the variance in composite language and FA of the posterior corpus callosum accounted for 19% (p = 0.02) of the variance in composite language, beyond that accounted for by post-menstrual age at scan and neonatal medical complications. The number of neonatal medical complications moderated the relationship between language and posterior corpus callosum FA but did not moderate the association in the other tract. Conclusion Language at age 2 is associated with white matter metrics in early infancy in preterm children. The different pattern of associations by fiber group may relate to the stage of brain maturation and/or the nature and timing of medical complications related to preterm birth. Future studies should replicate these findings with a larger sample size to assure reliability of the findings.
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Affiliation(s)
- Sarah E Dubner
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
| | - Jessica Rose
- Division of Pediatric Orthopaedics, Stanford University School of Medicine, Stanford, CA, USA
| | - Lisa Bruckert
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Heidi M Feldman
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Katherine E Travis
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
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17
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Breithaupt L, Chunga-Iturry N, Lyall AE, Cetin-Karayumak S, Becker KR, Thomas JJ, Slattery M, Makris N, Plessow F, Pasternak O, Holsen LM, Kubicki M, Misra M, Lawson EA, Eddy KT. Developmental stage-dependent relationships between ghrelin levels and hippocampal white matter connections in low-weight anorexia nervosa and atypical anorexia nervosa. Psychoneuroendocrinology 2020; 119:104722. [PMID: 32512249 PMCID: PMC8629489 DOI: 10.1016/j.psyneuen.2020.104722] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 04/29/2020] [Accepted: 05/18/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Disruptions in homeostatic and hedonic food motivation are proposed to underlie anorexia nervosa (AN) and atypical AN, restrictive eating disorders which commonly onset in puberty. Ghrelin, a neuroprotective hormone that drives hedonic eating is increased in AN and is expressed in the hippocampus. White matter (WM) undergoes significant change during puberty in regions involved in food motivation, particularly WM tracts connected with the hippocampus. The association between ghrelin and WM region of interest (ROI) with hippocampal connections in restrictive eating disorders, particularly in adolescence during key neurodevelopmental growth, is unknown. METHODS We evaluated fasting plasma ghrelin and WM microstructure (measured by free-water corrected fractional anisotropy (FA-t)) in WM ROIs with hippocampal connections - the fornix and the hippocampal portion of the cingulum - in 56 adolescent females (age range: 11.9 - 22.1 y; mean: 19.0 y) with low-weight eating disorders including AN and atypical AN (N = 36) and healthy controls (N = 20). RESULTS FA-t in the fornix or hippocampal portion of the fornix did not differ between groups. Ghrelin was higher in AN/atypical AN vs. HC and was positively correlated with puberty stage in the AN/atypical AN group, but not the HC group. The correlation between ghrelin and FA-t in the fornix was significantly different in females with AN/atypical AN compared to controls. In AN/atypical AN, pubertal stage moderated the relation between fasting plasma ghrelin and FA-t in the fornix: higher fasting ghrelin was associated with lower FA-t in the fornix in late-post-puberty, but was not associated with FA-t in the early to mid stages of puberty. CONCLUSIONS In post-pubertal females with low-weight AN/atypical AN, higher levels of ghrelin are associated with lower FA-t in the fornix. This relationship is not evident in the early to mid stages of puberty in AN/atypical AN or in HC, and may reflect a lack of possible neuroprotective effects of ghrelin in late-post puberty only. Understanding the effects of ghrelin on WM microstructure longitudinally and following recovery from AN/Atypical AN and how this differs across pubertal stages will be an important next step. These findings could ultimately inform treatment staging and aid in diagnosis and detection of AN/atypical AN.
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Affiliation(s)
- Lauren Breithaupt
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
| | - Natalia Chunga-Iturry
- Harvard Medical School, Boston, MA, USA; Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, USA
| | - Amanda E Lyall
- Harvard Medical School, Boston, MA, USA; Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, USA
| | - Suheyla Cetin-Karayumak
- Harvard Medical School, Boston, MA, USA; Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, USA
| | - Kendra R Becker
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Jennifer J Thomas
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Meghan Slattery
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Nikos Makris
- Harvard Medical School, Boston, MA, USA; Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, USA; Department of Neurology, Massachusetts General Hospital, Charlestown, MA, United States of America; Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - Franziska Plessow
- Harvard Medical School, Boston, MA, USA; Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Ofer Pasternak
- Harvard Medical School, Boston, MA, USA; Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, USA; Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - Laura M Holsen
- Harvard Medical School, Boston, MA, USA; Division of Women's Health, Brigham and Women's Hospital, Boston, MA, USA
| | - Marek Kubicki
- Harvard Medical School, Boston, MA, USA; Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, USA; Department of Neurology, Massachusetts General Hospital, Charlestown, MA, United States of America; Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - Madhusmita Misra
- Harvard Medical School, Boston, MA, USA; Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA; Division of Pediatric Endocrinology, Massachusetts General Hospital, Boston, MA, USA
| | - Elizabeth A Lawson
- Harvard Medical School, Boston, MA, USA; Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Kamryn T Eddy
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
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18
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Alfano V, Mele G, Cotugno A, Longarzo M. Multimodal neuroimaging in anorexia nervosa. J Neurosci Res 2020; 98:2178-2207. [PMID: 32770570 DOI: 10.1002/jnr.24674] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 02/26/2020] [Accepted: 05/25/2020] [Indexed: 12/13/2022]
Abstract
Anorexia nervosa (AN) is a severe and complex psychiatric disorder characterized by intense fear about weight gain and finalized to food-related control behaviors. Growing interest has been demonstrated about neurobiological processes subtend to AN physiopathology. The present review aimed to collect neurostructural and neurofunctional available data from 2010 to 2019. Results have been organized according to the neuroimaging technique employed, also including a specific section on electroencephalographic results, mostly neglected in previous reviews. Diffuse cerebral vulnerability has been demonstrated and the contribution of several structures has been identified. Insula, cingulate cortex, parietal and frontal areas are primarily involved both by structural and functional perspectives. Moreover, consistent alterations in white matter integrity and brain electrical activity have been reported. Neuroimaging findings give a substantial contribution to AN pathophysiological description, also in order to understand altered but reversible processes in the passage from acute illness phase to disorder's remission, useful also for defining therapy.
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19
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Kreilkamp BAK, Lisanti L, Glenn GR, Wieshmann UC, Das K, Marson AG, Keller SS. Comparison of manual and automated fiber quantification tractography in patients with temporal lobe epilepsy. NEUROIMAGE-CLINICAL 2019; 24:102024. [PMID: 31670154 PMCID: PMC6831895 DOI: 10.1016/j.nicl.2019.102024] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 09/05/2019] [Accepted: 09/27/2019] [Indexed: 11/25/2022]
Abstract
Tractography approaches showed moderate to good agreement for tract morphology. Along- and whole-tract diffusivity was significantly correlated across approaches. Whole-tract AFQ but not manual tract diffusivity correlated with clinical variables. Absence of excellent agreement between approaches warrants caution.
Objective To investigate the agreement between manually and automatically generated tracts from diffusion tensor imaging (DTI) in patients with temporal lobe epilepsy (TLE). Whole and along-the-tract diffusivity metrics and correlations with patient clinical characteristics were analyzed with respect to tractography approach. Methods We recruited 40 healthy controls and 24 patients with TLE who underwent conventional T1-weighted imaging and 60-direction DTI. An automated (Automated Fiber Quantification, AFQ) and manual (TrackVis) deterministic tractography approach was used to identify the uncinate fasciculus (UF) and parahippocampal white matter bundle (PHWM). Tract diffusion scalar metrics were analyzed with respect to agreement across automated and manual approaches (Dice Coefficient and Spearman correlations), to side of onset of epilepsy and patient clinical characteristics, including duration of epilepsy, age of onset and presence of hippocampal sclerosis. Results Across approaches the analysis of tract morphology similarity revealed Dice coefficients at moderate to good agreement (0.54 - 0.6) and significant correlations between diffusion values (Spearman's Rho=0.4–0.9). However, within bilateral PHWM, AFQ yielded significantly lower FA (left: Z = 4.4, p<0.001; right: Z = 5.1, p<0.001) and higher MD values (left: Z=-4.7, p<0.001; right: Z=-3.7, p<0.001) compared to the manual approach. Whole tract DTI metrics determined using AFQ were significantly correlated with patient characteristics, including age of epilepsy onset in FA (R = 0.6, p = 0.02) and MD of the ipsilateral PHWM (R=-0.6, p = 0.02), while duration of epilepsy corrected for age correlated with MD in ipsilateral PHWM (R = 0.7, p<0.01). Correlations between clinical metrics and diffusion values extracted using the manual whole tract technique did not survive correction for multiple comparisons. Both manual and automated along-the-tract analyses demonstrated significant correlations with patient clinical characteristics such as age of onset and epilepsy duration. The strongest and most widespread localized ipsi- and contralateral diffusivity alterations were observed in patients with left TLE and patients with HS compared to controls, while patients with right TLE and patients without HS did not show these strong effects. Conclusions Manual and AFQ tractography approaches revealed significant correlations in the reconstruction of tract morphology and extracted whole and along-tract diffusivity values. However, as non-identical methods they differed in the respective yield of significant results across clinical correlations and group-wise statistics. Given the absence of excellent agreement between manual and AFQ techniques as demonstrated in the present study, caution should be considered when using AFQ particularly when used without reference to benchmark manual measures.
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Affiliation(s)
- Barbara A K Kreilkamp
- Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom; Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom.
| | - Lucy Lisanti
- Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom; Royal Society, London, United Kingdom
| | - G Russell Glenn
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, United States
| | - Udo C Wieshmann
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - Kumar Das
- Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - Anthony G Marson
- Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom; Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - Simon S Keller
- Department of Molecular and Clinical Pharmacology, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom; Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
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20
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Abstract
Eating disorders are severe psychiatric illnesses with a typical age of onset in adolescence. Brain research in youth and young adults may help us identify specific neurobiology that contributes to onset and maintenance of those disorders. This article provides a state-of-the-art review of our current understanding of the neurobiology of anorexia nervosa and bulimia nervosa. This includes brain structure and function studies to understand food restriction, binge-eating or purging behaviors, cognitive and emotional factors, as well as interoception. Binge-eating disorder and avoidant restrictive food intake disorder are also discussed, but the literature is still very small.
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21
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Gaudio S, Carducci F, Piervincenzi C, Olivo G, Schiöth HB. Altered thalamo–cortical and occipital–parietal– temporal–frontal white matter connections in patients with anorexia and bulimia nervosa: a systematic review of diffusion tensor imaging studies. J Psychiatry Neurosci 2019; 44:324-339. [PMID: 30994310 PMCID: PMC6710091 DOI: 10.1503/jpn.180121] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Anorexia nervosa and bulimia nervosa are complex mental disorders, and their etiology is still not fully understood. This paper reviews the literature on diffusion tensor imaging studies in patients with anorexia nervosa and bulimia nervosa to explore the usefulness of white matter microstructural analysis in understanding the pathophysiology of eating disorders. METHODS We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify diffusion tensor imaging studies that compared patients with an eating disorder to control groups. We searched relevant databases for studies published from database inception to August 2018, using combinations of select keywords. We categorized white matter tracts according to their 3 main classes: projection (i.e., thalamo–cortical), association (i.e., occipital–parietal–temporal–frontal) and commissural (e.g., corpus callosum). RESULTS We included 19 papers that investigated a total of 427 participants with current or previous eating disorders and 444 controls. Overall, the studies used different diffusion tensor imaging approaches and showed widespread white matter abnormalities in patients with eating disorders. Despite differences among the studies, patients with anorexia nervosa showed mainly white matter microstructural abnormalities of thalamo–cortical tracts (i.e., corona radiata, thalamic radiations) and occipital–parietal–temporal–frontal tracts (i.e., left superior longitudinal and inferior fronto-occipital fasciculi). It was less clear whether white matter alterations persist after recovery from anorexia nervosa. Available data on bulimia nervosa were partially similar to those for anorexia nervosa. LIMITATIONS Study sample composition and diffusion tensor imaging analysis techniques were heterogeneous. The number of studies on bulimia nervosa was too limited to be conclusive. CONCLUSION White matter microstructure appears to be affected in anorexia nervosa, and these alterations may play a role in the pathophysiology of this eating disorder. Although we found white matter alterations in bulimia nervosa that were similar to those in anorexia nervosa, white matter changes in bulimia nervosa remain poorly investigated, and these findings were less conclusive. Further studies with longitudinal designs and multi-approach analyses are needed to better understand the role of white matter changes in eating disorders.
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Affiliation(s)
- Santino Gaudio
- From the Department of Neuroscience, Functional Pharmacology, Uppsala University, Uppsala, Sweden (Gaudio, Olivo, Schiöth); the Centre for Integrated Research, Area of Diagnostic Imaging, Universita Campus Bio-Medico di Roma, Rome, Italy (Gaudio); the Department of Physiology and Pharmacology, Neuroimaging Laboratory, Sapienza University, Rome, Italy (Carducci, Piervincenzi); and the Institute for Translational Medicine and Biotechnology, Sechenov First Moscow State Medical University, Moscow, Russia (Schiöth)
| | - Filippo Carducci
- From the Department of Neuroscience, Functional Pharmacology, Uppsala University, Uppsala, Sweden (Gaudio, Olivo, Schiöth); the Centre for Integrated Research, Area of Diagnostic Imaging, Universita Campus Bio-Medico di Roma, Rome, Italy (Gaudio); the Department of Physiology and Pharmacology, Neuroimaging Laboratory, Sapienza University, Rome, Italy (Carducci, Piervincenzi); and the Institute for Translational Medicine and Biotechnology, Sechenov First Moscow State Medical University, Moscow, Russia (Schiöth)
| | - Claudia Piervincenzi
- From the Department of Neuroscience, Functional Pharmacology, Uppsala University, Uppsala, Sweden (Gaudio, Olivo, Schiöth); the Centre for Integrated Research, Area of Diagnostic Imaging, Universita Campus Bio-Medico di Roma, Rome, Italy (Gaudio); the Department of Physiology and Pharmacology, Neuroimaging Laboratory, Sapienza University, Rome, Italy (Carducci, Piervincenzi); and the Institute for Translational Medicine and Biotechnology, Sechenov First Moscow State Medical University, Moscow, Russia (Schiöth)
| | - Gaia Olivo
- From the Department of Neuroscience, Functional Pharmacology, Uppsala University, Uppsala, Sweden (Gaudio, Olivo, Schiöth); the Centre for Integrated Research, Area of Diagnostic Imaging, Universita Campus Bio-Medico di Roma, Rome, Italy (Gaudio); the Department of Physiology and Pharmacology, Neuroimaging Laboratory, Sapienza University, Rome, Italy (Carducci, Piervincenzi); and the Institute for Translational Medicine and Biotechnology, Sechenov First Moscow State Medical University, Moscow, Russia (Schiöth)
| | - Helgi B. Schiöth
- From the Department of Neuroscience, Functional Pharmacology, Uppsala University, Uppsala, Sweden (Gaudio, Olivo, Schiöth); the Centre for Integrated Research, Area of Diagnostic Imaging, Universita Campus Bio-Medico di Roma, Rome, Italy (Gaudio); the Department of Physiology and Pharmacology, Neuroimaging Laboratory, Sapienza University, Rome, Italy (Carducci, Piervincenzi); and the Institute for Translational Medicine and Biotechnology, Sechenov First Moscow State Medical University, Moscow, Russia (Schiöth)
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22
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Nickel K, Tebartz van Elst L, Holovics L, Feige B, Glauche V, Fortenbacher T, Endres D, Zeeck A, Tüscher O, Joos A, Maier S. White Matter Abnormalities in the Corpus Callosum in Acute and Recovered Anorexia Nervosa Patients-A Diffusion Tensor Imaging Study. Front Psychiatry 2019; 10:490. [PMID: 31338044 PMCID: PMC6628864 DOI: 10.3389/fpsyt.2019.00490] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 06/21/2019] [Indexed: 12/26/2022] Open
Abstract
Objective: Severe malnutrition in patients with anorexia nervosa (AN) as well as possible trait-related aberrations lead to pronounced structural brain changes whose reversibility after recovery is currently unclear. Previous diffusion tensor imaging (DTI) studies investigating white matter (WM) microstructure alterations in AN are inconsistent. Methods: In this so far largest DTI study in adults, we investigated 33 AN patients, 20 recovered (REC), and 33 healthy women. DTI data were processed using the "DTI and Fiber tools," and the Computational Anatomy Toolbox. WM integrity, both in terms of fractional anisotropy (FA) and mean diffusivity (MD), was assessed. Results: We found a significant FA decrease in the corpus callosum (body) and an MD decrease in the posterior thalamic radiation in the AN group. The REC group displayed FA decrease in the corpus callosum in comparison to HC, whereas there were no MD differences between the REC and HC groups. Conclusion: Despite prolonged restoration of weight in the REC group, no significant regeneration of WM integrity in terms of FA could be observed. Transient changes in MD likely represent a reversible consequence of the acute state of starvation or result from dehydration. Reduction of FA either may be due to WM damage resulting from malnutrition or may be considered a pre-morbid marker.
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Affiliation(s)
- Kathrin Nickel
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ludger Tebartz van Elst
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Lukas Holovics
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Bernd Feige
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Volkmar Glauche
- Department of Neurology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Tina Fortenbacher
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dominique Endres
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Almut Zeeck
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Oliver Tüscher
- Department of Psychiatry and Psychotherapy, University of Mainz, Mainz, Germany
| | - Andreas Joos
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Psychotherapeutic Neurology, Kliniken Schmieder, Gailingen, Germany
| | - Simon Maier
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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23
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von Schwanenflug N, Müller DK, King JA, Ritschel F, Bernardoni F, Mohammadi S, Geisler D, Roessner V, Biemann R, Marxen M, Ehrlich S. Dynamic changes in white matter microstructure in anorexia nervosa: findings from a longitudinal study. Psychol Med 2019; 49:1555-1564. [PMID: 30149815 DOI: 10.1017/s003329171800212x] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Gray matter (GM) 'pseudoatrophy' is well-documented in patients with anorexia nervosa (AN), but changes in white matter (WM) are less well understood. Here we investigated the dynamics of microstructural WM brain changes in AN patients during short-term weight restoration in a combined longitudinal and cross-sectional study design. METHODS Diffusion-weighted images were acquired in young AN patients before (acAN-Tp1, n = 56) and after (acAN-Tp2, n = 44) short-term weight restoration as well as in age-matched healthy controls (HC, n = 60). Images were processed using Tract-Based-Spatial-Statistics to compare fractional anisotropy (FA) across groups and timepoints. RESULTS In the cross-sectional comparison, FA was significantly reduced in the callosal body in acAN-Tp1 compared with HC, while no differences were found between acAN-Tp2 and HC. In the longitudinal arm, FA increased with weight gain in acAN-Tp2 relative to acAN-Tp1 in large parts of the callosal body and the fornix, while it decreased in the right corticospinal tract. CONCLUSIONS Our findings reveal that dynamic, bidirectional changes in WM microstructure in young underweight patients with AN can be reversed with brief weight restoration therapy. These results parallel those previously observed in GM and suggest that alterations in WM in non-chronic AN are also state-dependent and rapidly reversible with successful intervention.
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Affiliation(s)
- Nina von Schwanenflug
- Division of Psychological and Social Medicine and Developmental Neuroscience,Faculty of Medicine,Technische Universität Dresden,Dresden,Germany
| | - Dirk K Müller
- Department of Psychiatry and Neuroimaging Center,Technische Universität Dresden,Dresden,Germany
| | - Joseph A King
- Division of Psychological and Social Medicine and Developmental Neuroscience,Faculty of Medicine,Technische Universität Dresden,Dresden,Germany
| | - Franziska Ritschel
- Division of Psychological and Social Medicine and Developmental Neuroscience,Faculty of Medicine,Technische Universität Dresden,Dresden,Germany
| | - Fabio Bernardoni
- Division of Psychological and Social Medicine and Developmental Neuroscience,Faculty of Medicine,Technische Universität Dresden,Dresden,Germany
| | - Siawoosh Mohammadi
- Department of Systems Neuroscience,Medical Center Hamburg-Eppendorf,Hamburg,Germany
| | - Daniel Geisler
- Division of Psychological and Social Medicine and Developmental Neuroscience,Faculty of Medicine,Technische Universität Dresden,Dresden,Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry,Faculty of Medicine,Eating Disorder Research and Treatment Center, Technische Universität Dresden,Dresden,Germany
| | - Ronald Biemann
- Institute of Clinical Chemistry and Pathobiochemistry, Otto-von-Guericke University,Magdeburg,Germany
| | - Michael Marxen
- Department of Psychiatry and Neuroimaging Center,Technische Universität Dresden,Dresden,Germany
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neuroscience,Faculty of Medicine,Technische Universität Dresden,Dresden,Germany
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24
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The reduction of astrocytes and brain volume loss in anorexia nervosa-the impact of starvation and refeeding in a rodent model. Transl Psychiatry 2019; 9:159. [PMID: 31164627 PMCID: PMC6548775 DOI: 10.1038/s41398-019-0493-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 02/28/2019] [Accepted: 04/10/2019] [Indexed: 11/16/2022] Open
Abstract
Anorexia nervosa (AN) is an often chronic, difficult to treat illness that leads to brain volume reductions in gray and white matter. The underlying pathophysiology is poorly understood, despite its potential importance in explaining the neuropsychological deficits and clinical symptoms associated with the illness. We used the activity-based anorexia model (ABA), which includes food reduction and running wheel access in female rats to study brain changes after starvation and refeeding. Longitudinal animal MRI and post-mortem brain sections confirmed a reduction in the mean brain volumes of ABA animals compared to controls. In addition, the mean number of astrocytes was reduced by over 50% in the cerebral cortex and corpus callosum, while the mean number of neurons was unchanged. Furthermore, mean astrocytic GFAP mRNA expression was similarly reduced in the ABA animals, as was the mean cell proliferation rate, whereas the mean apoptosis rate did not increase. After refeeding, the starvation-induced effects were almost completely reversed. The observation of the astrocyte reduction in our AN animal model is an important new finding that could help explain starvation-induced neuropsychological changes in patients with AN. Astrocyte-targeted research and interventions could become a new focus for both AN research and therapy.
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25
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Travis KE, Castro MRH, Berman S, Dodson CK, Mezer AA, Ben-Shachar M, Feldman HM. More than myelin: Probing white matter differences in prematurity with quantitative T1 and diffusion MRI. Neuroimage Clin 2019; 22:101756. [PMID: 30901711 PMCID: PMC6428958 DOI: 10.1016/j.nicl.2019.101756] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 03/03/2019] [Accepted: 03/09/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVE We combined diffusion MRI (dMRI) with quantitative T1 (qT1) relaxometry in a sample of school-aged children born preterm and full term to determine whether reduced fractional anisotropy (FA) within the corpus callosum of the preterm group could be explained by a reduction in myelin content, as indexed by R1 (1/T1) from qT1 scans. METHODS 8-year-old children born preterm (n = 29; GA 22-32 weeks) and full term (n = 24) underwent dMRI and qT1 scans. Four subdivisions of the corpus callosum were segmented in individual native space according to cortical projection zones (occipital, temporal, motor and anterior-frontal). Fractional anisotropy (FA) and R1 were quantified along the tract trajectory of each subdivision and compared across two birth groups. RESULTS Compared to controls, preterm children demonstrated significantly decreased FA in 3 of 4 analyzed corpus callosum subdivisions (temporal, motor, and anterior frontal segments) and decreased R1 in only 2 of 4 corpus callosum subdivisions (temporal and motor segments). FA and RD were significantly associated with R1 within temporal but not anterior frontal subdivisions of the corpus callosum in the term group; RD correlated with R1 in the anterior subdivision in the preterm group only. CONCLUSIONS Myelin content, as indexed by R1, drives some but not all of the differences in white matter between preterm and term born children. Other factors, such as axonal diameter and directional coherence, likely contributed to FA differences in the anterior frontal segment of the corpus callosum that were not well explained by R1.
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Affiliation(s)
- Katherine E Travis
- Division of Developmental and Behavioral Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Maria R H Castro
- Division of Developmental and Behavioral Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Shai Berman
- Edmond and Lily Safra Center for Brain Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Cory K Dodson
- Division of Developmental and Behavioral Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Aviv A Mezer
- Edmond and Lily Safra Center for Brain Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Michal Ben-Shachar
- The Gonda Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, Israel; Department of English Literature and Linguistics, Bar Ilan University, Ramat Gan, Israel
| | - Heidi M Feldman
- Division of Developmental and Behavioral Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
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26
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Barona M, Brown M, Clark C, Frangou S, White T, Micali N. White matter alterations in anorexia nervosa: Evidence from a voxel-based meta-analysis. Neurosci Biobehav Rev 2019; 100:285-295. [PMID: 30851283 DOI: 10.1016/j.neubiorev.2019.03.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 02/08/2019] [Accepted: 03/05/2019] [Indexed: 02/06/2023]
Abstract
Anorexia nervosa (AN) is a severe psychiatric disorder with a complex and poorly understood etiology. Recent studies have sought to investigate differences in white matter microstructure in AN, with significant results in several brain regions. A systematic literature search of Embase, PubMed and Psychinfo databases was conducted in order to identify Diffusion Tensor Imaging (DTI) studies of patients with AN and controls. We performed a meta-analysis of studies that met our inclusion criteria (N = 13) using effect size-signed differential mapping (AES-SDM) to detect differences in Fractional Anisotropy (FA) in patients with AN (N = 227) compared to healthy controls (N = 243). The quantitative meta-analysis of DTI studies identified decreased FA in the posterior areas of the corpus callosum, the left superior longitudinal fasciculus II, and the left precentral gyrus, as well as increased FA in the right cortico-spinal projections, and lingual gyrus in AN vs. controls. Studies of WM architecture are still limited in AN; further studies with longitudinal design are needed to better understand the complexity of abnormalities, and their persistence.
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Affiliation(s)
- Manuela Barona
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Melanie Brown
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| | | | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Tonya White
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Nadia Micali
- UCL Great Ormond Street Institute of Child Health, London, UK; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA; Department of Psychiatry, University of Geneva, Geneva, Switzerland.
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27
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Olivo G, Swenne I, Zhukovsky C, Tuunainen A, Saaid A, Salonen‐Ros H, Larsson E, Brooks SJ, Schiöth HB. Preserved white matter microstructure in adolescent patients with atypical anorexia nervosa. Int J Eat Disord 2019; 52:166-174. [PMID: 30676658 PMCID: PMC6590352 DOI: 10.1002/eat.23012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 12/10/2018] [Accepted: 12/17/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Patients with atypical anorexia nervosa (AN) are often in the normal-weight range at presentation; however, signs of starvation and medical instability are not rare. White matter (WM) microstructural correlates of atypical AN have not yet been investigated, leaving an important gap in our knowledge regarding the neural pathogenesis of this disorder. METHOD We investigated WM microstructural integrity in 25 drug-naïve adolescent patients with atypical AN and 25 healthy controls, using diffusion tensor imaging (DTI) with a tract-based spatial statistics (TBSS) approach. Psychological variables related to the eating disorder and depressive symptoms were also evaluated by administering the eating disorder examination questionnaire (EDE-Q) and the Montgomery-Åsberg depression rating scale (MADRS-S) respectively, to all participants. RESULTS Patients and controls were in the normal-weight range and did not differ from the body mass index standard deviations for their age. No between groups difference in WM microstructure could be detected. DISCUSSION Our findings support the hypothesis that brain structural alterations may not be associated to early-stage atypical AN. These findings also suggest that previous observations of alterations in WM microstructure in full syndrome AN may constitute state-related consequences of severe weight loss. Whether the preservation of WM structure is a pathogenetically discriminant feature of atypical AN or only an effect of a less severe nutritional disturbance, will have to be verified by future studies on larger samples, possibly directly comparing AN and atypical AN.
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Affiliation(s)
- Gaia Olivo
- Department of Neuroscience, Functional PharmacologyUppsala UniversityUppsalaSweden
| | - Ingemar Swenne
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - Christina Zhukovsky
- Department of Neuroscience, Functional PharmacologyUppsala UniversityUppsalaSweden
| | - Anna‐Kaisa Tuunainen
- Department of Neuroscience, Functional PharmacologyUppsala UniversityUppsalaSweden
| | - Avista Saaid
- Department of Neuroscience, Functional PharmacologyUppsala UniversityUppsalaSweden
| | - Helena Salonen‐Ros
- Department of Neuroscience, Child and Adolescent PsychiatryUppsala UniversityUppsalaSweden
| | - Elna‐Marie Larsson
- Department of Surgical Sciences, RadiologyUppsala UniversityUppsalaSweden
| | - Samantha J. Brooks
- Department of Human BiologyUniversity of Cape TownCape TownSouth Africa,School of Natural Sciences and PsychologyResearch Centre for Brain & BehaviourLiverpoolUnited Kingdom
| | - Helgi B. Schiöth
- Department of Neuroscience, Functional PharmacologyUppsala UniversityUppsalaSweden
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28
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Bohon C, Weinbach N, Lock J. A Protocol for Integrating Neuroscience Into Studies of Family-Based Treatment for Anorexia Nervosa: An Approach to Research and Potential Benefits for Clinical Care. Front Psychiatry 2019; 10:919. [PMID: 31920765 PMCID: PMC6930315 DOI: 10.3389/fpsyt.2019.00919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 11/19/2019] [Indexed: 11/16/2022] Open
Abstract
Anorexia nervosa (AN) is a life-threatening disorder with peak onset during adolescence. Prior research supports the effectiveness of family-based treatment (FBT) for AN in adolescents, but studies do not regularly include neuroimaging to investigate the effects of FBT on the brain. This is important because we know that malnutrition has a detrimental impact on brain volume, cortical thickness, and function, which often recover with weight restoration. Additionally, early weight gain in FBT has emerged as a robust predictor of treatment outcome, yet it is unclear whether it is associated with neural change. Understanding neural change during treatment, particularly in the early weeks, has the potential to improve outcome by enhancing motivation for rapid behavior change, while also highlighting mechanisms by which early treatment response leads to improved outcome. This manuscript describes a study protocol and discusses both challenges and implications for this type of integrative research.
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Affiliation(s)
- Cara Bohon
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Noam Weinbach
- Department Psychology, University of Haifa, Haifa, Israel
| | - James Lock
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
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29
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Phillipou A, Carruthers SP, Di Biase MA, Zalesky A, Abel LA, Castle DJ, Gurvich C, Rossell SL. White matter microstructure in anorexia nervosa. Hum Brain Mapp 2018; 39:4385-4392. [PMID: 29964345 DOI: 10.1002/hbm.24279] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 06/03/2018] [Accepted: 06/05/2018] [Indexed: 01/04/2023] Open
Abstract
The neurobiological underpinnings of anorexia nervosa (AN) are unclear. White matter deficits have been described in the illness, but findings are inconsistent between studies. The aim of this study was to investigate differences in white matter microstructure in AN using diffusion-weighted imaging (DWI). It was hypothesised that people with AN, relative to a healthy control (HC) group, would show decreased functional anisotropy (FA) and increased mean diffusivity (MD) in the fornix and superior longitudinal fasciculus, consistent with previous literature. Analyses were conducted on 23 females with AN and 26 age- and gender-matched HCs using tract-based spatial statistics (TBSS). The results revealed widespread FA decreases and MD increases in the AN group. Our hypothesis was largely supported, although FA differences were not specifically found in the fornix. The findings suggest extensive differences in white matter structure in AN, which may contribute to AN pathophysiology.
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Affiliation(s)
- Andrea Phillipou
- Department of Optometry & Vision Sciences, The University of Melbourne, Melbourne, Australia.,Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,Department of Mental Health, Austin Health, Melbourne, Australia.,Department of Mental Health, St Vincent's Hospital, Melbourne, Australia.,Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Sean P Carruthers
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia.,Monash Alfred Psychiatry Research Centre, Monash University & The Alfred Hospital, Melbourne, Australia
| | - Maria A Di Biase
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard, Medical School, Massachusetts.,Melbourne Neuropsychiatry Centre, The University of Melbourne, Melbourne, Australia
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, The University of Melbourne, Melbourne, Australia
| | - Larry A Abel
- Department of Optometry & Vision Sciences, The University of Melbourne, Melbourne, Australia
| | - David J Castle
- Department of Psychiatry, The University of Melbourne, Melbourne, Australia.,Department of Mental Health, St Vincent's Hospital, Melbourne, Australia
| | - Caroline Gurvich
- Monash Alfred Psychiatry Research Centre, Monash University & The Alfred Hospital, Melbourne, Australia
| | - Susan L Rossell
- Department of Mental Health, St Vincent's Hospital, Melbourne, Australia.,Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia.,Monash Alfred Psychiatry Research Centre, Monash University & The Alfred Hospital, Melbourne, Australia
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Structural Neuroimaging of Anorexia Nervosa: Future Directions in the Quest for Mechanisms Underlying Dynamic Alterations. Biol Psychiatry 2018; 83:224-234. [PMID: 28967386 PMCID: PMC6053269 DOI: 10.1016/j.biopsych.2017.08.011] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 07/21/2017] [Accepted: 08/14/2017] [Indexed: 02/07/2023]
Abstract
Anorexia nervosa (AN) is a serious eating disorder characterized by self-starvation and extreme weight loss. Pseudoatrophic brain changes are often readily visible in individual brain scans, and AN may be a valuable model disorder to study structural neuroplasticity. Structural magnetic resonance imaging studies have found reduced gray matter volume and cortical thinning in acutely underweight patients to normalize following successful treatment. However, some well-controlled studies have found regionally greater gray matter and persistence of structural alterations following long-term recovery. Findings from diffusion tensor imaging studies of white matter integrity and connectivity are also inconsistent. Furthermore, despite the severity of AN, the number of existing structural neuroimaging studies is still relatively low, and our knowledge of the underlying cellular and molecular mechanisms for macrostructural brain changes is rudimentary. We critically review the current state of structural neuroimaging in AN and discuss the potential neurobiological basis of structural brain alterations in the disorder, highlighting impediments to progress, recent developments, and promising future directions. In particular, we argue for the utility of more standardized data collection, adopting a connectomics approach to understanding brain network architecture, employing advanced magnetic resonance imaging methods that quantify biomarkers of brain tissue microstructure, integrating data from multiple imaging modalities, strategic longitudinal observation during weight restoration, and large-scale data pooling. Our overarching objective is to motivate carefully controlled research of brain structure in eating disorders, which will ultimately help predict therapeutic response and improve treatment.
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Pfuhl G, King JA, Geisler D, Roschinski B, Ritschel F, Seidel M, Bernardoni F, Müller DK, White T, Roessner V, Ehrlich S. Preserved white matter microstructure in young patients with anorexia nervosa? Hum Brain Mapp 2018; 37:4069-4083. [PMID: 27400772 DOI: 10.1002/hbm.23296] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 06/13/2016] [Accepted: 06/15/2016] [Indexed: 02/06/2023] Open
Abstract
A massive but reversible reduction of cortical thickness and subcortical gray matter (GM) volumes in Anorexia Nervosa (AN) has been recently reported. However, the literature on alterations in white matter (WM) volume and microstructure changes in both acutely underweight AN (acAN) and after recovery (recAN) is sparse and results are inconclusive. Here, T1-weighted and diffusion-weighted MRI data in a sizable sample of young and medication-free acAN (n = 35), recAN (n = 32), and age-matched female healthy controls (HC, n = 62) were obtained. For analysis, a well-validated global probabilistic tractography reconstruction algorithm including rigorous motion correction implemented in FreeSurfer: TRACULA (TRActs Constrained by UnderLying Anatomy) were used. Additionally, a clustering algorithm and a multivariate pattern classification technique to WM metrics to predict group membership were applied. No group differences in either WM volume or WM microstructure were detected with standard analysis procedures either in acAN or recAN relative to HC after controlling for the number of performed statistical tests. These findings were not affected by age, IQ, or psychiatric symptoms. While cluster analysis was unsuccessful at discriminating between groups, multivariate pattern classification showed some ability to separate acAN from HC (but not recAN from HC). However, these results were not compatible with a straightforward hypothesis of impaired WM microstructure. The current findings suggest that WM integrity is largely preserved in non-chronic AN. This finding stands in contrast to findings in GM, but may help to explain the relatively intact cognitive performance of young patients with AN and provide the basis for the fast recovery of GM structures. Hum Brain Mapp 37:4069-4083, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Gerit Pfuhl
- Eating Disorders Research and Treatment Center at the Dept. of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Department of Psychology, UiT the Arctic University of Norway & Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Joseph A King
- Eating Disorders Research and Treatment Center at the Dept. of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Daniel Geisler
- Eating Disorders Research and Treatment Center at the Dept. of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Benjamin Roschinski
- Eating Disorders Research and Treatment Center at the Dept. of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Franziska Ritschel
- Eating Disorders Research and Treatment Center at the Dept. of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Maria Seidel
- Eating Disorders Research and Treatment Center at the Dept. of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Fabio Bernardoni
- Eating Disorders Research and Treatment Center at the Dept. of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Dirk K Müller
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Tonya White
- Department of Child and Adolescent Psychiatry & Department of Radiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Veit Roessner
- Eating Disorders Research and Treatment Center at the Dept. of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Stefan Ehrlich
- Eating Disorders Research and Treatment Center at the Dept. of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany. .,Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany. .,MGH/MIT/HMS Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts. .,Harvard Medical School, Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.
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Seitz J, Konrad K, Herpertz-Dahlmann B. Extend, Pathomechanism and Clinical Consequences of Brain Volume Changes in Anorexia Nervosa. Curr Neuropharmacol 2018; 16:1164-1173. [PMID: 29119931 PMCID: PMC6187749 DOI: 10.2174/1570159x15666171109145651] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 01/01/1970] [Accepted: 11/07/2017] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Brain volume deficits of grey matter (GM) and white matter (WM) are often found in patients with anorexia nervosa (AN). However, until recently, little was known about the influencing factors of these brain volume alterations, nor their exact quantification and rehabilitation. METHODS This review addresses these open questions and further explores what is now known about the underlying pathobiology and the clinical consequences including human studies as well as animal studies mimicking anorexia nervosa in rodents. RESULTS GM was reduced by 3.7% in adults and 7.6% in adolescents with AN. WM was reduced on average 2.2% in adult patients and 3.2% in adolescents. Most volume deficits in adults are reversible after long-term recovery; for adolescents, data are less clear. The main influencing factors for GM were absolute lowest weight at admission and illness duration. Cerebellar and WM reductions at admission predicted clinical outcome at one year follow-up. New studies found GABA receptor changes in GM and astrocyte loss in both GM and WM, as well as a possible role for oestrogen deficit. All three could partly explain clinical symptoms of anxiety, rigidity and learning impairments in patients with AN. CONCLUSION Brain volume deficits in AN seem to play a causal role in the course and the prognosis of AN. A better understanding of these brain changes could lead to more targeted therapies for patients with AN, including astrocyte-directed approaches.
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Affiliation(s)
- Jochen Seitz
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, Aachen, Germany
| | - Kerstin Konrad
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, Aachen, Germany
| | - Beate Herpertz-Dahlmann
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, Aachen, Germany
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Bang L, Rø Ø, Endestad T. Normal white matter microstructure in women long-term recovered from anorexia nervosa: A diffusion tensor imaging study. Int J Eat Disord 2018; 51:46-52. [PMID: 29120488 DOI: 10.1002/eat.22802] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 10/25/2017] [Accepted: 10/26/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Studies point to white matter (WM) microstructure alterations in both adolescent and adult patients with anorexia nervosa (AN). These include reduced fractional anisotropy in several WM fiber tracts, suggesting reduced WM integrity. The extent to which these alterations are reversible with recovery from AN is unclear. There is a paucity of research investigating the presence of WM microstructure alterations in recovered AN patients, and results are inconsistent. This study aimed to investigate the presence of WM microstructure alterations in women long-term recovered from AN. METHOD Twenty-one adult women who were recovered from AN for at least 1 year were compared to 21 adult comparison women. Participants were recruited via user-organizations for eating disorders, local advertisements, and online forums. Diffusion tensor imaging was used to compare WM microstructure between groups. Correlations between WM microstructure and clinical characteristics were also explored. RESULTS There were no statistically significant between-group differences in WM microstructure. These null findings remained when employing liberal alpha level thresholds. Furthermore, there were no statistically significant correlations between WM microstructure and clinical characteristics. DISCUSSION Our findings showed normal WM microstructure in long-term recovered patients, indicating the alterations observed during the acute phase are reversible. Given the paucity of research and inconsistent findings, future studies are warranted to determine the presence of WM microstructure alterations following recovery from AN.
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Affiliation(s)
- Lasse Bang
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, P.O. Box 4956 Nydalen, Oslo, 0424, Norway
| | - Øyvind Rø
- Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, P.O. Box 4956 Nydalen, Oslo, 0424, Norway.,Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, P.O. Box 1171 Blindern, Oslo, 0318, Norway
| | - Tor Endestad
- Institute of Psychology, University of Oslo, P.O. Box 1094 Blindern, Oslo, 0317, Norway
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Gaudio S, Quattrocchi CC, Piervincenzi C, Zobel BB, Montecchi FR, Dakanalis A, Riva G, Carducci F. White matter abnormalities in treatment-naive adolescents at the earliest stages of Anorexia Nervosa: A diffusion tensor imaging study. Psychiatry Res Neuroimaging 2017; 266:138-145. [PMID: 28666248 DOI: 10.1016/j.pscychresns.2017.06.011] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 05/21/2017] [Accepted: 06/18/2017] [Indexed: 11/21/2022]
Abstract
Few studies have examined white matter (WM) integrity in long-lasting Anorexia Nervosa (AN) patients using Diffusion Tensor Imaging (DTI). In this paper, we investigated WM integrity at the earliest stages of AN (i.e. less than 6 months duration). Fourteen treatment-naive female adolescents with AN restrictive type (AN-r) in its earliest stages and 15 age-matched healthy females received brain MRI. Fractional Anisotropy (FA), Axial Diffusivity (AD), Radial diffusivity (RD), and Mean Diffusivity (MD) maps were computed from DTI data using Tract-Based Spatial Statistics analysis. AN-r patients showed FA decreases compared to controls (pFWE < 0.05) mainly in left anterior and superior corona radiata and left superior longitudinal fasciculus. AN-r patients also showed decreased AD in superior longitudinal fasciculus bilaterally and left superior and anterior corona radiata, (pFWE < 0.05). No significant differences were found in RD and MD values between the two groups. FA and AD integrity appears to be specifically affected at the earliest stages of AN. Alterations in the microstructural properties of the above mentioned tracts, also involved in cognitive control and visual perception and processing, may be early mechanisms of vulnerability/resilience of WM in AN and sustain the key symptoms of AN, such as impaired cognitive flexibility and body image distortion.
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Affiliation(s)
- Santino Gaudio
- Departmental Faculty of Medicine and Surgery, Università "Campus Bio-Medico di Roma", Rome, Italy; Eating Disorders Centre "La Cura del Girasole" ONLUS, Rome, Italy; Department of Neuroscience, Functional Pharmacology, Uppsala University, BMC, Box 593, 751 24 Uppsala, Sweden.
| | - Carlo Cosimo Quattrocchi
- Departmental Faculty of Medicine and Surgery, Università "Campus Bio-Medico di Roma", Rome, Italy
| | - Claudia Piervincenzi
- Department of Physiology and Pharmacology, Neuroimaging Laboratory, Sapienza University, Rome, Italy
| | - Bruno Beomonte Zobel
- Departmental Faculty of Medicine and Surgery, Università "Campus Bio-Medico di Roma", Rome, Italy
| | | | - Antonios Dakanalis
- Department of Brain and Behavioural Sciences, University of Pavia, P.za Botta 11, 27100 Pavia, Italy; Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy; Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Filippo Carducci
- Department of Physiology and Pharmacology, Neuroimaging Laboratory, Sapienza University, Rome, Italy
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Dodson CK, Travis KE, Ben-Shachar M, Feldman HM. White matter microstructure of 6-year old children born preterm and full term. NEUROIMAGE-CLINICAL 2017; 16:268-275. [PMID: 28840098 PMCID: PMC5558468 DOI: 10.1016/j.nicl.2017.08.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 08/04/2017] [Accepted: 08/07/2017] [Indexed: 01/03/2023]
Abstract
AIM We previously observed a complex pattern of differences in white matter (WM) microstructure between preterm-born (PT) and full-term-born (FT) children and adolescents age 9-17 years. The aim of this study was to determine if the same differences exist as early as age 6 years. METHOD We obtained diffusion MRI (dMRI) scans in children born PT at age 6 years (n = 20; 11 males) and FT (n = 38; 14 males), using two scanning protocols: 30 diffusion directions (b = 1000 s/mm2) and 96 diffusion directions (b = 2500 s/mm2). We used deterministic tractography and analyzed fractional anisotropy (FA) along bilateral cerebral WM pathways that demonstrated differences in the older sample. RESULTS Compared to the FT group, the PT group showed (1) significantly decreased FA in the uncinate fasciculi and forceps major and (2) significantly increased FA in the right anterior thalamic radiation, inferior fronto-occipital fasciculi, and inferior longitudinal fasciculi. This pattern of group differences resembles findings in the previous study of older PT and FT participants. Group differences were similar across dMRI acquisition protocols. INTERPRETATION The underlying neurobiology driving the pattern of PT-FT differences in FA is present as early as age 6 years. Generalization across dMRI acquisition protocols demonstrates the robustness of group differences in FA. Future studies will use quantitative neuroimaging techniques to understand the tissue properties that give rise to this consistent pattern of WM differences after PT birth.
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Affiliation(s)
- Cory K Dodson
- Division of Developmental and Behavioral Medicine, Department of Pediatrics, Stanford University School of Medicine, 1265 Welch Road X119, Stanford, CA 94305, USA
| | - Katherine E Travis
- Division of Developmental and Behavioral Medicine, Department of Pediatrics, Stanford University School of Medicine, 1265 Welch Road X119, Stanford, CA 94305, USA
| | - Michal Ben-Shachar
- The Gonda Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan 5290002, Israel.,Department of English Literature and Linguistics, Bar Ilan University, 5290002 Ramat Gan, Israel
| | - Heidi M Feldman
- Division of Developmental and Behavioral Medicine, Department of Pediatrics, Stanford University School of Medicine, 1265 Welch Road X119, Stanford, CA 94305, USA
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Olivo G, Wiemerslage L, Swenne I, Zhukowsky C, Salonen-Ros H, Larsson EM, Gaudio S, Brooks SJ, Schiöth HB. Limbic-thalamo-cortical projections and reward-related circuitry integrity affects eating behavior: A longitudinal DTI study in adolescents with restrictive eating disorders. PLoS One 2017; 12:e0172129. [PMID: 28248991 PMCID: PMC5332028 DOI: 10.1371/journal.pone.0172129] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 01/31/2017] [Indexed: 12/20/2022] Open
Abstract
Few studies have used diffusion tensor imaging (DTI) to investigate the micro-structural alterations of WM in patients with restrictive eating disorders (rED), and longitudinal data are lacking. Twelve patients with rED were scanned at diagnosis and after one year of family-based treatment, and compared to twenty-four healthy controls (HCs) through DTI analysis. A tract-based spatial statistics procedure was used to investigate diffusivity parameters: fractional anisotropy (FA) and mean, radial and axial diffusivities (MD, RD and AD, respectively). Reduced FA and increased RD were found in patients at baseline in the corpus callosum, corona radiata and posterior thalamic radiation compared with controls. However, no differences were found between follow-up patients and controls, suggesting a partial normalization of the diffusivity parameters. In patients, trends for a negative correlation were found between the baseline FA of the right anterior corona radiata and the Eating Disorder Examination Questionnaire total score, while a positive trend was found between the baseline FA in the splenium of corpus callosum and the weight loss occurred between maximal documented weight and time of admission. A positive trend for correlation was also found between baseline FA in the right anterior corona radiata and the decrease in the Obsessive-Compulsive Inventory Revised total score over time. Our results suggest that the integrity of the limbic–thalamo–cortical projections and the reward-related circuitry are important for cognitive control processes and reward responsiveness in regulating eating behavior.
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Affiliation(s)
- Gaia Olivo
- Department of Neuroscience, Functional Pharmacology, Uppsala University, Uppsala, Sweden
- * E-mail:
| | - Lyle Wiemerslage
- Department of Neuroscience, Functional Pharmacology, Uppsala University, Uppsala, Sweden
| | - Ingemar Swenne
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Christina Zhukowsky
- Department of Neuroscience, Functional Pharmacology, Uppsala University, Uppsala, Sweden
| | - Helena Salonen-Ros
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Elna-Marie Larsson
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
| | - Santino Gaudio
- Department of Neuroscience, Functional Pharmacology, Uppsala University, Uppsala, Sweden
- Centre for Integrated Research (CIR), Area of Diagnostic Imaging, Università “Campus Bio-Medico di Roma”, Rome, Italy
| | - Samantha J. Brooks
- Deptartment of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Helgi B. Schiöth
- Department of Neuroscience, Functional Pharmacology, Uppsala University, Uppsala, Sweden
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Track-weighted imaging methods: extracting information from a streamlines tractogram. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2017; 30:317-335. [DOI: 10.1007/s10334-017-0608-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 01/22/2017] [Accepted: 01/23/2017] [Indexed: 12/13/2022]
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White matter properties differ in 6-year old Readers and Pre-readers. Brain Struct Funct 2016; 222:1685-1703. [PMID: 27631434 DOI: 10.1007/s00429-016-1302-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 09/01/2016] [Indexed: 10/21/2022]
Abstract
Reading, an essential life skill in modern society, is typically learned during childhood. Adults who can read show white matter differences compared to adults who never learned to read. Studies have not established whether children who can read show similar white matter differences compared to children who cannot read. We compared 6-year old children who could decode written English words and pseudowords (n = 31; Readers) and 6-year old children who could not decode pseudowords and had a standard score <100 on a task for reading single words (n = 11; Pre-readers). We employed diffusion MRI and tractography to extract fractional anisotropy (FA) along the trajectory of six bilateral intra-hemispheric tracts and two posterior subdivisions of the corpus callosum. Readers demonstrated significantly increased FA within the left anterior segment of the superior longitudinal fasciculus (aSLF-L) and the right uncinate fasciculus (UF-R) compared to Pre-readers. FA in the aSLF-L was significantly correlated with phonological awareness; FA in the UF-R was significantly correlated with language. Correlations in the UF-R but not the aSLF-L remained significant after controlling for reading ability, revealing that UF-R group differences were related to both children's language and reading abilities. Taken together, these findings demonstrate new evidence showing that individual differences in white matter structure relate to whether children have begun to read.
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Psomiades M, Fonteneau C, Mondino M, Luck D, Haesebaert F, Suaud-Chagny MF, Brunelin J. Integrity of the arcuate fasciculus in patients with schizophrenia with auditory verbal hallucinations: A DTI-tractography study. NEUROIMAGE-CLINICAL 2016; 12:970-975. [PMID: 27995063 PMCID: PMC5153606 DOI: 10.1016/j.nicl.2016.04.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 04/25/2016] [Accepted: 04/27/2016] [Indexed: 12/15/2022]
Abstract
Auditory verbal hallucinations (AVH) of schizophrenia are associated with a disrupted connectivity between frontal and temporoparietal language areas. We hypothesized that this dysconnectivity is underpinned by white matter abnormalities in the left arcuate fasciculus, the main fiber bundle connecting speech production and perception areas. We therefore investigated the relationship between AVH severity and the integrity of the arcuate fasciculus measured by diffusion tensor imaging (DTI) tractography in patients with schizophrenia. Thirty-eight patients with treatment-resistant schizophrenia were included: 26 presented with daily severe treatment-resistant AVH, 12 reported prominent negative symptoms and no AVH. Fractional anisotropy (FA) was measured along the length of the left and right anterior arcuate fasciculi and severity of AVH was assessed using P3 PANSS item. FA values were significantly higher in the left arcuate fasciculus in patients with AVH than in no AVH patients (F(1,35) = 3.86; p = 0.05). No difference was observed in the right arcuate fasciculus. There was a significant positive correlation between FA value in the left arcuate fasciculus and the severity of AVH (r = 0.36; p = 0.02). No correlation was observed between FA values and PANSS total score suggesting a specific relationship between AVH severity and the left arcuate fasciculus integrity. These results support the hypothesis of a relationship between left frontotemporal connectivity and AVH in patients with schizophrenia and suggest that whilst a disruption of frontotemporal connectivity might be present to ensure the emergence of AVH, more severe anatomical alterations may prevent the occurrence of AVH in patients with schizophrenia. Fractional anisotropy (FA) in the left arcuate fasciculus (AF) correlated with severity of hallucinations. Hallucinating patients had greater FA in the left AF than non-hallucinating patients. We did not find any association between hallucinations and FA in the right AF.
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Affiliation(s)
- Marion Psomiades
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Bron, France
| | - Clara Fonteneau
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Bron, France
| | - Marine Mondino
- Centre Interdisciplinaire de Recherche en Réadaptation et en Intégration Sociale (CIRRIS), Centre de Recherche de l'Institut Universitaire en Santé Mentale (CRIUSM), Université Laval, Québec, QC, Canada
| | - David Luck
- Institut Universitaire en Santé Mentale de Montréal Research Center, Québec, QC, Canada; Department of Psychiatry, University of Montreal, QC, Canada
| | - Frederic Haesebaert
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Bron, France
| | - Marie-Françoise Suaud-Chagny
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Bron, France
| | - Jerome Brunelin
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, Centre Hospitalier Le Vinatier, Université Claude Bernard Lyon 1, Bron, France; Centre Interdisciplinaire de Recherche en Réadaptation et en Intégration Sociale (CIRRIS), Centre de Recherche de l'Institut Universitaire en Santé Mentale (CRIUSM), Université Laval, Québec, QC, Canada
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40
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Vogel K, Timmers I, Kumar V, Nickl-Jockschat T, Bastiani M, Roebroek A, Herpertz-Dahlmann B, Konrad K, Goebel R, Seitz J. White matter microstructural changes in adolescent anorexia nervosa including an exploratory longitudinal study. Neuroimage Clin 2016; 11:614-621. [PMID: 27182488 PMCID: PMC4857215 DOI: 10.1016/j.nicl.2016.04.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 03/12/2016] [Accepted: 04/05/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND Anorexia nervosa (AN) often begins in adolescence, however, the understanding of the underlying pathophysiology at this developmentally important age is scarce, impeding early interventions. We used diffusion tensor imaging (DTI) to investigate microstructural white matter (WM) brain changes including an experimental longitudinal follow-up. METHODS We acquired whole brain diffusion-weighted brain scans of 22 adolescent female hospitalized patients with AN at admission and nine patients longitudinally at discharge after weight rehabilitation. Patients (10-18 years) were compared to 21 typically developing controls (TD). Tract-based spatial statistics (TBSS) were applied to compare fractional anisotropy (FA) across groups and time points. Associations between average FA values of the global WM skeleton and weight as well as illness duration parameters were analyzed by multiple linear regression. RESULTS We observed increased FA in bilateral frontal, parietal and temporal areas in AN patients at admission compared to TD. Higher FA of the global WM skeleton at admission was associated with faster weight loss prior to admission. Exploratory longitudinal analysis showed this FA increase to be partially normalized after weight rehabilitation. CONCLUSIONS Our findings reveal a markedly different pattern of WM microstructural changes in adolescent AN compared to most previous results in adult AN. This could signify a different susceptibility and reaction to semi-starvation in the still developing brain of adolescents or a time-dependent pathomechanism differing with extend of chronicity. Higher FA at admission in adolescents with AN could point to WM fibers being packed together more closely.
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Affiliation(s)
- Katja Vogel
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital, RWTH Aachen University, Neuenhofer Weg 21, 52074 Aachen, Germany
| | - Inge Timmers
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Vinod Kumar
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany; JARA-Translational Brain Medicine (The Jülich Aachen Research Alliance), Forschungszentrum Jülich GmbH, 52425 Jülich, Germany
| | - Thomas Nickl-Jockschat
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany; JARA-Translational Brain Medicine (The Jülich Aachen Research Alliance), Forschungszentrum Jülich GmbH, 52425 Jülich, Germany
| | - Matteo Bastiani
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands; Oxford Centre for Functional MRI of the Brain, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom
| | - Alard Roebroek
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Beate Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital, RWTH Aachen University, Neuenhofer Weg 21, 52074 Aachen, Germany
| | - Kerstin Konrad
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital, RWTH Aachen University, Neuenhofer Weg 21, 52074 Aachen, Germany
| | - Rainer Goebel
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Jochen Seitz
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital, RWTH Aachen University, Neuenhofer Weg 21, 52074 Aachen, Germany; Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
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