Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Feb;52(2):166-174.
doi: 10.1002/eat.23012. Epub 2019 Jan 24.

Preserved white matter microstructure in adolescent patients with atypical anorexia nervosa

Gaia Olivo  1 , Ingemar Swenne  2 , Christina Zhukovsky  1 , Anna-Kaisa Tuunainen  1 , Avista Saaid  1 , Helena Salonen-Ros  3 , Elna-Marie Larsson  4 , Samantha J Brooks  5   6 , Helgi B Schiöth  1
Affiliations

Preserved white matter microstructure in adolescent patients with atypical anorexia nervosa

Gaia Olivo et al. Int J Eat Disord. 2019 Feb.

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.

Keywords: adolescent; anorexia nervosa; brain; cognitive neuroscience; diffusion tensor imaging; feeding and eating disorders; neuroimaging.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Fractional anisotropy increases and decreases in patients with anorexia nervosa. The figure summarizes previous findings relative to fractional anisotropy alterations detected in patients with full‐syndrome anorexia nervosa, compared with age‐matched controls. Several factors, listed in the figure, can disrupt white matter microstructure in adult and adolescent patients. In adolescent patients (left), increases (pink) as well as decreases (blue) in FA values have been variably reported in several white matter structures, and sometimes both increases and decreases have been detected in the same tracts (purple and light blue), such as the corpus callosum, even in the same paper (Travis et al.). Conversely, in adults, FA has been consistently found to be decreased in several structures (blue). The figures have been generated with FSL for illustrative purposes only
Figure 2
Figure 2
Psychometric questionnaires scores in patients compared with controls. The figure shows the mean scores on the EDE‐Q (upper panel) and MADRS‐S (lower panel) questionnaire in patients (blue) and controls (green). The patients scored significantly higher on the (a) EDE‐Q total score and EDE‐Q subscales, namely (b) Restraint, (c) Eating concern, (d) Weight concern, and (e) Shape concern. They did also score significantly higher on the (f) MADRS‐S, compared with controls
See this image and copyright information in PMC

References

    1. Alexander, A. L. , Lee, J. E. , Lazar, M. , & Field, A. S. (2007). Diffusion tensor imaging of the brain. Neurotherapeutics, 4(3), 316–329. 10.1016/j.nurt.2007.05.011 - DOI - PMC - PubMed
    1. American Psychiatric Association . (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
    1. Arain, M. , Haque, M. , Johal, L. , Mathur, P. , Nel, W. , Rais, A. , … Sharma, S. (2013). Maturation of the adolescent brain. Neuropsychiatric Disease and Treatment, 9, 449–461. 10.2147/NDT.S39776 - DOI - PMC - PubMed
    1. Beato‐Fernandez, L. , Rodriguez‐Cano, T. , & Garcia‐Vilches, I. (2011). Psychopathological alterations and neuroimaging findings with discriminant value in eating behavior disorders. Actas Españolas de Psiquiatría, 39(4), 203–210. - PubMed
    1. Beaulieu, C. (2002). The basis of anisotropic water diffusion in the nervous system ‐ a technical review. NMR in Biomedicine, 15(7–8), 435–455. 10.1002/nbm.782 - DOI - PubMed

Publication types