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[Preprint]. 2024 Nov 13:2024.11.12.24317128.
doi: 10.1101/2024.11.12.24317128.

Neuroimaging Insights into Brain Mechanisms of Early-onset Restrictive Eating Disorders

Clara A Moreau  1 , Anael Ayrolles  2   3 , Christopher R K Ching  4 , Robin Bonicel  2   3 , Alexandre Mathieu  2 , Coline Stordeur  3 , Pierre Bergeret  1 , Nicolas Traut  2 , Lydie Tran  2 , David Germanaud  5   6   7 , Marianne Alison  8 , Monique Elmaleh-Bergès  8 , Stefan Ehrlich  9 , Paul M Thompson  4 , Thomas Bourgeron  2 , Richard Delorme  2   3
Affiliations

Neuroimaging Insights into Brain Mechanisms of Early-onset Restrictive Eating Disorders

Clara A Moreau et al. medRxiv. .

Update in

  • Neuroimaging insights into brain mechanisms of early-onset restrictive eating disorders.
    Moreau CA, Ayrolles A, Ching CRK, Bonicel R, Mathieu A, Stordeur C, El Khantour C, Bergeret P, Traut N, Tran L, Germanaud D, Alison M, Elmaleh-Bergès M, Ehrlich S, Thompson PM, Bourgeron T, Delorme R. Moreau CA, et al. Nat Ment Health. 2025;3(7):780-788. doi: 10.1038/s44220-025-00447-x. Epub 2025 Jun 24. Nat Ment Health. 2025. PMID: 40655158 Free PMC article.

Abstract

Background: Early-onset restrictive eating disorders (rEO-ED) encompass a heterogeneous group of conditions, including early-onset anorexia nervosa (EO-AN) and avoidant restrictive food intake disorders (ARFID). Almost nothing is known about the consequences of rEO-ED on brain development.

Methods: We performed the largest comparison of MRI-derived brain features in children and early adolescents (<13 years) with EO-AN (n=124), ARFID (n=50), and typically developing individuals (TD, n=112).

Results: Despite similar body mass index (BMI) distributions, EO-AN and ARFID showed divergent structural patterns, suggesting independent brain mechanisms. Half the regional brain measures were correlated with BMI in EO-AN and none in ARFID, indicating a partial mediation of EO-AN signal by BMI. EO-AN was associated with a widespread pattern of thinner cortex, while underweight ARFID patients exhibited smaller surface area and subcortical volumes than TD.

Conclusion: Future studies will be required to partition the contribution of low BMI vs. ED mechanisms in neurodevelopmental disorders.

Keywords: Avoidant restrictive food intake disorder; Body Mass Index; Cortical Thickness; Early-onset anorexia nervosa; Structural MRI; Transdiagnostic approaches.

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Conflict of interest statement

Financial Disclosure CAM, AA, RB, AM, CS, PB, NT, LT, DG, MA, MEB, SE, TB, and RD reported no biomedical financial interests or potential conflicts of interest.

Figures

Figure 1.
Figure 1.
Characterization of rEO-EDs’ effect on brain structure A. Effect of EO-AN (dark red dots) and ARFID (yellow dots) on five global brain metrics (ICV: intracranial volume, Total SA: total surface area, Mean CT: mean cortical thickness, CSF: cerebrospinal fluid, Total GV: total gray matter volume). Triangles represent significant effect sizes. B-C. Brain maps (FDR thresholded) showing Cohen’s d values for each of the 68 cortical regions (thickness) and the 16 subcortical regions and ventricles (volumes) for EO-AN versus typically developing individuals (TD) (B) and ARFID versus TD. CT: cortical thickness, SV: subcortical volume.
Figure 2.
Figure 2.
Partition of BMI vs. rEO-ED effects on brain features A. Effects on cortical thickness (CT) and subcortical volumes (SV) of EO-acAN (acutely-ill subgroup, BMI <3rd percentile at scan) versus TD. B. Effects on surface area (SA) and SV of unARFID (underweight subgroup, BMI <3rd percentile at scan) versus TD. C. Effects of the EO-acAN versus unARFID on CT, SA and SV. D. Brain maps summarizing the 84 correlations between BMI and CT (68 cortical regions) as well as SV (14 subcortical regions + 2 lateral ventricles) in EO-AN patients. E. Correlations between residuals (removing the effect of age, sex, and machine) of the thickness of the right middle temporal gyrus and Z-scored BMI in individuals with EO-AN (dark red dots) and ARFID (yellow dots). We selected the right middle temporal gyrus as it showed the highest correlation with BMI in patients with EO-AN.
Figure 3.
Figure 3.
Similarities of the EO-AN brain pattern with additional psychiatric conditions A. Distribution of effect sizes of three psychiatric conditions on regional CT (previously published by the ENIGMA consortium), as well as EO-AN (computed in this study). B. Brain maps representing patterns of abnormalities in CT reported by the ENIGMA consortium for three psychiatric conditions (see methods) and EO-AN. C. Relationship between SNP-based correlations (rG, provided by,) and brain-based correlations (computed in this study). Abbreviations: ADHD: Attention Deficit Hyperactivity Disorder, ASD: Autism Spectrum Disorder, OCD: Obsessive-Compulsive Disorder, CT: Cortical Thickness.
See this image and copyright information in PMC

References

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