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. 2025 Nov:191:542-546.
doi: 10.1016/j.jpsychires.2025.09.055. Epub 2025 Oct 4.

Prioritizing brain Metabolism: Evidence from brain temperatures of severe underweight individuals

Arne Doose  1 , Friederike I Tam  2 , Dominic Arold  1 , Carolin Kutzke  1 , Tyler Starr  3 , Veit Roessner  4 , Jennifer Linn  5 , Alexander P Lin  3 , Stefan Ehrlich  6
Affiliations

Prioritizing brain Metabolism: Evidence from brain temperatures of severe underweight individuals

Arne Doose et al. J Psychiatr Res. 2025 Nov.

Abstract

Objective: Severe and prolonged underweight can lead to a hypometabolic state and hormonal adaptations that reduce body temperature often found in Anorexia Nervosa (AN). However, the effect of these changes on brain temperature remains unclear. We aimed to investigate whether brain temperature remains stable despite lower body temperature in a severe underweight state, testing the hypothesis that the brain prioritizes its own energy needs during periods of food deprivation.

Method: We collected magnetic resonance spectroscopy (MRS) measurements from 30 female patients with acute Anorexia Nervosa (acAN) in a severe underweight state and 30 age-matched healthy female control participants (HC). MRS allows for a non-invasive assessment of brain temperature by calculating the difference between the temperature-independent peak of N-acetylaspartate (NAA) and the temperature-dependent peak of water (H20) in each voxel (ΔH20-NAA).

Results: Our results showed no group differences in (ΔH20-NAA) between acAN and HC. This is supported by Bayesian hypothesis testing, providing strong evidence for the absence of lower brain temperatures in severely underweight states.

Conclusion: Our results are an indication that in a state of low energy availability, brain metabolism is prioritized.

Keywords: Anorexia nervosa; Brain temperature; Magnetic resonance spectroscopy; Metabolism.

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Conflict of interest statement

Declaration of competing interest Conflict of interest disclosure. F.T. and S.E. have received research grants from the “Marga and Walter Boll-Stiftung” and the B. Braun Stiftung. F.T. has received funding from the Medical Faculty of the Technische Universität Dresden (“Habilitation Funding for Women”). V.R. has received payment for consulting and writing activities from Eli Lilly and Co., Novartis and Shire Pharmaceuticals/Takeda, lecture honoraria from Eli Lilly and Co., Novartis, Shire Pharmaceuticals/Takeda, and Medice Pharma, and support for research from Shire Pharmaceuticals/Takeda and Novartis. V.R. has carried out (and is currently carrying out) clinical trials in cooperation with Novartis, Shire Pharmaceuticals/Takeda and Otsuka. V.R. has no financial relationship with the organizations that sponsored the research. All other authors reported no conflicts of interest.

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