Journal
BIOLOGICAL PSYCHIATRY
Volume 92, Issue 9, Pages 730-738Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.biopsych.2022.04.022
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Funding
- Carus Promotionskolleg
- Ministeriode Igualdad [234/09]
- Generalitat de Catalunya [2009 SGR 1119, 2017 SGR 4881]
- National Institutes of Health [R21MH86017, R01MH113588, RC1MH088678, R01MH042984-17A1]
- Biomedical Research Centre
- Alicia Koplowitz Foundation [DN040546]
- German Ministry for Educationand Research [01GV0602, 01GV0623]
- National Institute of Mental Health [R01MH105662, R01MH093535, K23MH080135, R01MH096777, K23MH112949, K23MH118418]
- Centre for Addiction and Mental Health Alternative Funding Plan Innovation Fund
- Swiss Anorexia Nervosa Foundation [19-12, 57-16]
- Palatin Foundation
- Gottfriedand Julia Bangerter-Rhyner-Foundation
- Weston A. Price Foundation
- Carlos III Research Institute of the Spanish Ministry of Health [FIS PI040829]
- National Institute for Health Research Mental Health Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust and King's College London
- German Research Foundation [SI 2087/2-1, BR4852/1-1, EH 367/5-1, EH 367/7-1]
- Research Council of Norway [288083, 223273]
- South-Eastern Norway Regional Health Authority [2019069, 2021070, 500189]
- National Institute of Health Research Senior Investigator Award
- NARSAD Young Investigator Grant from the Brain and Behavior Research Foundation
- Technische Universitaet Dresden [SFB 940]
- European Union [848158]
- National Institutes of Health Big Data to Knowledge award [U54 EB020403]
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Our study found substantial reductions in cortical thickness, subcortical volumes, and cortical surface area in patients with AN. These deficits were associated with lower body mass index in the AN sample and were less pronounced in partially weight-restored patients. These findings underscore the importance of considering weight loss and renutrition in research on AN.
BACKGROUND: The pattern of structural brain abnormalities in anorexia nervosa (AN) is still not well understood. While several studies report substantial deficits in gray matter volume and cortical thickness in acutely underweight patients, others find no differences, or even increases in patients compared with healthy control subjects. Recent weight regain before scanning may explain some of this heterogeneity. To clarify the extent, magnitude, and de-pendencies of gray matter changes in AN, we conducted a prospective, coordinated meta-analysis of multicenter neuroimaging data.METHODS: We analyzed T1-weighted structural magnetic resonance imaging scans assessed with standardized methods from 685 female patients with AN and 963 female healthy control subjects across 22 sites worldwide. In addition to a case-control comparison, we conducted a 3-group analysis comparing healthy control subjects with acutely underweight AN patients (n = 466) and partially weight-restored patients in treatment (n = 251).RESULTS: In AN, reductions in cortical thickness, subcortical volumes, and, to a lesser extent, cortical surface area were sizable (Cohen's d up to 0.95), widespread, and colocalized with hub regions. Highlighting the effects of un-dernutrition, these deficits were associated with lower body mass index in the AN sample and were less pronounced in partially weight-restored patients.CONCLUSIONS: The effect sizes observed for cortical thickness deficits in acute AN are the largest of any psychiatric disorder investigated in the ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis) Consortium to date. These results confirm the importance of considering weight loss and renutrition in biomedical research on AN and underscore the importance of treatment engagement to prevent potentially long-lasting structural brain changes in this population.
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