Dynamic changes in white matter microstructure in anorexia nervosa: findings from a longitudinal study. Issue 9 (28th August 2018)

• Record Type: Journal Article
• Authors: von Schwanenflug, Nina; Müller, Dirk K.; King, Joseph A.; Ritschel, Franziska; Bernardoni, Fabio; Mohammadi, Siawoosh; Geisler, Daniel; Roessner, Veit; Biemann, Ronald; Marxen, Michael; Ehrlich, Stefan
• Is Part Of: Psychological medicine. Volume 49:Issue 9(2019)
• Page Start: 1555
• Page End: 1564
• Publication Date: 2018-08-28
• Subjects: Anorexia nervosa, -- diffusion tensor imaging, -- eating disorders, -- longitudinal, -- magnetic resonance imaging, -- TBSS, -- white matter; Psychiatry -- Periodicals; Medicine and psychology -- Periodicals; Clinical psychology -- Periodicals; 616.89
• DOI: 10.1017/S003329171800212X
• Languages: English
• ISSNs: 0033-2917

Abstract

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.