Attachment status is associated with grey matter recovery in adolescent anorexia nervosa: Findings from a longitudinal study. (12th February 2022) - Lenhart, Lukas
Abstract: The aim of the present study was to investigate whether grey matter (GM) reductions in acute anorexia nervosa (AN) are (i) valid for adolescents (age 14–18 years), (ii) reversible following short‐term psychotherapeutic and nutritional therapy and (iii) depend on psychological components like attachment trauma. 3T MRI including a high‐resolution T1 MPRAGE was performed in 22 female adolescents in the acute state of AN (age: 15.2 ± 1.2 years) and after weight restoration (duration: 2.6 ± 1 months, n = 18) and compared with 18 gender‐matched healthy controls. The Adult Attachment Projective Picture System was used to classify resolved and unresolved attachment patterns. GM decreases were localized in extensive cortical areas including the insula, prefrontal and cingulate cortices as well as subcortical regions during acute AN, which partially increased after therapy with a relative sparing of the hippocampus and parahippocampal gyrus. The resolved group showed more GM recovery in regions of the left hippocampus and parahippocampal gyrus, bilateral cerebellar regions, right precuneus and adjacent cingulate cortices relative to the unresolved pattern. Structural anomalies in adolescent AN that recovered after treatment may be primarily the consequence of malnutrition, whereas several regions did not display significant recovery. Attachment status seems to influence region‐specific GM recovery. Abstract : Initial grey matter reductions in regions that are considered as crucial components of anorexia nervosa are shown to mainly recover after weight restoration in adolescence. Nevertheless, several brain regions remain at decreased levels after treatment. Patients with attachment trauma demonstrate less grey matter recovery in regions of the right precuneus/posterior cingulate, as well as the left hippocampus, left parahippocampal gyrus and cerebellar areas after weight recovery suggesting that attachment patterns might contribute to region‐specific grey matter recovery.