uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Preserved white matter microstructure in adolescent patients with atypical anorexia nervosa
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.ORCID iD: 0000-0002-7514-4493
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Pediatric Endocrinology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.ORCID iD: 0000-0003-4907-4433
Show others and affiliations
2019 (English)In: International Journal of Eating Disorders, ISSN 0276-3478, E-ISSN 1098-108X, Vol. 52, no 2, p. 166-174Article in journal (Refereed) Published
Abstract [en]

Objective: Patients with atypical anorexia nervosa (AN) are often in the normal-weight range at presentation; however, signs of starvation and medical instability are not rare. White matter (WM) microstructural correlates of atypical AN have not yet been investigated, leaving an important gap in our knowledge regarding the neural pathogenesis of this disorder.

Method: We investigated WM microstructural integrity in 25 drug-naive adolescent patients with atypical AN and 25 healthy controls, using diffusion tensor imaging (DTI) with a tract-based spatial statistics (TBSS) approach. Psychological variables related to the eating disorder and depressive symptoms were also evaluated by administering the eating disorder examination questionnaire (EDE-Q) and the Montgomery-angstrom sberg depression rating scale (MADRS-S) respectively, to all participants.

Results: Patients and controls were in the normal-weight range and did not differ from the body mass index standard deviations for their age. No between groups difference in WM microstructure could be detected.

Discussion: Our findings support the hypothesis that brain structural alterations may not be associated to early-stage atypical AN. These findings also suggest that previous observations of alterations in WM microstructure in full syndrome AN may constitute state-related consequences of severe weight loss. Whether the preservation of WM structure is a pathogenetically discriminant feature of atypical AN or only an effect of a less severe nutritional disturbance, will have to be verified by future studies on larger samples, possibly directly comparing AN and atypical AN.

Place, publisher, year, edition, pages
2019. Vol. 52, no 2, p. 166-174
Keywords [en]
adolescent, anorexia nervosa, brain, cognitive neuroscience, diffusion tensor imaging, feeding and eating disorders, neuroimaging
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:uu:diva-378685DOI: 10.1002/eat.23012ISI: 000458301700008PubMedID: 30676658OAI: oai:DiVA.org:uu-378685DiVA, id: diva2:1295692
Funder
Swedish Research CouncilThe Swedish Brain FoundationAvailable from: 2019-03-12 Created: 2019-03-12 Last updated: 2019-07-30Bibliographically approved
In thesis
1. Brain Structure and Function in Adolescents with Atypical Anorexia Nervosa
Open this publication in new window or tab >>Brain Structure and Function in Adolescents with Atypical Anorexia Nervosa
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Atypical anorexia nervosa (AAN) has a high incidence in adolescents, resulting in significant morbidity and mortality. The weight loss is generally less pronounced than that experienced in full-syndrome anorexia nervosa (AN), but the medical consequences can be as severe. Neuroimaging could improve our knowledge regarding the pathogenesis of eating disorders, however research on adolescents is limited, and no neuroimaging studies have been conducted in AAN. In paper I, we investigated brain structure through a voxel-based morphometry analysis in 22 drug-naïve adolescent females newly-diagnosed with AAN, and 38 age- and sex-matched healthy controls. In Paper II, we investigated white matter microstructural integrity on 25 drug-naïve adolescent patients with AAN and 25 healthy controls, using diffusion tensor imaging with a tract-based spatial statistics approach. No differences in brain structure could be detected, indicating preserved regional grey matter volumes and white matter diffusivity in patients with AAN compared to controls. These findings suggest that previous observations of brain structure alterations in full syndrome AN may constitute state-related consequences of severe underweight. Alternatively, the preservation of brain structure might indeed differentiate AAN from AN. In paper III, we investigated resting-state functional connectivity in 22 drug-naïve adolescent patients with AAN, and 24 healthy controls. We report reduced connectivity in patients in brain areas involved in face-processing and social cognition, while an increased connectivity, correlating with depressive symptoms, was found in areas involved in the multimodal integration of sensory stimuli, aesthetic judgment, and social rejection anxiety. These findings point toward a core role for an altered development of socio-emotional skills in the pathogenesis of AAN. In Paper IV, we investigated neural connectivity underlying visual processing of foods with different caloric content in a sample of 28 adolescent females diagnosed with AAN, and 33 age- and sex-matched healthy controls. Our results showed higher connectivity in patients in pathways related to the integration of sensory input and memory retrieval, in response to food with high caloric content. This, however, was coupled to lower connectivity in salience and attentional networks, and lower connectivity between areas involved in visual food cues processing and appetite regulatory regions. Thus, despite food with high caloric content is associated to greater processing of somatosensory information in patients, it is attributed less salience and engages patients’ attention less than food with low caloric content.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2019. p. 68
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1585
Keywords
MRI, functional MRI, fMRI, magnetic resonance imaging, neuroimaging, brain imaging, anorexia nervosa, eating disorders, neuroscience, adolescents
National Category
Psychiatry Radiology, Nuclear Medicine and Medical Imaging Neurosciences
Research subject
Medical Science; Neuroscience
Identifiers
urn:nbn:se:uu:diva-389865 (URN)978-91-513-0702-2 (ISBN)
Public defence
2019-09-18, Room B42, Uppsala biomedicinska centrum (BMC), Husargatan 3, Uppsala, 10:00 (English)
Opponent
Supervisors
Available from: 2019-08-28 Created: 2019-07-30 Last updated: 2019-09-17

Open Access in DiVA

fulltext(1282 kB)108 downloads
File information
File name FULLTEXT01.pdfFile size 1282 kBChecksum SHA-512
1b7ab4604c6504f9cfd33b53030f0df7864edab3aedfd85add150a9054d39a9bd3f9fa4c554b8587f2983bf2b782e1659bdc415a5b7d271e2dc3a449f997f3ea
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Authority records BETA

Olivo, GaiaSwenne, IngemarZhukovsky, ChristinaTuunainen, Anna-KaisaSalonen-Ros, HelenaLarsson, Elna-MarieSchiöth, Helgi B.

Search in DiVA

By author/editor
Olivo, GaiaSwenne, IngemarZhukovsky, ChristinaTuunainen, Anna-KaisaSalonen-Ros, HelenaLarsson, Elna-MarieSchiöth, Helgi B.
By organisation
Functional PharmacologyPediatric EndocrinologyChild and Adolescent PsychiatryRadiology
In the same journal
International Journal of Eating Disorders
Psychiatry

Search outside of DiVA

GoogleGoogle Scholar
Total: 108 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 218 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf