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Preserved white matter microstructure in adolescent patients with atypical anorexia nervosa
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Funktionell farmakologi.ORCID-id: 0000-0002-7514-4493
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Barnendokrinologisk forskning.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Funktionell farmakologi.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Funktionell farmakologi.ORCID-id: 0000-0003-4907-4433
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2019 (Engelska)Ingår i: International Journal of Eating Disorders, ISSN 0276-3478, E-ISSN 1098-108X, Vol. 52, nr 2, s. 166-174Artikel i tidskrift (Refereegranskat) 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.

Ort, förlag, år, upplaga, sidor
2019. Vol. 52, nr 2, s. 166-174
Nyckelord [en]
adolescent, anorexia nervosa, brain, cognitive neuroscience, diffusion tensor imaging, feeding and eating disorders, neuroimaging
Nationell ämneskategori
Psykiatri
Identifikatorer
URN: urn:nbn:se:uu:diva-378685DOI: 10.1002/eat.23012ISI: 000458301700008PubMedID: 30676658OAI: oai:DiVA.org:uu-378685DiVA, id: diva2:1295692
Forskningsfinansiär
VetenskapsrådetHjärnfondenTillgänglig från: 2019-03-12 Skapad: 2019-03-12 Senast uppdaterad: 2019-07-30Bibliografiskt granskad
Ingår i avhandling
1. Brain Structure and Function in Adolescents with Atypical Anorexia Nervosa
Öppna denna publikation i ny flik eller fönster >>Brain Structure and Function in Adolescents with Atypical Anorexia Nervosa
2019 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
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.

Ort, förlag, år, upplaga, sidor
Uppsala: Acta Universitatis Upsaliensis, 2019. s. 68
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1585
Nyckelord
MRI, functional MRI, fMRI, magnetic resonance imaging, neuroimaging, brain imaging, anorexia nervosa, eating disorders, neuroscience, adolescents
Nationell ämneskategori
Psykiatri Radiologi och bildbehandling Neurovetenskaper
Forskningsämne
Medicinsk vetenskap; Neurovetenskap
Identifikatorer
urn:nbn:se:uu:diva-389865 (URN)978-91-513-0702-2 (ISBN)
Disputation
2019-09-18, Room B42, Uppsala biomedicinska centrum (BMC), Husargatan 3, Uppsala, 10:00 (Engelska)
Opponent
Handledare
Tillgänglig från: 2019-08-28 Skapad: 2019-07-30 Senast uppdaterad: 2019-09-17

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

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