Brain Structure in Acutely Underweight and Partially Weight-Restored Individuals With Anorexia Nervosa: A Coordinated Analysis by the ENIGMA Eating Disorders Working Group.
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Walton Esther, Bernardoni Fabio, Batury Victoria-Luise, Bahnsen Klaas, Larivière Sara, Abbate-Daga Giovanni, Andres-Perpiña Susana, Bang Lasse, Bischoff-Grethe Amanda, Brooks Samantha J, Campbell Iain C, Cascino Giammarco, Castro-Fornieles Josefina, Collantoni Enrico, D'Agata Federico, Dahmen Brigitte, Danner Unna N, Favaro Angela, Feusner Jamie D, Frank Guido K W, Friederich Hans-Christoph, Graner John L, Herpertz-Dahlmann Beate, Hess Andreas, Horndasch Stefanie, Kaplan Allan S, Kaufmann Lisa-Katrin, Kaye Walter H, Khalsa Sahib S, LaBar Kevin S, Lavagnino Luca, Lazaro Luisa, Manara Renzo, Miles Amy E, Milos Gabriella F, Monteleone Alessio Maria, Monteleone Palmiero, Mwangi Benson, O'Daly Owen, Pariente Jose, Roesch Julie, Schmidt Ulrike H, Seitz Jochen, Shott Megan E, Simon Joe J, Smeets Paul A M, Tamnes Christian K, Tenconi Elena, Thomopoulos Sophia I, van Elburg Annemarie A, Voineskos Aristotle N, von Polier Georg G, Wierenga Christina E, Zucker Nancy L, Jahanshad Neda, King Joseph A, Thompson Paul M, Berner Laura A, Ehrlich Stefan
Аннотация
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 undernutrition, 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.