Altered White Matter Connectivity in Young Acutely Underweight Patients With Anorexia Nervosa

Research output: Contribution to journalResearch articleContributedpeer-review


Objective: Reductions of gray matter volume and cortical thickness in anorexia nervosa (AN) are well documented. However, findings regarding the integrity of white matter (WM) as studied via diffusion weighted imaging (DWI) are remarkably heterogeneous, and WM connectivity has been examined only in small samples using a limited number of regions of interest. The present study investigated whole-brain WM connectivity for the first time in a large sample of acutely underweight patients with AN. Method: DWI data from predominantly adolescent patients with acute AN (n = 96, mean age = 16.3 years) and age-matched healthy control participants (n = 96, mean age = 17.2 years) were analyzed. WM connectivity networks were generated from fiber-tractography−derived streamlines connecting 233 cortical/subcortical regions. To identify group differences, network-based statistic was used while taking head motion, WM, and ventricular volume into account. Results: Patients with AN were characterized by 6 WM subnetworks with abnormal architecture, as indicated by increased fractional anisotropy located primarily in parietal−occipital regions and accompanied by reduced radial diffusivity. Group differences based on number of streamlines reached only nominal significance. Conclusion: Our study reveals pronounced alterations in the WM connectome in young patients with AN. In contrast to known reductions in gray matter in the acutely underweight state of AN, this pattern does not necessarily indicate a deterioration of the WM network. Future studies using advanced MRI sequences will have to clarify interrelations with axonal packing or myelination, and whether the changes should be considered a consequence of undernutrition or a vulnerability for developing or maintaining AN.


Original languageEnglish
Pages (from-to)331-340
Number of pages10
Journal Journal of the American Academy of Child and Adolescent Psychiatry : JAACAP
Issue number2
Publication statusPublished - Feb 2022

External IDs

Scopus 85109448299
Mendeley 62ebcf1f-a3bc-35f9-8ba9-9a5f1f306ef4
unpaywall 10.1016/j.jaac.2021.04.019
ORCID /0000-0003-2076-5329/work/93627368


Research priority areas of TU Dresden


  • anorexia nervosa, diffusion weighted imaging, fiber tractography, structural connectivity, white matter

Library keywords