Brain Structure in Acutely Underweight and Partially Weight-Restored Individuals With Anorexia Nervosa: A Coordinated Analysis by the ENIGMA Eating Disorders Working Group

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Esther Walton - , Bath Spa University (Author)
  • Fabio Bernardoni - , Division of Psychological and Social Medicine and Developmental Neurosciences (Author)
  • Victoria-Luise Batury - , Division of Psychological and Social Medicine and Developmental Neurosciences (Author)
  • Klaas Bahnsen - , Division of Psychological and Social Medicine and Developmental Neurosciences (Author)
  • Sara Larivière - , McGill University (Author)
  • Giovanni Abbate-Daga - , University of Turin (Author)
  • Susana Andres-Perpiña - , University of Barcelona (Author)
  • Lasse Bang - , University of Oslo (Author)
  • Amanda Bischoff-Grethe - , University of California at San Diego (Author)
  • Samantha J Brooks - , Uppsala University (Author)
  • Iain C Campbell - , King's College London (KCL) (Author)
  • Giammarco Cascino - , University of Salerno (Author)
  • Josefina Castro-Fornieles - , University of Barcelona (Author)
  • Enrico Collantoni - , University of Padua (Author)
  • Federico D'Agata - , University of Turin (Author)
  • Brigitte Dahmen - , RWTH Aachen University, University Hospital Aachen (Author)
  • Unna N Danner - , Utrecht University (Author)
  • Angela Favaro - , University of Padua (Author)
  • Jamie D Feusner - , University of Toronto (Author)
  • Guido K W Frank - , University of California at San Diego (Author)
  • Hans-Christoph Friederich - , University Hospital Heidelberg (Author)
  • John L Graner - , Duke University (Author)
  • Beate Herpertz-Dahlmann - , RWTH Aachen University, University Hospital Aachen (Author)
  • Andreas Hess - , Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Stefanie Horndasch - , University Hospital at the Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Allan S Kaplan - , University of Toronto (Author)
  • Lisa-Katrin Kaufmann - , University of Zurich (Author)
  • Walter H Kaye - , University of California at San Diego (Author)
  • Sahib S Khalsa - , University of Tulsa (Author)
  • Kevin S LaBar - , Duke University (Author)
  • Luca Lavagnino - , University of Texas Health Science Center at Houston (Author)
  • Luisa Lazaro - , University of Barcelona (Author)
  • Renzo Manara - , University of Padua (Author)
  • Amy E Miles - , University of Toronto (Author)
  • Gabriella F Milos - , University of Zurich (Author)
  • Alessio Maria Monteleone - , University of Campania Luigi Vanvitelli (Author)
  • Palmiero Monteleone - , University of Salerno (Author)
  • Benson Mwangi - , University of Texas Health Science Center at Houston (Author)
  • Owen O'Daly - , King's College London (KCL) (Author)
  • Jose Pariente - , Magnetic Resonance Image Core Facility (Author)
  • Julie Roesch - , University Hospital at the Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Ulrike H Schmidt - , Tokyo Institute of Psychiatry, TUD Dresden University of Technology, King's College London (KCL) (Author)
  • Jochen Seitz - , RWTH Aachen University, University Hospital Aachen (Author)
  • Megan E Shott - , University of California at San Diego (Author)
  • Joe J Simon - , University Hospital Heidelberg (Author)
  • Paul A M Smeets - , Utrecht University (Author)
  • Christian K Tamnes - , University of Oslo (Author)
  • Elena Tenconi - , University of Padua (Author)
  • Sophia I Thomopoulos - , University of Southern California (Author)
  • Annemarie A van Elburg - , Utrecht University (Author)
  • Aristotle N Voineskos - , University of Toronto (Author)
  • Georg G von Polier - , University Hospital Frankfurt (Author)
  • Christina E Wierenga - , University of California at San Diego (Author)
  • Nancy L Zucker - , Duke University (Author)
  • Neda Jahanshad - , University of Southern California (Author)
  • Joseph A King - , Division of Psychological and Social Medicine and Developmental Neurosciences, TUD Dresden University of Technology (Author)
  • Paul M Thompson - , University of Southern California (Author)
  • Laura A Berner - , Icahn School of Medicine at Mount Sinai (Author)
  • Stefan Ehrlich - , Division of Psychological and Social Medicine and Developmental Neurosciences, TUD Dresden University of Technology (Author)

Abstract

BACKGROUND: The pattern of structural brain abnormalities in anorexia nervosa (AN) is still not well understood. While several studies report substantial deficits in gray matter volume and cortical thickness in acutely underweight patients, others find no differences, or even increases in patients compared with healthy control subjects. Recent weight regain before scanning may explain some of this heterogeneity. To clarify the extent, magnitude, and dependencies of gray matter changes in AN, we conducted a prospective, coordinated meta-analysis of multicenter neuroimaging data.

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.

Details

Original languageEnglish
Pages (from-to)730-738
Number of pages9
JournalBiological psychiatry
Volume92
Issue number9
Publication statusPublished - 1 Nov 2022
Peer-reviewedYes

External IDs

Scopus 85136665057
ORCID /0000-0002-2864-5578/work/142233485
ORCID /0000-0003-2132-4445/work/142236359
ORCID /0000-0002-5112-405X/work/142242687
ORCID /0000-0002-5413-0359/work/142248936

Keywords

Sustainable Development Goals

Keywords

  • Anorexia Nervosa/diagnostic imaging, Brain/diagnostic imaging, Cerebral Cortex/diagnostic imaging, Female, Humans, Magnetic Resonance Imaging/methods, Multicenter Studies as Topic, Prospective Studies, Thinness

Library keywords