Triangulating brain alterations in anorexia nervosa: a multimodal investigation of magnetic resonance spectroscopy, morphometry and blood-based biomarkers

Research output: Contribution to journalResearch articleContributedpeer-review



The acute state of anorexia nervosa (AN) is associated with widespread reductions in cortical gray matter (GM) thickness and white matter (WM) volume, suspected changes in myelin content and elevated levels of the neuronal damage marker neurofilament light (NF-L), but the underlying mechanisms remain largely unclear. To gain a deeper understanding of brain changes in AN, we applied a multimodal approach combining advanced neuroimaging methods with analysis of blood-derived biomarkers. In addition to standard measures of cortical GM thickness and WM volume, we analyzed tissue-specific profiles of brain metabolites using multivoxel proton magnetic resonance spectroscopy, T1 relaxation time as a proxy of myelin content leveraging advanced quantitative MRI methods and serum NF-L concentrations in a sample of 30 female, predominately adolescent patients with AN and 30 age-matched female healthy control participants. In patients with AN, we found a reduction in GM cortical thickness and GM total N-acetyl aspartate. The latter predicted higher NF-L levels, which were elevated in AN. Furthermore, GM total choline was elevated. In WM, there were no group differences in either imaging markers, choline levels or N-acetyl aspartate levels. The current study provides evidence for neuronal damage processes as well as for increased membrane lipid catabolism and turnover in GM in acute AN but no evidence for WM pathology. Our results illustrate the potential of multimodal research including tissue-specific proton magnetic resonance spectroscopy analyses to shed light on brain changes in psychiatric and neurological conditions, which may ultimately lead to better treatments.


Original languageEnglish
Article number277
JournalTranslational psychiatry
Issue number1
Publication statusPublished - Dec 2023

External IDs

PubMed 37573444
ORCID /0000-0002-2864-5578/work/145695547
ORCID /0000-0003-2132-4445/work/145696025
ORCID /0000-0002-6152-5834/work/145697530
ORCID /0000-0002-5026-1239/work/145698595
ORCID /0000-0002-4897-1119/work/145698677
ORCID /0000-0001-8333-867X/work/145698866
ORCID /0000-0001-8204-5699/work/156335427


Research priority areas of TU Dresden

Sustainable Development Goals


  • Adolescent, Anorexia Nervosa/diagnostic imaging, Biomarkers, Brain/diagnostic imaging, Choline, Female, Gray Matter/diagnostic imaging, Humans, Magnetic Resonance Imaging/methods, Magnetic Resonance Spectroscopy, White Matter/pathology

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