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

Walton E, Bernardoni F, Batury VL, Bahnsen K, Larivière S, Abbate-Daga G, Andres-Perpiña S, Bang L, Bischoff-Grethe A, Brooks SJ, Campbell IC, Cascino G, Castro-Fornieles J, Collantoni E, D'Agata F, Dahmen B, Danner UN, Favaro A, Feusner JD, Frank GK, Friederich HC, Graner JL, Herpertz-Dahlmann B, Heß A, Horndasch S, Kaplan AS, Kaufmann LK, Kaye WH, Khalsa SS, LaBar KS, Lavagnino L, Lazaro L, Manara R, Miles AE, Milos GF, Monteleone AM, Monteleone P, Mwangi B, O'Daly O, Pariente J, Rösch J, Schmidt UH, Seitz J, Shott ME, Simon JJ, Smeets PA, Tamnes CK, Tenconi E, Thomopoulos SI, van Elburg AA, Voineskos AN, von Polier GG, Wierenga CE, Zucker NL, Jahanshad N, King JA, Thompson PM, Berner LA, Ehrlich S (2022)

Publication Type: Journal article

Publication year: 2022

Journal

DOI: 10.1016/j.biopsych.2022.04.022

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.

Authors with CRIS profile

Involved external institutions

University of Bath United Kingdom (GB) Universitätsklinikum Carl Gustav Carus Dresden Germany (DE) McConnell Brain Imaging Centre (BIC) Canada (CA) University of Turin / Università degli Studi di Torino (UNITO) Italy (IT) Hospital Clínic de Barcelona Spain (ES) Norwegian Institute of Public Health (NIPH) / Folkehelseinstituttet Norway (NO) Liverpool John Moores University (JMU) United Kingdom (GB) King’s College London United Kingdom (GB) Università degli Studi di Salerno Italy (IT) University of Padua / Universita degli Studi di Padova Italy (IT) Universitätsklinikum Aachen (UKA) Germany (DE) Altrecht Netherlands (NL) University of Toronto Canada (CA) Universitätsklinikum Heidelberg Germany (DE) Duke University United States (USA) (US) Universitätsspital Zürich (USZ) Switzerland (CH) The University of Tulsa United States (USA) (US) University of Texas Health Science Center at Houston (UTHealth) United States (USA) (US) Università degli studi della Campania Luigi Vanvitelli Italy (IT) Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Spain (ES) University Medical Centre Utrecht (UMC Utrecht) Netherlands (NL) University of Oslo Norway (NO) Keck School of Medicine of USC United States (USA) (US) Duke University Medical Center United States (USA) (US) Icahn School of Medicine at Mount Sinai United States (USA) (US)

How to cite

APA:

Walton, E., Bernardoni, F., Batury, V.L., Bahnsen, K., Larivière, S., Abbate-Daga, G.,... Ehrlich, S. (2022). Brain Structure in Acutely Underweight and Partially Weight-Restored Individuals With Anorexia Nervosa: A Coordinated Analysis by the ENIGMA Eating Disorders Working Group. Biological Psychiatry. https://dx.doi.org/10.1016/j.biopsych.2022.04.022

MLA:

Walton, Esther, et al. "Brain Structure in Acutely Underweight and Partially Weight-Restored Individuals With Anorexia Nervosa: A Coordinated Analysis by the ENIGMA Eating Disorders Working Group." Biological Psychiatry (2022).

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