Sheng Min, Lu Hanzhang, Liu Peiying, Thomas Binu P, McAdams Carrie J
Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, TX 75390, United States.
Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, TX 75390, United States; Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390, United States.
Psychiatry Res. 2015 May 30;232(2):175-83. doi: 10.1016/j.pscychresns.2015.02.008. Epub 2015 Feb 27.
Anorexia nervosa is a serious psychiatric disorder characterized by restricted eating, a pursuit of thinness, and altered perceptions of body shape and size. Neuroimaging in anorexia nervosa has revealed morphological and functional alterations in the brain. A better understanding of physiological changes in anorexia nervosa could provide a brain-specific health marker relevant to treatment and outcomes. In this study, we applied several advanced magnetic resonance imaging (MRI) techniques to quantify regional and global cerebral blood flow (CBF) in 25 healthy women (HC), 23 patients currently with anorexia (AN-C) and 19 patients in long-term weight recovery following anorexia (AN-WR). Specifically, CBF was measured with pseudo-continuous arterial spin labeling (pCASL) MRI and then verified by a different technique, phase contrast (PC) MRI. Venous T2 values were determined by T2 relaxation under spin tagging (TRUST) MRI, and were used to corroborate the CBF results. These novel techniques were implemented on a standard 3T MRI scanner without any exogenous tracers, and the total scan duration was less than 10min. Voxel-wise comparison revealed that the AN-WR group showed lower CBF in bilateral temporal and frontal lobes than the AN-C group. Compared with the HC group, the AN-C group also showed higher CBF in the right temporal lobe. Whole-brain-averaged CBF was significantly decreased in the AN-WR group compared with the AN-C group, consistent with the PC-MRI results. Venous T2 values were lower in the AN-WR group than in the AN-C group, consistent with the CBF results. A review of prior work examining CBF in anorexia nervosa is included in the discussion. This study identifies several differences in the cerebral physiological alterations in anorexia nervosa, and finds specific differences relevant to the current state of the disorder.
神经性厌食症是一种严重的精神疾病，其特征为饮食受限、追求消瘦以及对身体形状和大小的认知改变。神经性厌食症的神经影像学研究揭示了大脑的形态和功能改变。更好地理解神经性厌食症的生理变化可为治疗和预后提供与大脑相关的健康指标。在本研究中，我们应用了几种先进的磁共振成像（MRI）技术，对25名健康女性（HC）、23名当前患有厌食症的患者（AN-C）和19名厌食症长期体重恢复患者（AN-WR）的局部和全脑脑血流量（CBF）进行量化。具体而言，通过伪连续动脉自旋标记（pCASL）MRI测量CBF，然后用另一种技术相位对比（PC）MRI进行验证。静脉T2值通过自旋标记下的T2弛豫（TRUST）MRI测定，并用于证实CBF结果。这些新技术在标准3T MRI扫描仪上实施，无需任何外源性示踪剂，总扫描时间不到10分钟。体素水平比较显示，AN-WR组双侧颞叶和额叶的CBF低于AN-C组。与HC组相比，AN-C组右侧颞叶的CBF也更高。与AN-C组相比，AN-WR组的全脑平均CBF显著降低，与PC-MRI结果一致。AN-WR组的静脉T2值低于AN-C组，与CBF结果一致。讨论中包括了对先前研究神经性厌食症CBF的工作的综述。本研究确定了神经性厌食症脑生理改变的几个差异，并发现了与该疾病当前状态相关的具体差异。
