Division of Psychological and Social Medicine and Developmental Neuroscience,Faculty of Medicine,Technische Universität Dresden,Dresden,Germany.
Department of Psychiatry and Neuroimaging Center,Technische Universität Dresden,Dresden,Germany.
Psychol Med. 2019 Jul;49(9):1555-1564. doi: 10.1017/S003329171800212X. Epub 2018 Aug 28.
Gray matter (GM) 'pseudoatrophy' is well-documented in patients with anorexia nervosa (AN), but changes in white matter (WM) are less well understood. Here we investigated the dynamics of microstructural WM brain changes in AN patients during short-term weight restoration in a combined longitudinal and cross-sectional study design.
Diffusion-weighted images were acquired in young AN patients before (acAN-Tp1, n = 56) and after (acAN-Tp2, n = 44) short-term weight restoration as well as in age-matched healthy controls (HC, n = 60). Images were processed using Tract-Based-Spatial-Statistics to compare fractional anisotropy (FA) across groups and timepoints.
In the cross-sectional comparison, FA was significantly reduced in the callosal body in acAN-Tp1 compared with HC, while no differences were found between acAN-Tp2 and HC. In the longitudinal arm, FA increased with weight gain in acAN-Tp2 relative to acAN-Tp1 in large parts of the callosal body and the fornix, while it decreased in the right corticospinal tract.
Our findings reveal that dynamic, bidirectional changes in WM microstructure in young underweight patients with AN can be reversed with brief weight restoration therapy. These results parallel those previously observed in GM and suggest that alterations in WM in non-chronic AN are also state-dependent and rapidly reversible with successful intervention.
厌食症（AN）患者的灰质（GM）“假性萎缩”已有充分记录，但对其白质（WM）变化的了解较少。在此，我们通过联合纵向和横断面研究设计，研究了 AN 患者在短期体重恢复期间 WM 微观结构脑变化的动态。
在短期体重恢复前后（acAN-Tp1，n = 56；acAN-Tp2，n = 44），以及在年龄匹配的健康对照组（HC，n = 60）中，对年轻的 AN 患者进行了弥散加权成像采集。使用基于束的空间统计学（Tract-Based-Spatial-Statistics）处理图像，以比较组间和时间点的各向异性分数（FA）。
在横断面比较中，与 HC 相比，acAN-Tp1 中的胼胝体体部 FA 明显降低，而 acAN-Tp2 与 HC 之间无差异。在纵向组中，与 acAN-Tp1 相比，acAN-Tp2 中的 FA 随体重增加而增加，而在右侧皮质脊髓束中则降低。
我们的发现表明，AN 年轻消瘦患者 WM 微观结构的动态、双向变化可以通过短暂的体重恢复治疗来逆转。这些结果与 GM 中之前观察到的结果相似，表明非慢性 AN 中的 WM 改变也是状态依赖性的，并且随着成功的干预可以迅速逆转。
