Nickel Kathrin, Tebartz van Elst Ludger, Holovics Lukas, Feige Bernd, Glauche Volkmar, Fortenbacher Tina, Endres Dominique, Zeeck Almut, Tüscher Oliver, Joos Andreas, Maier Simon
Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Front Psychiatry. 2019 Jul 8;10:490. doi: 10.3389/fpsyt.2019.00490. eCollection 2019.
Severe malnutrition in patients with anorexia nervosa (AN) as well as possible trait-related aberrations lead to pronounced structural brain changes whose reversibility after recovery is currently unclear. Previous diffusion tensor imaging (DTI) studies investigating white matter (WM) microstructure alterations in AN are inconsistent. In this so far largest DTI study in adults, we investigated 33 AN patients, 20 recovered (REC), and 33 healthy women. DTI data were processed using the "DTI and Fiber tools," and the Computational Anatomy Toolbox. WM integrity, both in terms of fractional anisotropy (FA) and mean diffusivity (MD), was assessed. We found a significant FA decrease in the corpus callosum (body) and an MD decrease in the posterior thalamic radiation in the AN group. The REC group displayed FA decrease in the corpus callosum in comparison to HC, whereas there were no MD differences between the REC and HC groups. Despite prolonged restoration of weight in the REC group, no significant regeneration of WM integrity in terms of FA could be observed. Transient changes in MD likely represent a reversible consequence of the acute state of starvation or result from dehydration. Reduction of FA either may be due to WM damage resulting from malnutrition or may be considered a pre-morbid marker.
神经性厌食症（AN）患者的严重营养不良以及可能与特质相关的异常会导致明显的脑结构变化，目前尚不清楚恢复后脑结构变化的可逆性。先前关于AN患者白质（WM）微观结构改变的扩散张量成像（DTI）研究结果并不一致。在这项迄今为止针对成年人规模最大的DTI研究中，我们调查了33例AN患者、20例康复者（REC）以及33名健康女性。使用“DTI与纤维工具”以及计算解剖工具箱对DTI数据进行处理。从分数各向异性（FA）和平均扩散率（MD）两方面评估WM完整性。我们发现，AN组胼胝体（体部）FA显著降低，丘脑后辐射MD降低。与健康对照组（HC）相比，REC组胼胝体FA降低，而REC组与HC组之间MD无差异。尽管REC组体重恢复时间延长，但在FA方面未观察到WM完整性的显著恢复。MD的短暂变化可能代表饥饿急性期的可逆后果或由脱水导致。FA降低可能是由于营养不良导致的WM损伤，也可能被视为病前标志物。
