Gander Manuela, Lenhart Lukas, Steiger Ruth, Buchheim Anna, Mangesius Stephanie, Birkl Christoph, Haid-Stecher Nina, Fuchs Martin, Libal Anna, Dabkowska-Mika Agnieszka, Gizewski Elke Ruth, Sevecke Kathrin
Institute of Psychology, Leopold-Franzens-University of Innsbruck, 6020 Innsbruck, Austria.
Department of Child and Adolescent Psychiatry, Tirol Kliniken, 6060 Hall in Tirol, Austria.
Brain Sci. 2023 May 14;13(5):798. doi: 10.3390/brainsci13050798.
In the present study, we explore the role of attachment for microstructural white matter (WM) changes in adolescents with anorexia nervosa (AN) before and after exposure to short-term and nutritional treatment. The case sample consisted of 22 female adolescent inpatients with AN (mean age: 15.2 ± 1.2 years) and the control sample were 18 gender-matched healthy adolescents (mean age: 16.8 ± 0.9 years). We performed a 3T MRI in the patient group during the acute state of AN and after weight restoration (duration: 2.6 ± 1 months) and compared the data to a healthy control group. To classify attachment patterns, we used the Adult Attachment Projective Picture System. In the patient sample, over 50% were classified with an attachment trauma/unresolved attachment status. Prior to treatment exposure, fractional anisotropy (FA) reductions and concordant mean diffusivity (MD) increases were evident in the fornix, the corpus callosum and WM regions of the thalamus, which normalized in the corpus callosum and the fornix post-therapy in the total patient sample ( < 0.002). In the acute state, patients with an attachment trauma demonstrated significant FA decreases compared to healthy controls, but no MD increases, in the corpus callosum and cingulum bilaterally, which remained decreased after therapy. Attachment patterns seem to be associated with region-specific changes of WM alterations in AN.
在本研究中，我们探讨了依恋在神经性厌食症（AN）青少年短期营养治疗前后白质微观结构变化中的作用。病例样本包括22名患有AN的女性青少年住院患者（平均年龄：15.2±1.2岁），对照样本为18名性别匹配的健康青少年（平均年龄：16.8±0.9岁）。我们在AN患者组的急性期和体重恢复后（持续时间：2.6±1个月）进行了3T磁共振成像，并将数据与健康对照组进行比较。为了分类依恋模式，我们使用了成人依恋投射图片系统。在患者样本中，超过50%被归类为依恋创伤/未解决的依恋状态。在治疗前，穹窿、胼胝体和丘脑白质区域的分数各向异性（FA）降低和平均扩散率（MD）相应增加明显，在整个患者样本中，胼胝体和穹窿在治疗后恢复正常（<0.002）。在急性期，与健康对照组相比，有依恋创伤的患者双侧胼胝体和扣带的FA显著降低，但MD没有增加，治疗后仍保持降低。依恋模式似乎与AN中白质改变的区域特异性变化有关。
