Lyall Amanda E, Breithaupt Lauren, Ji Chunni, Haidar Anastasia, Kotler Elana, Becker Kendra R, Plessow Franziska, Slattery Meghan, Thomas Jennifer J, Holsen Laura M, Misra Madhusmita, Eddy Kamryn T, Lawson Elizabeth A
Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Int J Eat Disord. 2024 Apr;57(4):951-966. doi: 10.1002/eat.24168. Epub 2024 Feb 17.
Few studies have focused on brain structure in atypical anorexia nervosa (atypical AN). This study investigates differences in gray matter volume (GMV) between females with anorexia nervosa (AN) and atypical AN, and healthy controls (HC).
Structural magnetic resonance imaging data were acquired for 37 AN, 23 atypical AN, and 41 HC female participants. Freesurfer was used to extract GMV, cortical thickness, and surface area for six brain lobes and associated cortical regions of interest (ROI). Primary analyses employed linear mixed-effects models to compare group differences in lobar GMV, followed by secondary analyses on ROIs within significant lobes. We also explored relationships between cortical gray matter and both body mass index (BMI) and symptom severity.
Our primary analyses revealed significant lower GMV in frontal, temporal and parietal areas (FDR < .05) in AN and atypical AN when compared to HC. Lobar GMV comparisons were non-significant between atypical AN and AN. The parietal lobe exhibited the greatest proportion of affected cortical ROIs in both AN versus HC and atypical AN versus HC. BMI, but not symptom severity, was found to be associated with cortical GMV in the parietal, frontal, temporal, and cingulate lobes. No significant differences were observed in cortical thickness or surface area.
We observed lower GMV in frontal, temporal, and parietal areas, when compared to HC, but no differences between AN and atypical AN. This indicates potentially overlapping structural phenotypes between these disorders and evidence of brain changes among those who are not below the clinical underweight threshold.
Despite individuals with atypical anorexia nervosa presenting above the clinical weight threshold, lower cortical gray matter volume was observed in partial, temporal, and frontal cortices, compared to healthy individuals. No significant differences were found in cortical gray matter volume between anorexia nervosa and atypical anorexia nervosa. This underscores the importance of continuing to assess and target weight gain in clinical care, even for those who are presenting above the low-weight clinical criteria.
很少有研究关注非典型神经性厌食症（非典型AN）的脑结构。本研究调查神经性厌食症（AN）女性、非典型AN女性与健康对照（HC）之间的灰质体积（GMV）差异。
对37名AN女性、23名非典型AN女性和41名HC女性参与者采集结构磁共振成像数据。使用FreeSurfer提取六个脑叶及相关皮质感兴趣区域（ROI）的GMV、皮质厚度和表面积。主要分析采用线性混合效应模型比较脑叶GMV的组间差异，随后对显著脑叶内的ROI进行二次分析。我们还探讨了皮质灰质与体重指数（BMI）和症状严重程度之间的关系。
我们的主要分析显示，与HC相比，AN和非典型AN的额叶、颞叶和顶叶区域的GMV显著降低（FDR <.05）。非典型AN和AN之间的脑叶GMV比较无显著差异。在AN与HC以及非典型AN与HC的比较中，顶叶受影响的皮质ROI比例最大。发现BMI而非症状严重程度与顶叶、额叶、颞叶和扣带回的皮质GMV相关。皮质厚度或表面积未观察到显著差异。
与HC相比，我们观察到额叶、颞叶和顶叶区域的GMV较低，但AN和非典型AN之间无差异。这表明这些疾病之间可能存在重叠的结构表型，以及在未低于临床体重过轻阈值的人群中存在脑变化的证据。
尽管非典型神经性厌食症患者的体重高于临床阈值，但与健康个体相比，在部分、颞叶和额叶皮质中观察到较低的皮质灰质体积。神经性厌食症和非典型神经性厌食症之间的皮质灰质体积未发现显著差异。这强调了在临床护理中持续评估和针对体重增加的重要性，即使对于那些体重高于低体重临床标准的患者也是如此。
