Stratton Tatiana, Bahnsen Klaas, Geisler Daniel, Bernardoni Fabio, Gaser Christian, Ehrlich Stefan, Walton Esther
Department of Psychology, University of Bath, Bath, UK.
Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
Br J Psychiatry. 2024 Nov;225(5):499-505. doi: 10.1192/bjp.2024.119. Epub 2024 Dec 11.
Anorexia nervosa is a psychiatric disorder characterised by undernutrition, significantly low body weight and large, although possibly transient, reductions in brain structure. Advanced brain ageing tracks accelerated age-related changes in brain morphology that have been linked to psychopathology and adverse clinical outcomes.
The aim of the current case-control study was to characterise cross-sectional and longitudinal patterns of advanced brain age in acute anorexia nervosa and during the recovery process.
Measures of grey- and white-matter-based brain age were obtained from T1-weighted magnetic resonance imaging scans of 129 acutely underweight female anorexia nervosa patients (of which 95 were assessed both at baseline and after approximately 3 months of nutritional therapy), 39 recovered patients and 167 healthy female controls, aged 12-23 years. The difference between chronological age and grey- or white-matter-based brain age was calculated to indicate brain-predicted age difference (BrainAGE and BrainAGE).
Acute anorexia nervosa patients at baseline, but not recovered patients, showed a higher BrainAGE of 1.79 years (95% CI [1.45, 2.13]) compared to healthy controls. However, the difference was largely reduced for BrainAGE. After partial weight restoration, BrainAGE decreased substantially (beta = -1.69; CI [-1.93, -1.46]). BrainAGEs were unrelated to symptom severity or depression, but larger weight gain predicted larger normalisation of BrainAGE in the longitudinal patient sample (beta = -0.65; CI [-0.75, -0.54]).
Our findings suggest that in patients with anorexia nervosa, undernutrition is an important predictor of advanced grey-matter-based brain age, which itself might be transient in nature and largely undetectable after weight recovery.
神经性厌食症是一种精神疾病，其特征为营养不良、体重显著偏低以及大脑结构出现大幅（尽管可能是暂时的）缩减。脑老化加速反映了与年龄相关的大脑形态变化加速，这些变化与精神病理学及不良临床结局有关。
本病例对照研究的目的是描述急性神经性厌食症患者及康复过程中脑老化加速的横断面和纵向模式。
基于灰质和白质的脑龄测量值来自129名急性体重过轻的女性神经性厌食症患者（其中95名在基线时及营养治疗约3个月后均接受了评估）、39名康复患者以及167名年龄在12至23岁之间的健康女性对照者的T1加权磁共振成像扫描。计算实际年龄与基于灰质或白质的脑龄之间的差异，以表明脑预测年龄差异（BrainAGE和BrainAGE）。
与健康对照者相比，急性神经性厌食症患者在基线时（而非康复患者）的BrainAGE更高，为1.79岁（95%可信区间[1.45, 2.13]）。然而，BrainAGE的差异在很大程度上有所减小。部分体重恢复后，BrainAGE大幅下降（β = -1.69；可信区间[-1.93, -1.46]）。BrainAGE与症状严重程度或抑郁无关，但在纵向患者样本中，体重增加越多，BrainAGE的正常化程度越高（β = -0.65；可信区间[-0.75, -0.54]）。
我们的研究结果表明，在神经性厌食症患者中，营养不良是基于灰质的脑老化加速的重要预测因素，这种脑老化加速本身可能是暂时的，体重恢复后在很大程度上无法检测到。
