Collantoni Enrico, Pessotto Gianni, Meregalli Valentina, Madan Christopher R, Miola Alessandro, Cascino Giammarco, Monteleone Alessio Maria, Favaro Angela
Department of Neurosciences, University of Padua, Via Giustiniani, 2 - 35128, Padua, Italy.
Padua Neuroscience Center, University of Padua, Padua, Italy.
Eur Arch Psychiatry Clin Neurosci. 2025 Apr 30. doi: 10.1007/s00406-025-02001-3.
Eating disorders (EDs) are complex psychiatric conditions with neurodevelopmental and neuroprogressive underpinnings. Altered cortical morphology, including gyrification patterns, may reflect these processes, offering insights into EDs pathophysiology.
This systematic review and qualitative synthesis aimed to describe available neuroimaging findings on cortical complexity, including gyrification and sulcal morphology, in individuals with EDs compared to healthy controls (HC).
Thirteen studies, including 525 patients with anorexia nervosa (AN), 69 patients with bulimia nervosa (BN) and 478 HC, were reviewed. Data on local gyrification index (LGI), sulcal morphology, and related cortical measures were systematically analyzed to identify consistent patterns of brain alterations.
A consistent reduction in LGI across frontal, temporal, and parietal regions was reported in patients with acute AN compared to HC. These findings suggest the presence of an altered cortical folding in AN, with alterations that may partially normalize following weight restoration. Studies on bulimia nervosa (BN) are limited, with findings remaining inconclusive. Emerging metrics, such as absolute mean curvature and fractal dimension, provide further insights but lack methodological consistency across studies.
Altered cortical folding patterns, particularly decreased gyrification, may reflect neurodevelopmental disruption and the state-dependent effects of malnutrition in AN. Future research should focus on longitudinal studies and standardized neuroimaging methods to clarify these findings and expand knowledge on BN and binge eating disorder (BED).
饮食失调（EDs）是具有神经发育和神经进展基础的复杂精神疾病。包括脑回形成模式在内的皮质形态改变可能反映这些过程，为饮食失调的病理生理学提供见解。
本系统评价和定性综合分析旨在描述与健康对照（HC）相比，饮食失调个体在皮质复杂性方面（包括脑回形成和脑沟形态）的现有神经影像学研究结果。
对13项研究进行了综述，其中包括525例神经性厌食症（AN）患者、69例神经性贪食症（BN）患者和478名健康对照。对局部脑回指数（LGI）、脑沟形态及相关皮质测量数据进行系统分析，以确定大脑改变的一致模式。
与健康对照相比，急性神经性厌食症患者额叶、颞叶和顶叶区域的局部脑回指数持续降低。这些发现表明神经性厌食症存在皮质折叠改变，体重恢复后这些改变可能部分恢复正常。关于神经性贪食症（BN）的研究有限，结果尚无定论。绝对平均曲率和分形维数等新指标提供了进一步的见解，但各研究间缺乏方法学一致性。
皮质折叠模式改变，尤其是脑回形成减少，可能反映神经性厌食症中的神经发育破坏和营养不良的状态依赖性影响。未来的研究应侧重于纵向研究和标准化神经影像学方法，以阐明这些发现并扩展对神经性贪食症和暴饮暴食症（BED）的认识。
