White matter microstructural changes in adolescent anorexia nervosa including an exploratory longitudinal study

Katja Vogel, Inge Timmers, Vinod Kumar, Thomas Nickl-Jockschat, Matteo Bastiani, Alard Roebroeck, Beate Herpertz-Dahlmann, Kerstin Konrad, Rainer Goebel, Jochen Seitz

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Abstract

BACKGROUND: Anorexia nervosa (AN) often begins in adolescence, however, the understanding of the underlying pathophysiology at this developmentally important age is scarce, impeding early interventions. We used diffusion tensor imaging (DTI) to investigate microstructural white matter (WM) brain changes including an experimental longitudinal follow-up.

METHODS: We acquired whole brain diffusion-weighted brain scans of 22 adolescent female hospitalized patients with AN at admission and nine patients longitudinally at discharge after weight rehabilitation. Patients (10-18 years) were compared to 21 typically developing controls (TD). Tract-based spatial statistics (TBSS) were applied to compare fractional anisotropy (FA) across groups and time points. Associations between average FA values of the global WM skeleton and weight as well as illness duration parameters were analyzed by multiple linear regression.

RESULTS: We observed increased FA in bilateral frontal, parietal and temporal areas in AN patients at admission compared to TD. Higher FA of the global WM skeleton at admission was associated with faster weight loss prior to admission. Exploratory longitudinal analysis showed this FA increase to be partially normalized after weight rehabilitation.

CONCLUSIONS: Our findings reveal a markedly different pattern of WM microstructural changes in adolescent AN compared to most previous results in adult AN. This could signify a different susceptibility and reaction to semi-starvation in the still developing brain of adolescents or a time-dependent pathomechanism differing with extend of chronicity. Higher FA at admission in adolescents with AN could point to WM fibers being packed together more closely.

Original languageEnglish
Pages (from-to)614-621
Number of pages8
JournalNeuroImage: Clinical
Volume11
DOIs
Publication statusPublished - Apr 2016

Keywords

  • Anorexia nervosa
  • Adolescence
  • DTI
  • TBSS
  • Fractional anisotropy
  • SUBJECT DIFFUSION DATA
  • SPATIAL STATISTICS
  • EATING-DISORDERS
  • VOXELWISE ANALYSIS
  • BRAIN VOLUME
  • GRAY-MATTER
  • INTEGRITY
  • ABNORMALITIES
  • EPIDEMIOLOGY
  • PREVALENCE

Cite this

Vogel, Katja ; Timmers, Inge ; Kumar, Vinod ; Nickl-Jockschat, Thomas ; Bastiani, Matteo ; Roebroeck, Alard ; Herpertz-Dahlmann, Beate ; Konrad, Kerstin ; Goebel, Rainer ; Seitz, Jochen. / White matter microstructural changes in adolescent anorexia nervosa including an exploratory longitudinal study. In: NeuroImage: Clinical. 2016 ; Vol. 11. pp. 614-621.
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abstract = "BACKGROUND: Anorexia nervosa (AN) often begins in adolescence, however, the understanding of the underlying pathophysiology at this developmentally important age is scarce, impeding early interventions. We used diffusion tensor imaging (DTI) to investigate microstructural white matter (WM) brain changes including an experimental longitudinal follow-up.METHODS: We acquired whole brain diffusion-weighted brain scans of 22 adolescent female hospitalized patients with AN at admission and nine patients longitudinally at discharge after weight rehabilitation. Patients (10-18 years) were compared to 21 typically developing controls (TD). Tract-based spatial statistics (TBSS) were applied to compare fractional anisotropy (FA) across groups and time points. Associations between average FA values of the global WM skeleton and weight as well as illness duration parameters were analyzed by multiple linear regression.RESULTS: We observed increased FA in bilateral frontal, parietal and temporal areas in AN patients at admission compared to TD. Higher FA of the global WM skeleton at admission was associated with faster weight loss prior to admission. Exploratory longitudinal analysis showed this FA increase to be partially normalized after weight rehabilitation.CONCLUSIONS: Our findings reveal a markedly different pattern of WM microstructural changes in adolescent AN compared to most previous results in adult AN. This could signify a different susceptibility and reaction to semi-starvation in the still developing brain of adolescents or a time-dependent pathomechanism differing with extend of chronicity. Higher FA at admission in adolescents with AN could point to WM fibers being packed together more closely.",
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author = "Katja Vogel and Inge Timmers and Vinod Kumar and Thomas Nickl-Jockschat and Matteo Bastiani and Alard Roebroeck and Beate Herpertz-Dahlmann and Kerstin Konrad and Rainer Goebel and Jochen Seitz",
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Vogel, K, Timmers, I, Kumar, V, Nickl-Jockschat, T, Bastiani, M, Roebroeck, A, Herpertz-Dahlmann, B, Konrad, K, Goebel, R & Seitz, J 2016, 'White matter microstructural changes in adolescent anorexia nervosa including an exploratory longitudinal study', NeuroImage: Clinical, vol. 11, pp. 614-621. https://doi.org/10.1016/j.nicl.2016.04.002

White matter microstructural changes in adolescent anorexia nervosa including an exploratory longitudinal study. / Vogel, Katja; Timmers, Inge; Kumar, Vinod; Nickl-Jockschat, Thomas; Bastiani, Matteo; Roebroeck, Alard; Herpertz-Dahlmann, Beate; Konrad, Kerstin; Goebel, Rainer; Seitz, Jochen.

In: NeuroImage: Clinical, Vol. 11, 04.2016, p. 614-621.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - White matter microstructural changes in adolescent anorexia nervosa including an exploratory longitudinal study

AU - Vogel, Katja

AU - Timmers, Inge

AU - Kumar, Vinod

AU - Nickl-Jockschat, Thomas

AU - Bastiani, Matteo

AU - Roebroeck, Alard

AU - Herpertz-Dahlmann, Beate

AU - Konrad, Kerstin

AU - Goebel, Rainer

AU - Seitz, Jochen

PY - 2016/4

Y1 - 2016/4

N2 - BACKGROUND: Anorexia nervosa (AN) often begins in adolescence, however, the understanding of the underlying pathophysiology at this developmentally important age is scarce, impeding early interventions. We used diffusion tensor imaging (DTI) to investigate microstructural white matter (WM) brain changes including an experimental longitudinal follow-up.METHODS: We acquired whole brain diffusion-weighted brain scans of 22 adolescent female hospitalized patients with AN at admission and nine patients longitudinally at discharge after weight rehabilitation. Patients (10-18 years) were compared to 21 typically developing controls (TD). Tract-based spatial statistics (TBSS) were applied to compare fractional anisotropy (FA) across groups and time points. Associations between average FA values of the global WM skeleton and weight as well as illness duration parameters were analyzed by multiple linear regression.RESULTS: We observed increased FA in bilateral frontal, parietal and temporal areas in AN patients at admission compared to TD. Higher FA of the global WM skeleton at admission was associated with faster weight loss prior to admission. Exploratory longitudinal analysis showed this FA increase to be partially normalized after weight rehabilitation.CONCLUSIONS: Our findings reveal a markedly different pattern of WM microstructural changes in adolescent AN compared to most previous results in adult AN. This could signify a different susceptibility and reaction to semi-starvation in the still developing brain of adolescents or a time-dependent pathomechanism differing with extend of chronicity. Higher FA at admission in adolescents with AN could point to WM fibers being packed together more closely.

AB - BACKGROUND: Anorexia nervosa (AN) often begins in adolescence, however, the understanding of the underlying pathophysiology at this developmentally important age is scarce, impeding early interventions. We used diffusion tensor imaging (DTI) to investigate microstructural white matter (WM) brain changes including an experimental longitudinal follow-up.METHODS: We acquired whole brain diffusion-weighted brain scans of 22 adolescent female hospitalized patients with AN at admission and nine patients longitudinally at discharge after weight rehabilitation. Patients (10-18 years) were compared to 21 typically developing controls (TD). Tract-based spatial statistics (TBSS) were applied to compare fractional anisotropy (FA) across groups and time points. Associations between average FA values of the global WM skeleton and weight as well as illness duration parameters were analyzed by multiple linear regression.RESULTS: We observed increased FA in bilateral frontal, parietal and temporal areas in AN patients at admission compared to TD. Higher FA of the global WM skeleton at admission was associated with faster weight loss prior to admission. Exploratory longitudinal analysis showed this FA increase to be partially normalized after weight rehabilitation.CONCLUSIONS: Our findings reveal a markedly different pattern of WM microstructural changes in adolescent AN compared to most previous results in adult AN. This could signify a different susceptibility and reaction to semi-starvation in the still developing brain of adolescents or a time-dependent pathomechanism differing with extend of chronicity. Higher FA at admission in adolescents with AN could point to WM fibers being packed together more closely.

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KW - Adolescence

KW - DTI

KW - TBSS

KW - Fractional anisotropy

KW - SUBJECT DIFFUSION DATA

KW - SPATIAL STATISTICS

KW - EATING-DISORDERS

KW - VOXELWISE ANALYSIS

KW - BRAIN VOLUME

KW - GRAY-MATTER

KW - INTEGRITY

KW - ABNORMALITIES

KW - EPIDEMIOLOGY

KW - PREVALENCE

U2 - 10.1016/j.nicl.2016.04.002

DO - 10.1016/j.nicl.2016.04.002

M3 - Article

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VL - 11

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EP - 621

JO - NeuroImage: Clinical

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SN - 2213-1582

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