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Longitudinal study in adolescent anorexia nervosa: evaluation of cortico-striatal and default mode network resting-state brain circuits

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Abstract

Anorexia nervosa (AN) typically emerges in adolescence. The cortico-striatal system (CSTS) and the default mode network (DMN) are brain circuits with a crucial development during this period. These circuits underlie cognitive functions that are impaired in AN, such as cognitive flexibility and inhibition, among others. Little is known about their involvement in adolescent AN and how weight and symptom improvement might modulate potential alterations in these circuits. Forty-seven adolescent females (30 AN, 17 healthy control) were clinically/neuropsychologically evaluated and scanned during a 3T-MRI resting-state session on two occasions, before and after a 6-month multidisciplinary treatment of the AN patients. Baseline and baseline-to-follow-up between-group differences in CSTS and DMN resting-state connectivity were evaluated, as well as their association with clinical/neuropsychological variables. Increased connectivity between the left dorsal putamen and the left precuneus was found in AN at baseline. At follow-up, body mass index and clinical symptoms had improved in the AN group. An interaction effect was found in the connectivity between the right dorsal caudate to right mid-anterior insular cortex, with lower baseline AN connectivity that improved at follow-up; this improvement was weakly associated with changes in neuropsychological (Stroop test) performance. These results support the presence of CSTS connectivity alterations in adolescents with AN, which improve with weight and symptom improvement. In addition, at the level of caudate-insula connectivity, they might be associated with inhibitory processing performance. Alterations in CSTS pathways might be involved in AN from the early stages of the disorder.

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Acknowledgements

This study was supported by grants from the Alicia Koplowitz Foundation (FAK) (DN040546) and the Generalitat de Catalunya (Child Psychiatry and Psychology Group, 2017SGR4881 and CERCA programme). E.V. was partly supported by a Río Hortega fellowship, provided by the Carlos III Health Institute (ISCIII), Spain (CM15/000839).

Funding

This study was supported by grants from the Alicia Koplowitz Foundation (FAK) (DN040546) and the Generalitat de Catalunya (Child Psychiatry and Psychology Group, 2017SGR4881 and CERCA programme). E.V. was partly supported by a Río Hortega fellowship, provided by the Carlos III Health Institute (ISCIII), Spain (CM15/000839).

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Authors and Affiliations

  1. Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Sant Joan de Déu 2, 08950, Esplugues de Llobregat, Spain

    Esther Via

  2. Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain

    Esther Via

  3. Mental Health Department, Unitat de Neurociència Traslacional, Parc Taulí University Hospital, Institut d’Investigació i Innovació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Barcelona, Spain

    Esther Via

  4. Magnetic Resonance Image Core Facility, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain

    Anna Calvo, Jose Pariente & Nuria Bargallo

  5. Child and Adolescent Psychiatry and Psychology Department, 2017SGR881, Institute Clinic of Neurosciences, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain

    Elena de la Serna, Anna Blázquez, Luisa Lázaro, Susana Andrés-Perpiñá, María Teresa Plana, Itziar Flamarique, Esteve Martínez, Elena Moreno & Josefina Castro-Fornieles

  6. Image Diagnostic Center, Hospital Clínic of Barcelona, Barcelona, Spain

    Nuria Bargallo

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  1. Esther Via
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Correspondence to Esther Via.

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The ethics committee of clinical research of the Hospital Clínic approved the study protocol. The investigation was carried out in accordance with the latest version of the Declaration of Helsinki (Seoul, Republic of Korea, October 2008).

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Supplementary Information

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787_2021_1880_MOESM1_ESM.ppt

Supplementary file1 Supplementary Fig. 1. Connectivity maps between each seed region and the rest of the brain in the healthy control group. Maps corresponding to baseline MRI images, positive connectivity maps. The threshold was set at p<.005, uncorrected, for display purposes. Coloured bar represents T values. Age was not added as a covariate in this model. These results replicate the previous pattern of rsFC in the striatum: Ventral caudate showed increased rsFC with the anterior prefrontal and perigenual anterior cingulate cortex. Dorsal caudate showed increased rsFC with the medial frontal cortex and dorsal parts of the anterior cingulate cortex, extending to the dorsal prefrontal cortex (frontal-eye field area). Ventral putamen showed increased rsFC with the insular cortex, the dorsal anterior cingulate cortex and the inferior frontal gyrus. Dorsal putamen showed increased rsFC with the insular cortex-opercula, extending to the dorsolateral prefrontal cortex, the inferior frontal cortex and the thalamus (PPT 899 kb)

787_2021_1880_MOESM2_ESM.ppt

Supplementary file2 Supplementary Figure 2. ICA-based maps of the DMN. Image representing the two resting-state networks obtained from the ICA analysis that were identified as part of the DMN, with more anterior parts emerging in the resting-state network A and more posterior ones in the resting-state network B (PPT 547 kb)

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Via, E., Calvo, A., de la Serna, E. et al. Longitudinal study in adolescent anorexia nervosa: evaluation of cortico-striatal and default mode network resting-state brain circuits. Eur Child Adolesc Psychiatry 32, 513–526 (2023). https://doi.org/10.1007/s00787-021-01880-w

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