Journal of Neural Transmission

, Volume 123, Issue 8, pp 949–959 | Cite as

Brain morphological changes in adolescent and adult patients with anorexia nervosa

  • J. SeitzEmail author
  • B. Herpertz-Dahlmann
  • K. Konrad
Psychiatry and Preclinical Psychiatric Studies - Original Article


Gray matter (GM) and white matter (WM) volume loss occur in the brains of patients with acute anorexia nervosa (AN) and improve again upon weight restoration. Adolescence is an important time period for AN to begin. However, little is known about the differences between brain changes in adolescents vs adults. We used a meta-analysis and a qualitative review of all MRI studies regarding acute structural brain volume changes and their recovery in adolescents and adults with AN. 29 studies with 473 acute, 121 short-term weight-recovered and 255 long-term recovered patients with AN were included in the meta-analysis. In acute AN, GM and WM were reduced compared to healthy controls. Acute adolescent patients showed a significantly greater GM reduction than adults (−8.4 vs −3.1 %), the difference in WM (−4.0 vs −2.1 %) did not reach significance. Short-term weight-recovered patients showed a remaining GM deficit of 3.6 % and a non-significant WM reduction of 0.9 % with no age differences. Following 1.5–8 years of remission, GM and WM were no longer significantly reduced in adults (GM −0.4 %, WM −0.7 %); long-term studies for adolescents were scarce. The qualitative review showed that GM volume loss was correlated with cognitive deficits and three studies found GM regions, cerebellar deficits and WM to be predictive of outcome. GM and WM are strongly reduced in acute AN and even more pronounced in adolescence. Long-term recovery appears to be complete for adults while no conclusions can be drawn for adolescents, thus caution remains.


Anorexia nervosa Meta-analysis Volume change Adolescents Time course Developm. Psych 


Compliance with ethical standards


This study was funded by internal board funds.

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

702_2016_1567_MOESM1_ESM.pdf (1.9 mb)
RevMan 5.3 results for GM, WM and CSF for acutely ill AN compared to HC (Supp Fig. 1–3), short term recovered compared to HC (Supp Fig. 4–6) and longterm recovered AN compared to HC (Supp Fig. 7–9). For studies where brain volumes correction for ICV was possible, means indicate % of ICV. For studies without brain volume correction, means indicate mm3 brain volume. (PDF 1899 kb)


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Copyright information

© Springer-Verlag Wien 2016

Authors and Affiliations

  1. 1.Department of Child and Adolescent Psychiatry, Psychotherapy and PsychosomaticsUniversity Hospital RWTH University AachenAachenGermany

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