Brain morphological changes in adolescent and adult patients with anorexia nervosa
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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.
KeywordsAnorexia 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.
- Bomba M, Riva A, Morzenti S et al (2015) Global and regional brain volumes normalization in weight-recovered adolescents with anorexia nervosa: preliminary findings of a longitudinal voxel-based morphometry study. Neuropsychiatr Dis Treat 11:637–645. doi: 10.2147/NDT.S73239 CrossRefPubMedPubMedCentralGoogle Scholar
- Buhren K, Holtkamp K, Herpertz-Dahlmann B, Konrad K (2008) Neuropsychological performance in anorexia and bulimia nervosa. ZKinder JugendpsychiatrPsychother 36:377–386Google Scholar
- Gibson KR, Petersen AC (1991) Brain maturation and cognitive development: comparative and cross-cultural perspectives. Transaction PublishersGoogle Scholar
- Mühlau M, Gaser C, Ilg R et al (2007) Gray matter decrease of the anterior cingulate cortex in anorexia nervosa. AmJPsychiatry 164:1850–1857Google Scholar
- Murrin LC, Sanders JD, Bylund DB (2007) Comparison of the maturation of the adrenergic and serotonergic neurotransmitter systems in the brain: implications for differential drug effects on juveniles and adults. Biochem Pharmacol 73:1225–1236. doi: 10.1016/j.bcp.2007.01.028 CrossRefPubMedPubMedCentralGoogle Scholar
- Nogal P, Pniewska-Siark B, Lewinski A (2008) Relation of trophic changes in the central nervous system, measured by the width of cordical sulci, to the clinical course of anorexia nervosa (II). NeuroEndocrinolLett 29:879–883Google Scholar
- Seitz J, Bühren K, von Polier GG et al (2014) Morphological changes in the brain of acutely ill and weight-recovered patients with anorexia nervosa. A meta-analysis and qualitative review. Z Für Kinder- Jugendpsychiatrie Psychother 42:7–17. doi: 10.1024/1422-4917/a000265 (quiz 17–18) CrossRefGoogle Scholar