A longitudinal magnetic resonance imaging study of brain changes in adolescents with anorexia nervosa
D. K. Katzman, R. B. Zipursky, E. K. Lambe and D. J. Mikulis
Department of Paediatrics, Hospital for Sick Children, Toronto, Ontario.
OBJECTIVE: To assess whether the cerebral gray and white matter volume
deficits described in patients with anorexia nervosa (AN) are fully
reversible with weight rehabilitation. DESIGN: A prospective cohort study
using magnetic resonance imaging to examine the brains of female
adolescents after weight recovery from AN. SETTING: An adolescent eating
disorder program located in a tertiary care children's hospital.
PARTICIPANTS: Of 13 patients who underwent a previous magnetic resonance
imaging study at a low weight, 6 patients were weight recovered and
underwent rescanning. All brain measures were corrected for the effects of
intracranial volume and age, based on a regression analysis of a group of
34 healthy female control subjects. Scans from the patients with AN were
also compared with scans from an age-matched subset of 16 healthy female
controls. MAIN OUTCOME MEASURES: White matter volumes, gray matter volumes,
and cerebrospinal fluid volumes in the weight-recovered AN group. RESULTS:
Quantitative analysis showed that white matter and ventricular
cerebrospinal fluid volumes changed significantly (P = .03 for both) on
weight recovery from AN. The weight-recovered patients had significant gray
matter volume deficits (P = .01) and elevated cerebrospinal fluid volumes
(P = .005) compared with those of the age-matched controls. They no longer
had significant (P = .30) white matter volume deficits. CONCLUSION: The
finding of persistent gray matter volume deficits in patients who have
recovered their weight after AN suggests an irreversible component to the
structural brain changes associated with AN, in addition to a component
that resolves on weight recovery.
