Abstract
Anorexia nervosa (AN) is a severe psychiatric disorder with high mortality and, to a large extent, unknown pathophysiology. Structural brain differences, such as global or focal reductions in grey or white matter volumes, as well as enlargement of the sulci and the ventricles, have repeatedly been observed in individuals with AN. However, many of the documented aberrances normalize with weight recovery, even though some studies show enduring changes. To further explore whether AN is associated with neuronal damage, we analysed the levels of neurofilament light chain (NfL), a marker reflecting ongoing neuronal injury, in plasma samples from females with AN, females recovered from AN (AN-REC) and normal-weight age-matched female controls (CTRLS). We detected significantly increased plasma levels of NfL in AN vs CTRLS (medianAN = 15.6 pg/ml, IQRAN = 12.1–21.3, medianCTRL = 9.3 pg/ml, IQRCTRL = 6.4–12.9, and p < 0.0001), AN vs AN-REC (medianAN-REC = 11.1 pg/ml, IQRAN-REC = 8.6–15.5, and p < 0.0001), and AN-REC vs CTRLS (p = 0.004). The plasma levels of NfL are negatively associated with BMI overall samples (β (±se) = −0.62 ± 0.087 and p = 6.9‧10−12). This indicates that AN is associated with neuronal damage that partially normalizes with weight recovery. Further studies are needed to determine which brain areas are affected, and potential long-term sequelae.
Highlights
Anorexia nervosa (AN) is a psychiatric disorder characterized by persistent restriction of food intake resulting in significantly low body weight, combined with fear of gaining weight or behaviours that interfere with weight gain, and body image distortion[1,2]
The difference in plasma neurofilament light chain (NfL) between AN-REC and CTRLS was smaller than the difference between AN and CTRLS suggesting that NfL might normalize somewhat with weight recovery
Elevated NfL levels have previously been documented in blood and/or cerebrospinal fluid (CSF) in several neurodegenerative conditions[32,33,34,35,36], in ischaemic stroke[37], and even in bipolar disorder[38]
Summary
Anorexia nervosa (AN) is a psychiatric disorder characterized by persistent restriction of food intake resulting in significantly low body weight, combined with fear of gaining weight or behaviours that interfere with weight gain, and body image distortion[1,2]. The disorder affects ~1% of females and 0.1% of males, and an ~10% lethality makes it the most lethal psychiatric disorder[3,4,5]. Relapse rates and treatment failures are very common[6]. The pathoetiology has not been clarified, even though interactions among genetic, environmental, and neurobiological factors clearly contribute[1]. Twin studies have identified a strong genetic contribution, i.e., 58–70% of variance in liability is due to additive genetic factors[5,7,8].
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