Psychoradiological investigations of gray matter alterations in patients with anorexia nervosa

Simin Zhang,Huaiqiang Sun,Qiang Yue,Qiyong Gong,Qiaoyue Tan,Jingkai Su,Weina Wang,Xiaorui Su,Xibiao Yang,Graham J Kemp,Youjin Zhao

doi:10.1038/s41398-018-0323-3

Abstract

Anorexia nervosa (AN) is a severe psychiatric disorder with high mortality. The underlying neurobiological mechanisms are not well understood, and high-resolution structural magnetic resonance brain imaging studies have given inconsistent results. Here we aimed to psychoradiologically define the most prominent and replicable abnormalities of gray matter volume (GMV) in AN patients, and to examine their relationship to demographics and clinical characteristics, by means of a new coordinate-based meta-analytic technique called seed-based d mapping (SDM). In a pooled analysis of all AN patients we identified decreased GMV in the bilateral median cingulate cortices and posterior cingulate cortices extending to the bilateral precuneus, and the supplementary motor area. In subgroup analysis we found an additional decreased GMV in the right fusiform in adult AN, and a decreased GMV in the left amygdala and left anterior cingulate cortex in AN patients without comorbidity (pure AN). Thus, the most consistent GMV alterations in AN patients are in the default mode network and the sensorimotor network. These psychoradiological findings of the brain abnormalities might underpin the neuropathophysiology in AN.

Highlights

Anorexia nervosa (AN) is a serious and distinctive psychiatric disorder, affecting adolescent girls and young adult women[1]
Study selection A systematic strategy was used to search for relevant studies published in PubMed, Embase, Web of Science, and Google Scholar up to May 2018 using combinations of the terms “anorexia nervosa” or “AN” or “eating disorder” plus “VBM” or “voxel-based morphometry” or “whole brain” or “morphometric”
The following were criteria for inclusion: (i) an original article in a peer-reviewed journal; (ii) including patients with a primary diagnosis of AN based on DSM criteria; (iii) reporting a VBM case-control study on AN patients and healthy control (HC) subjects; (iv) reporting whole-brain gray matter volume (GMV) alterations in a stereotactic space in three-dimensional standard coordinates; (v) using significance thresholds for data that were either corrected for multiple comparisons or uncorrected with spatial extent thresholds

Summary

Introduction

Anorexia nervosa (AN) is a serious and distinctive psychiatric disorder, affecting adolescent girls and young adult women[1]. Relatively rare (prevalence ~0.3%), AN has serious medical consequences (mortality ~10%) and poses a major clinical, psychological, and societal burden[2]. As defined in the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013), AN is characterized by an intense fear of weight gain and a distorted view of body shape, which motivates severe dietary restriction or other weight loss. Cognitive and emotional functioning are markedly disturbed, and serious medical morbidity and psychiatric comorbidity are common[4]. AN has a complex etiology, involving genetic/neurobiological, social–environmental and psychological factors[5]. Radiological techniques such as magnetic resonance imaging (MRI) is an important psychoradiologic technique (https://radiopaedia.org/articles/psychoradiology)[64,65,66,67].

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