Abstract
BackgroundPrevious Magnetic Resonance Imaging (MRI) studies of people with anorexia nervosa (AN) have shown differences in brain structure. This study aimed to provide preliminary extensions of this data by examining how different levels of appetitive restraint impact on brain volume.MethodsVoxel based morphometry (VBM), corrected for total intracranial volume, age, BMI, years of education in 14 women with AN (8 RAN and 6 BPAN) and 21 women (HC) was performed. Correlations between brain volume and dietary restraint were done using Statistical Package for the Social Sciences (SPSS).ResultsIncreased right dorsolateral prefrontal cortex (DLPFC) and reduced right anterior insular cortex, bilateral parahippocampal gyrus, left fusiform gyrus, left cerebellum and right posterior cingulate volumes in AN compared to HC. RAN compared to BPAN had reduced left orbitofrontal cortex, right anterior insular cortex, bilateral parahippocampal gyrus and left cerebellum. Age negatively correlated with right DLPFC volume in HC but not in AN; dietary restraint and BMI predicted 57% of variance in right DLPFC volume in AN.ConclusionsIn AN, brain volume differences were found in appetitive, somatosensory and top-down control brain regions. Differences in regional GMV may be linked to levels of appetitive restraint, but whether they are state or trait is unclear. Nevertheless, these discrete brain volume differences provide candidate brain regions for further structural and functional study in people with eating disorders.
Highlights
Previous Magnetic Resonance Imaging (MRI) studies of people with anorexia nervosa (AN) have shown differences in brain structure
A recent region of interest study using Magnetic Resonance Spectroscopy (MRS) has shown that different brain metabolite correlations were found in the anterior cingulate cortex (ACC) in women with AN compared to bulimia nervosa, in that the latter showed correlations of metabolites with ‘drive for thinness’ [18]
There was no significant difference in BMI between the subtypes the self-reported lowest lifetime BMI was significantly lower in the RAN compared to the BPAN group (11.73 ± 0.38 vs. 13.36 ± 0.39 kg/m2, P < 0.01)
Summary
Previous Magnetic Resonance Imaging (MRI) studies of people with anorexia nervosa (AN) have shown differences in brain structure. People with RAN engage in pathological dietary restriction whereas those with the BPAN subtype eat, but engage in compensatory behaviours (bingeing or purging or both) to avoid weight gain. Regional reductions, in the precuneus, seem to persist even after long-term recovery [16] These effects seem prominent in females with the restricting type of AN [6]. Direct comparisons of brain volume using VBM between those who binge (e.g. bulimia nervosa) and AN have only been done to date in those who have recovered from an eating disorder, and show normalization in brain volumes [9]. No VBM study has directly compared brain volume differences between the subtypes of AN and examined the effect of differential levels of dietary restraint on brain volume
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