Lower region-specific gray matter volume in females with atypical anorexia nervosa and anorexia nervosa
Amanda E. Lyall PhD
Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts, USA
Contribution: Conceptualization, Investigation, Methodology, Project administration, Supervision, Writing - original draft, Writing - review & editing
Search for more papers by this authorCorresponding Author
Lauren Breithaupt PhD
Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts, USA
Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA
Correspondence
Lauren Breithaupt, Department of Psychiatry, Harvard Medical School, 399 Revolution Drive, 11th Floor, Somerville, MA 02145, USA.
Email: [email protected]
Contribution: Conceptualization, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Supervision, Writing - original draft, Writing - review & editing
Search for more papers by this authorChunni Ji MS
Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts, USA
Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA
Division of Women's Health, Department of Medicine, and Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Contribution: Data curation, Formal analysis, Methodology, Visualization, Writing - review & editing
Search for more papers by this authorAnastasia Haidar BA
Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Contribution: Data curation, Formal analysis, Visualization, Writing - review & editing
Search for more papers by this authorElana Kotler BA
Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Contribution: Data curation, Formal analysis, Visualization, Writing - review & editing
Search for more papers by this authorKendra R. Becker PhD
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts, USA
Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA
Contribution: Supervision, Writing - review & editing
Search for more papers by this authorFranziska Plessow PhD
Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts, USA
Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Contribution: Writing - review & editing
Search for more papers by this authorMeghan Slattery MSN
Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts, USA
Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Contribution: Data curation, Project administration, Writing - review & editing
Search for more papers by this authorJennifer J. Thomas PhD
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts, USA
Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA
Contribution: Funding acquisition, Resources, Supervision, Writing - review & editing
Search for more papers by this authorLaura M. Holsen PhD
Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts, USA
Division of Women's Health, Department of Medicine, and Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Contribution: Funding acquisition, Methodology, Supervision, Writing - review & editing
Search for more papers by this authorMadhusmita Misra MD, MPH
Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts, USA
Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Division of Pediatric Endocrinology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Contribution: Funding acquisition, Resources, Supervision, Writing - review & editing
Search for more papers by this authorKamryn T. Eddy PhD
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts, USA
Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA
Contribution: Funding acquisition, Resources, Supervision, Writing - review & editing
Search for more papers by this authorElizabeth A. Lawson MD
Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts, USA
Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Contribution: Funding acquisition, Resources, Supervision, Writing - review & editing
Search for more papers by this authorAmanda E. Lyall PhD
Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts, USA
Contribution: Conceptualization, Investigation, Methodology, Project administration, Supervision, Writing - original draft, Writing - review & editing
Search for more papers by this authorCorresponding Author
Lauren Breithaupt PhD
Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts, USA
Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA
Correspondence
Lauren Breithaupt, Department of Psychiatry, Harvard Medical School, 399 Revolution Drive, 11th Floor, Somerville, MA 02145, USA.
Email: [email protected]
Contribution: Conceptualization, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Supervision, Writing - original draft, Writing - review & editing
Search for more papers by this authorChunni Ji MS
Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts, USA
Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA
Division of Women's Health, Department of Medicine, and Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Contribution: Data curation, Formal analysis, Methodology, Visualization, Writing - review & editing
Search for more papers by this authorAnastasia Haidar BA
Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Contribution: Data curation, Formal analysis, Visualization, Writing - review & editing
Search for more papers by this authorElana Kotler BA
Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Contribution: Data curation, Formal analysis, Visualization, Writing - review & editing
Search for more papers by this authorKendra R. Becker PhD
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts, USA
Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA
Contribution: Supervision, Writing - review & editing
Search for more papers by this authorFranziska Plessow PhD
Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts, USA
Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Contribution: Writing - review & editing
Search for more papers by this authorMeghan Slattery MSN
Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts, USA
Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Contribution: Data curation, Project administration, Writing - review & editing
Search for more papers by this authorJennifer J. Thomas PhD
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts, USA
Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA
Contribution: Funding acquisition, Resources, Supervision, Writing - review & editing
Search for more papers by this authorLaura M. Holsen PhD
Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts, USA
Division of Women's Health, Department of Medicine, and Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Contribution: Funding acquisition, Methodology, Supervision, Writing - review & editing
Search for more papers by this authorMadhusmita Misra MD, MPH
Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts, USA
Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Division of Pediatric Endocrinology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Contribution: Funding acquisition, Resources, Supervision, Writing - review & editing
Search for more papers by this authorKamryn T. Eddy PhD
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts, USA
Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA
Contribution: Funding acquisition, Resources, Supervision, Writing - review & editing
Search for more papers by this authorElizabeth A. Lawson MD
Mass General Brigham Multidisciplinary Eating Disorders Research Collaborative, Mass General Brigham, Boston, Massachusetts, USA
Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Contribution: Funding acquisition, Resources, Supervision, Writing - review & editing
Search for more papers by this authorAmanda E. Lyall and Lauren Breithaupt share first authorship.
Chunni Ji, Anastasia Haidar and Elana Kotler share second authorship.
Madhusmita Misra, Kamryn T. Eddy and Elizabeth A. Lawson share last authorship.
Abstract
Objective
Few studies have focused on brain structure in atypical anorexia nervosa (atypical AN). This study investigates differences in gray matter volume (GMV) between females with anorexia nervosa (AN) and atypical AN, and healthy controls (HC).
Method
Structural magnetic resonance imaging data were acquired for 37 AN, 23 atypical AN, and 41 HC female participants. Freesurfer was used to extract GMV, cortical thickness, and surface area for six brain lobes and associated cortical regions of interest (ROI). Primary analyses employed linear mixed-effects models to compare group differences in lobar GMV, followed by secondary analyses on ROIs within significant lobes. We also explored relationships between cortical gray matter and both body mass index (BMI) and symptom severity.
Results
Our primary analyses revealed significant lower GMV in frontal, temporal and parietal areas (FDR < .05) in AN and atypical AN when compared to HC. Lobar GMV comparisons were non-significant between atypical AN and AN. The parietal lobe exhibited the greatest proportion of affected cortical ROIs in both AN versus HC and atypical AN versus HC. BMI, but not symptom severity, was found to be associated with cortical GMV in the parietal, frontal, temporal, and cingulate lobes. No significant differences were observed in cortical thickness or surface area.
Discussion
We observed lower GMV in frontal, temporal, and parietal areas, when compared to HC, but no differences between AN and atypical AN. This indicates potentially overlapping structural phenotypes between these disorders and evidence of brain changes among those who are not below the clinical underweight threshold.
Public significance
Despite individuals with atypical anorexia nervosa presenting above the clinical weight threshold, lower cortical gray matter volume was observed in partial, temporal, and frontal cortices, compared to healthy individuals. No significant differences were found in cortical gray matter volume between anorexia nervosa and atypical anorexia nervosa. This underscores the importance of continuing to assess and target weight gain in clinical care, even for those who are presenting above the low-weight clinical criteria.
CONFLICT OF INTEREST STATEMENT
The authors report the following conflicts of interest. L.B. serves as a consultant for Otsuka Pharmaceuticals. E.A.L. receives grant support and research study drug from Tonix Pharmaceuticals and receives royalties from UpToDate. J.J.T., K.R.B., and K.T.E. receive royalties from Cambridge University Press for The Picky Eater's Recovery Book: Overcoming Avoidant/Restrictive Food Intake Disorder. M.M. receives research study drug from Tonix Pharmaceuticals and royalties from UpToDate. M.M. has also served as a Key Opinion Leader for Lumos Pharmaceuticals.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available from the senior authors upon reasonable request.
Supporting Information
| Filename | Description |
|---|---|
| eat24168-sup-0001-Supinfo.docxWord 2007 document , 126.3 KB | TABLE S1. Group differences in gray matter volume (GMV) within cortical lobes according to DSM-5 diagnosis. TABLE S2. Group difference in cortical thickness (CT) within cortical lobes according to DSM-5 diagnosis. TABLE S3. Group differences in surface area (SA) within cortical lobes according to DSM-5 diagnosis. TABLE S4. Group differences for the region of interest analysis—DSM-5 diagnosis. TABLE S5. Group differences for the region of interest analysis, including all ROIs—DSM-5 diagnosis. TABLE S6. Association of BMI z-score with GMV in each lobe, accounting for EDE global, hemispheric variations, and eTIV. Table S7. Association of EDE global with GMV in each lobe, accounting for BMI z-score, hemispheric variations, and eTIV. TABLE S8. Demographic and clinical description of recategorized AN-hist and At-AN-hist. TABLE S9. Group differences in gray matter volume (GMV) within cortical lobes based on reclassified groups using historical data. FIGURE S1. Relationships between GMV and BMI z-scores in AN and atypical AN. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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