CEREBRAL GRAY-MATTER VOLUME DEFICITS AFTER WEIGHT RECOVERY FROM ANOREXIA-NERVOSA

Background: Structural changes have been observed in the brains of low -weight patients with anorexia nervosa (AN), including increased cereb rospinal fluid (CSF) volumes and decreased gray matter and white matte r volumes. We hypothesized that subjects who are weight-recovered from AN would show elevated CSF volumes and reduced gray matter volumes co mpared with controls. Methods: We used magnetic resonance imaging to c ompare the brains of 12 subjects who are weight-recovered from AN (tim e since weight recovery, 1-23 years) with those of 18 healthy control subjects and 13 low-weight patients with AN. Axial, dual-echo scans of the whole brain were segmented into gray matter, white matter, and CS F compartments by means of a computerized volumetric approach. Brain m easures were corrected for the significant effects of intracranial vol ume and age, based on regression analysis of a larger group of 30 heal thy female controls. Results: t Tests showed that the weight-recovered group had significantly greater CSF volumes and smaller gray matter v olumes than the control group. By comparison with low-weight patients, the weight-recovered subjects had significantly smaller CSF volumes a nd significantly larger gray matter and white matter volumes. in the w eight-recovered group, neither the CSF elevations nor gray matter defi cits were correlated with the length of time since weight recovery. Co nclusions: The persistent gray matter volume deficits in subjects who are weight-recovered from AN suggest that there may be an irreversible component to the brain changes associated with the illness. The neuro pathological features of this irreversible component have yet to be ch aracterized.