Dk. Katzman et al., A LONGITUDINAL MAGNETIC-RESONANCE-IMAGING STUDY OF BRAIN CHANGES IN ADOLESCENTS WITH ANOREXIA-NERVOSA, Archives of pediatrics & adolescent medicine, 151(8), 1997, pp. 793-797
Objective: To assess whether the cerebral gray and white matter volume
deficits described in patients with anorexia nervosa (AN) are fully r
eversible with weight rehabilitation. Design: A prospective cohort stu
dy using magnetic resonance imaging to examine the brains of female ad
olescents after weight recovery from AN. Setting: An adolescent eating
disorder program located in a tertiary care children's hospital. Part
icipants: Of 13 patients who underwent a previous magnetic resonance i
maging study at a low weight, 6 patients were weight recovered and und
erwent rescanning. All brain measures were corrected for the effects o
f intracranial volume and age, based on a regression analysis of a gro
up of 34 healthy female control subjects. Scans from the patients with
AN were also compared with scans from an age-matched subset of 16 hea
lthy female controls. Main Outcome Measures: White matter volumes, gra
y matter volumes, and cerebrospinal fluid volumes in the weight-recove
red AN group. Results: Quantitative analysis showed that white matter
and ventricular cerebrospinal fluid volumes changed significantly (P=.
03 for both) on weight recovery from AN. The weight-recovered patients
had significant gray matter volume deficits (P=.01) and elevated cere
brospinal fluid volumes (P=.005) compared with those of the age-matche
d controls. They no longer had significant (P=.30) white matter volume
deficits. Conclusion: The finding of persistent gray matter volume de
ficits in patients who have recovered their weight after AN suggests a
n irreversible component to the structural brain changes associated wi
th AN, in addition to a component that resolves on weight recovery.