A LONGITUDINAL MAGNETIC-RESONANCE-IMAGING STUDY OF BRAIN CHANGES IN ADOLESCENTS WITH ANOREXIA-NERVOSA

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.