Restraint of appetite and reduced regional brain volumes in anorexia nervosa: a voxel-based morphometric study

Samantha J Brooks, Gareth J Barker, Owen G O'Daly, Michael Brammer, Steven C R Williams, Christian Benedict, Helgi B Schiöth, Janet Treasure, Iain C Campbell, Samantha J Brooks, Gareth J Barker, Owen G O'Daly, Michael Brammer, Steven C R Williams, Christian Benedict, Helgi B Schiöth, Janet Treasure, Iain C Campbell

Abstract

Background: Previous 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.

Methods: Voxel 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).

Results: Increased 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.

Conclusions: In 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.

Figures

Figure 1
Figure 1
Gray matter volume differences between all women with AN (n = 14) and healthy controls (n = 21). Voxel-based morphometry maps thresholded at p = 0.002 for false positives and corrected for covariates (Total gray Matter Volume, Age). Red indicates deficits in gray matter volume in women with AN compared to controls, blue indicates excesses in gray matter volume in women with AN compared to controls. Z score coordinates given are from the Talairach atlas.
Figure 2
Figure 2
Gray matter differences between women with restricting (n = 8) and binge purge AN (n = 6). Voxel-based morphometry maps thresholded at p = 0.01 for false positives and corrected for covariates (Total gray matter volume, Age, BMI, Years Education, Trait Anxiety). Red indicates deficits in gray matter volume in women with RAN compared to BPAN. Z score coordinates given are from the Talairach atlas.
Figure 3
Figure 3
Regression analyses with brain volumes. Negative correlation with age and right DLPFC volume in a) healthy women; b) no correlation in women with AN; c) regression analysis: first level predictor restraint (EDE-Q); d) second level predictor current BMI (log transformed) of right DLPFC volume in women with AN; both predictors were weighted for duration of illness.

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