Structural Magnetic Resonance Imaging in Eating Disorders: A Systematic Review of Voxel-Based Morphometry Studies

King's College London, Institute of Psychiatry, Department of Psychological Medicine, Section of Eating Disorders, London, UK.
European Eating Disorders Review (Impact Factor: 2.46). 03/2012; 20(2):94-105. DOI: 10.1002/erv.1163
Source: PubMed

ABSTRACT This systematic review summarises and critically appraises the literature on structural magnetic resonance imaging in people with a current or past eating disorder. Studies using voxel-based morphometry image analysis were included. Ten studies reported on a total of 236 people with a current or past eating disorder and 257 healthy controls. Sample heterogeneity prohibited a meta-analytic approach. The findings do not unequivocally indicate grey or white matter volume abnormalities in people with an eating disorder. Nevertheless, these preliminary data suggest that, compared with healthy controls, people with anorexia nervosa have decreased grey matter in a range of brain regions and that those with bulimia nervosa have increased grey matter volumes in frontal and ventral striatal areas. Research in the recovery phase and longitudinal studies suggest that potential brain tissue abnormalities may recover with clinical improvement. Overall, as the available data are inconclusive, further efforts in this field are warranted.

Download full-text


Available from: Marcelo Berlim, Mar 07, 2014
106 Reads
  • Source
    • "Neuroimaging research has identified a variety of neuroanatomical substrates of ED pathophysiology. For example, on structural imaging, ED patients show reductions in gray matter volume in regions involved in reward, impulse control, and emotion regulation: the caudate nucleus, ventral striatum (VS), anterior cingulate (ACC) and orbitofrontal cortex (OFC) (Friederich et al., 2012; Schäfer et al., 2010; Titova et al., 2013; Van den Eynde et al., 2012). Likewise, functional magnetic resonance imaging (fMRI) studies in ED reveal abnormal patterns of resting-state connectivity in the default-mode network (Cowdrey et al., 2014) and other intrinsic brain networks incorporating the ACC and insula (Amianto et al., 2013). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Conventional treatments for eating disorders are associated with poor response rates and frequent relapse. Novel treatments are needed, in combination with markers to characterize and predict treatment response. Here, resting-state functional magnetic resonance imaging (rs-fMRI) was used to identify predictors and correlates of response to repetitive transcranial magnetic stimulation (rTMS) of the dorsomedial prefrontal cortex (dmPFC) at 10 Hz for eating disorders with refractory binge/purge symptomatology. Methods: 28 subjects with anorexia nervosa, binge-purge subtype or bulimia nervosa underwent 20-30 sessions of 10 Hz dmPFC rTMS. rs-fMRI data were collected before and after rTMS. Subjects were stratified into responder and nonresponder groups using a criterion of ≥50% reduction in weekly binge/purge frequency. Neural predictors and correlates of response were identified using seed-based functional connectivity (FC), using the dmPFC and adjacent dorsal anterior cingulate cortex (dACC) as regions of interest. Results: 16 of 28 subjects met response criteria. Treatment responders had lower baseline FC from dmPFC to lateral orbitofrontal cortex and right posterior insula, and from dACC to right posterior insula and hippocampus. Responders had low baseline FC from the dACC to the ventral striatum and anterior insula; this connectivity increased over treatment. However, in nonresponders, frontostriatal FC was high at baseline, and dmPFC-rTMS suppressed FC in association with symptomatic worsening. Conclusions: Enhanced frontostriatal connectivity was associated with responders to dmPFC-rTMS for binge/purge behavior. rTMS caused paradoxical suppression of frontostriatal connectivity in nonresponders. rs-fMRI could prove critical for optimizing stimulation parameters in a future sham-controlled trial of rTMS in disordered eating.
    Clinical neuroimaging 07/2015; 8:611-618. DOI:10.1016/j.nicl.2015.06.008 · 2.53 Impact Factor
  • Source
    • "The neurodevelopmental hypothesis of ED has been substantiated by recent research, both crosssectionally (Lopez, Tchanturia, Stahl, & Treasure, 2008; Tchanturia et al., 2012; Treasure & Schmidt, 2013; Van den Eynde et al., 2011), and in children at high-risk for ED (Kothari, Rosinska, Treasure, & Micali, 2014; Kothari, Solmi, Treasure, & Micali, 2013). Complementing neuropsychological research, brain imaging techniques have the potential to become reliable tools for the early identification of risk and illness, and evidence suggests that ED are associated with differences in grey matter and white matter volume in a range of brain areas (Frieling et al., 2012; Kazlouski et al., 2011; Van den Eynde et al., 2012). This is the largest follow-up of a cohort of VPT young adults investigating ED psychopathology to date. "
    [Show abstract] [Hide abstract]
    ABSTRACT: This study investigates the prevalence of eating disorder (ED) psychopathology, neuropsychological function, structural brain correlates and risk mechanisms in a prospective cohort of very preterm (VPT) young adults. We assessed ED psychopathology and neuropsychological correlates in 143 cohort individuals born at <33 weeks of gestation. Structural brain correlates and risk factors at birth, in childhood and adolescence, were investigated using prospectively collected data throughout childhood/adolescence. VPT-born individuals had high levels of ED psychopathology at age 21 years. Executive function did not correlate with ED symptomatology. VPT adults presenting with ED psychopathology had smaller grey matter volume at age 14/15 years in the left posterior cerebellum and smaller white matter volume in the fusiform gyrus bilaterally, compared with VPT adults with no ED psychopathology. Caesarean delivery predicted engaging in compensatory behaviours, and severe eating difficulty at age 14 years predicted ED symptomatology in young adulthood. VPT individuals are at risk for ED symptomatology, with evidence of associated structural alterations in posterior brain regions. Further prospective studies are needed to clarify the pathways that lead from perinatal/obstetric complications to ED and relevant neurobiological mechanisms. © 2015 The Authors. European Eating Disorders Review published by John Wiley &Sons, Ltd.
    European Eating Disorders Review 01/2015; 23(2). DOI:10.1002/erv.2346 · 2.46 Impact Factor
  • Source
    • "AN is associated with a myriad of physical and psychological comorbidities, high levels of mortality and disability [1]. Significant advances have been made over the last decade in our understanding of the neural correlates of AN, with research highlighting both structural [9] [25] [37]; and functional [6] [30] [34] [39] alterations in the brain. These neuroimaging studies reveal gray and white matter alterations, and disturbances in limbic, frontal and parietal areas, in addition to alterations in the functioning of neurotransmitters including serotonin and dopamine at different stages of AN. "
    [Show abstract] [Hide abstract]
    ABSTRACT: But de l’étude Plusieurs études récentes en EEG et en PET-scan ont montré une hyperactivation de l’hémisphère droit dans l’anorexie nerveuse (AN). Notre étude vise à réexaminer cette notion en testant l’excitabilité corticale des patients présentant une AN, au moyen de la stimulation magnétique transcrânienne (SMT). Méthodes Nous avons étudié 13 patients remplissant les critères DSM-IV d’AN, comparés à 14 sujets témoins appariés par l’âge et le sexe. Chaque patient était évalué cliniquement au moyen des tests suivants : Eating Disorder Inventory (EDI), Eating Attitude Test (EAT) Beck's Depression Inventory (BDI-II). Les mesures réalisées par SMT incluaient : le seuil moteur au repos (SMR) et sous-activation volontaire (SMA), les potentiels évoqués moteurs (PEM), la durée de la période de silence corticale (PSC), l’inhibition transcalleuse (IT), l’inhibition intracorticale de courte latence (ICCL) du premier interosseux dorsal (PID). Nous avons également mesuré le temps de latence (TL) des PEM œsophagiens. Résultats Le SMR et le temps de latence des PEM œsophagiens et du PID étaient significativement réduits dans le groupe AN par rapport aux contrôles. Il n’y avait pas de différences significatives au niveau des SMA et PSC. On a également retrouvé des corrélations négatives significatives entre les scores EAT et le SMR, le TL et IT. Bien que les patients anorexiques présentaient un score BDI plus élevé, celui-ci n’était pas corrélé à l’excitabilité corticale. Conclusions Les sujets anorexiques présentent une excitabilité corticale motrice et oesophagienne accrue, corrélée aux symptômes cliniques de l’AN.
    Neurophysiologie Clinique/Clinical Neurophysiology 09/2014; 44(3). DOI:10.1016/j.neucli.2014.08.002 · 1.24 Impact Factor
Show more