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Abstract
Background
Anorexia Nervosa (AN) is a psychiatric disorder characterised by undernutrition, significantly low body weight and large, although possibly transient reductions in brain structure. Advanced brain ageing tracks accelerated age-related changes in brain morphology that have been linked to psychopathology and adverse clinical outcomes.
Aim
The aim of the current case-control study was to characterize cross-sectional and longitudinal patterns of advanced brain age in acute AN and during the recovery process.
Methods
Measures of grey- and white-matter-based brain age were obtained from T1-weighted magnetic resonance imaging scans of 129 acutely underweight female AN patients (of which 95 were assessed both at baseline and after approximately 3-months of nutritional therapy), 39 recovered patients and 167 healthy female controls, aged 12 to 23 years. The difference between chronological age and grey- or white-matter-based brain age was calculated to indicate brain-predicted age difference (BrainAGEGM and BrainAGEWM).
Results
Acute AN patients at baseline, but not recovered patients, showed a higher BrainAGEGM of 1.79 years (95% CI [1.45, 2.13]) compared to healthy controls. However, the difference was largely reduced for BrainAGEWM. After partial weight restoration BrainAGEGM decreased substantially (beta = -1.69; CI [-1.93, -1.46]). BrainAGEs were unrelated to symptom severity or depression, but larger weight gain predicted larger normalization of BrainAGEGM in the longitudinal patient sample (beta = -0.65; CI [-0.75, -0.54]).
Conclusions
Our findings suggest that in patients with AN undernutrition is an important predictor of advanced grey-matter-based brain age, which itself might be transient in nature and largely undetectable after weight recovery.
Anorexia Nervosa (AN) is a psychiatric disorder characterised by undernutrition, significantly low body weight and large, although possibly transient reductions in brain structure. Advanced brain ageing tracks accelerated age-related changes in brain morphology that have been linked to psychopathology and adverse clinical outcomes.
Aim
The aim of the current case-control study was to characterize cross-sectional and longitudinal patterns of advanced brain age in acute AN and during the recovery process.
Methods
Measures of grey- and white-matter-based brain age were obtained from T1-weighted magnetic resonance imaging scans of 129 acutely underweight female AN patients (of which 95 were assessed both at baseline and after approximately 3-months of nutritional therapy), 39 recovered patients and 167 healthy female controls, aged 12 to 23 years. The difference between chronological age and grey- or white-matter-based brain age was calculated to indicate brain-predicted age difference (BrainAGEGM and BrainAGEWM).
Results
Acute AN patients at baseline, but not recovered patients, showed a higher BrainAGEGM of 1.79 years (95% CI [1.45, 2.13]) compared to healthy controls. However, the difference was largely reduced for BrainAGEWM. After partial weight restoration BrainAGEGM decreased substantially (beta = -1.69; CI [-1.93, -1.46]). BrainAGEs were unrelated to symptom severity or depression, but larger weight gain predicted larger normalization of BrainAGEGM in the longitudinal patient sample (beta = -0.65; CI [-0.75, -0.54]).
Conclusions
Our findings suggest that in patients with AN undernutrition is an important predictor of advanced grey-matter-based brain age, which itself might be transient in nature and largely undetectable after weight recovery.
| Original language | English |
|---|---|
| Pages (from-to) | 499-505 |
| Journal | The British Journal of Psychiatry |
| Volume | 225 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 30 Nov 2024 |
Data Availability Statement
The data used in this study cannot be publicly deposited. The data that support the findings of this study are available from author S.E., upon reasonable request.Funding
This work was supported by the Deutsche Forschungsgemeinschaft (EH 367/5- 1, EH 367/7-1, and SFB 940), the B. Braun- Stiftung, the Marga and Walter BollStiftung, and the Swiss Anorexia Nervosa Foundation. K.B. was supported by a scholarship from the Technical University Dresden within the Carus Promotionskolleg program. EW was supported by the European Union Horizon 2020 research and innovation programme (EarlyCause, grant number 848158) and by UK Research and Innovation (UKRI) under the UK government’s Horizon Europe / ERC Frontier Research Guarantee [grant number EP/Y015037/1].
| Funders | Funder number |
|---|---|
| UK Research & Innovation | EP/Y015037/1 |
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BrainHealth - Decoding life course pathways of mental ageing - Frontier Research Guarantee
Walton, E. (PI) & Ward, A. (CoI)
1/10/23 → 30/09/28
Project: EU Commission
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