Lower gray matter volumes of frontal lobes and insula in adolescents with anorexia nervosa restricting type: Findings from a Brain Morphometry Study
Open accessAbstract
BACKGROUND: Brain atrophy in anorexia nervosa (AN) is one of the most marked structural brain changes observed in mental disorders. In this study, we propose a whole brain analysis approach to characterize global and regional cerebral volumes in adolescents with restricting-type anorexia nervosa (AN-r). METHODS: A total of 48 adolescent females (age range 13-18 years) were enrolled in the study (24 right-handed AN-r in the early stages of the illness and treated in the same clinical setting and 24 age-matched healthy controls [HC]). High-resolution T1-weighted magnetic resonance images were acquired. Cerebral volumes, including the total amounts of gray matter (GM), white matter (WM), and cerebrospinal fluid (CSF) were obtained with the Statistical Parametric Mapping software (SPM8); specific cortical regional volumes were computed by applying an atlas-based cortical parcellation to the SPM8 GM segments. Analysis of variance (ANOVA) was performed to identify any significant between-group differences in global and regional brain volumes. RESULTS: The analyses revealed reduced total GM volumes (p = 0.02) and increased CSF (p = 0.05) in AN-r, compared with HC. No significant between-group difference was found in WM volumes. At the regional level, significantly lower GM volumes in both frontal lobes (p = 0.006) and in the left insula (p = 0.016) were detected. No significant relationships were found between cerebral volumes and duration of illness, psychiatric comorbidities, psychopharmacological treatment, prepubertal phase, or presence of amenorrhea. CONCLUSIONS: The topographic distribution of GM reduction in a homogenous group of AN-r involves regions responsible for the emotional and cognitive deficits associated with the illness. These findings are discussed in relation to the roles of the insular cortex and the frontal lobes.
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Research has documented extensive cognitive impairments associated with malnutrition in anorexia nervosa, including brain atrophy, cognitive distortions, reduced executive functioning, and emotional processing issues.
“This raises profound concerns, given that research has documented extensive cognitive impairments associated with malnutrition in anorexia nervosa, including brain atrophy, cognitive distortions, reduced executive functioning, and emotional processing issues (151–155).”
From Assisted death in eating disorders: a systematic review of cases and clinical rationales (2024) · cites this paper as [152]
The Introduction reports reduced brain volume in anorexia nervosa and links frontal and parietal regions to executive-function deficits and body-image distortions. The Discussion connects the affected regions to emotional and cognitive processing. But it says whether the brain changes result from starvation or precede the illness remains debated; this study did not establish that malnutrition causes the listed cognitive impairments. Page numbers are unavailable in our copy. (LLM, conf=0.87)
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“These structural changes in areas that are involved in cognitive, motivational and emotional processing may underlie some aspects of the psychopathology of AN, such as impaired cognitivebehavioral flexibility, great concern about errors and striving for perfectionism [35,36].”
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Assisted death in eating disorders: a systematic review of cases and clinical rationales
Roff, C., & Cook-Cottone, C. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1431771 · Cited by 16 · see citing works
- Authors
- Curzio, O., Calderoni, S., Maestro, S., Rossi, G., De Pasquale, C. F., Belmonti, V., Apicella, F., Muratori, F., & Retico, A.
- Affiliations
- Istituto di Fisiologia Clinica (IT)
- University of Pisa (IT)
- Fondazione Stella Maris (IT)
- Istituto Nazionale di Fisica Nucleare (IT)
- Corresponding author
- Curzio, O.
- ORCID
- Venue
- European Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2020
- Volume
- 63
- Issue
- 1
- Pages
- e27-e27
- ISSN
- 0924-9338 (ISSN-L)
- 1778-3585
- PMC
- PMC7315882
- OpenAlex
- W3012274617
- Cited by
- 26
- References
- 70
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 9 · 2023: 3 · 2022: 3 · 2021: 1 · 2020: 2
- FWCI
- 0.90
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- European Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Ministero della Salute
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Keywords
- adolescents, gray matter volume, frontal lobe, insula, brain atrophy, cerebrospinal fluid, white matter, cortical parcellation, brain morphometry
- MeSH terms
- Adolescent, Analysis of Variance, Anorexia Nervosa, Brain, Brain Mapping, Cerebral Cortex, Female, Frontal Lobe, Humans, Magnetic Resonance Imaging, Organ Size, Severity of Illness Index, Case-Control Studies, Gray Matter
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