Structural brain alterations in adolescents with anorexia nervosa

Anorexia nervosa is a mental health disorder in which biological factors are important pathophysiological determinants. In the last few years, we have witnessed an increase in the use of neuroimaging techniques to study the brain structure of people with anorexia nervosa. These studies have found brain alterations based on the global reductions of grey matter volumes of cortical and subcortical regions in adolescents with anorexia nervosa. Recent neuroimaging techniques have also begun to study the water diffusion alteration in the brain, whose understanding is still in its early research stages. However, the diversity in the study of these analysis samples calls for more studies able to determine the regional brain differences typical in underweight adolescents with anorexia nervosa. Furthermore, it is not clear if the recovery of the brain alterations can be achieved after weight-restoration treatment. The majority of these studies have followed a cross-sectional design and the need of longitudinal studies is expressed. The aim of this dissertation is the study of the brain structure in underweight adolescent girls with anorexia nervosa before and after short-term weight restoration in comparison to age-gender matched healthy control participants. The present dissertation outlines significant brain abnormalities in adolescent girls with anorexia nervosa. The use of neuroimaging techniques of voxel based morphometry and diffusion tensor imaging indicate alterations in cortical and subcortical regions. The abnormalities in the cingulate cortex, parietal association cortices, and insula, among other regions, have been linked to typical features of anorexia nervosa which could possibly explain the pathophysiology of the disorder. Weight restoration treatment begins to normalize these brain alterations and provides advantageous psychological and physiological changes. Factors such as age, the length of treatment, and the stage of the disorder may be key features that influence the recovery process. Future studies should elucidate their specific impact and influence treatments accordingly. In sum, this dissertation provides a framework of the brain structure in adolescents with anorexia nervosa and specifies factors that could intervene in the development of the disorder