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Psychiatry Res Neuroimaging. 2017 Aug 30;266:138-145. doi: 10.1016/j.pscychresns.2017.06.011. Epub 2017 Jun 20.

White matter abnormalities in treatment-naive adolescents at the earliest stages of Anorexia Nervosa: A diffusion tensor imaging study.

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Departmental Faculty of Medicine and Surgery, Università "Campus Bio-Medico di Roma", Rome, Italy; Eating Disorders Centre "La Cura del Girasole" ONLUS, Rome, Italy; Department of Neuroscience, Functional Pharmacology, Uppsala University, BMC, Box 593, 751 24 Uppsala, Sweden. Electronic address:
Departmental Faculty of Medicine and Surgery, Università "Campus Bio-Medico di Roma", Rome, Italy.
Department of Physiology and Pharmacology, Neuroimaging Laboratory, Sapienza University, Rome, Italy.
Eating Disorders Centre "La Cura del Girasole" ONLUS, Rome, Italy.
Department of Brain and Behavioural Sciences, University of Pavia, Botta 11, 27100 Pavia, Italy; Department of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy.
Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy; Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.


Few studies have examined white matter (WM) integrity in long-lasting Anorexia Nervosa (AN) patients using Diffusion Tensor Imaging (DTI). In this paper, we investigated WM integrity at the earliest stages of AN (i.e. less than 6 months duration). Fourteen treatment-naive female adolescents with AN restrictive type (AN-r) in its earliest stages and 15 age-matched healthy females received brain MRI. Fractional Anisotropy (FA), Axial Diffusivity (AD), Radial diffusivity (RD), and Mean Diffusivity (MD) maps were computed from DTI data using Tract-Based Spatial Statistics analysis. AN-r patients showed FA decreases compared to controls (pFWE < 0.05) mainly in left anterior and superior corona radiata and left superior longitudinal fasciculus. AN-r patients also showed decreased AD in superior longitudinal fasciculus bilaterally and left superior and anterior corona radiata, (pFWE < 0.05). No significant differences were found in RD and MD values between the two groups. FA and AD integrity appears to be specifically affected at the earliest stages of AN. Alterations in the microstructural properties of the above mentioned tracts, also involved in cognitive control and visual perception and processing, may be early mechanisms of vulnerability/resilience of WM in AN and sustain the key symptoms of AN, such as impaired cognitive flexibility and body image distortion.


Adolescence; Anorexia nervosa; Corona radiata; Diffusion tensor imaging; Eating disorder; Superior longitudinal fasciculus; Voxel based morphometry

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