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J Am Acad Child Adolesc Psychiatry. 2017 Oct;56(10):866-874.e7. doi: 10.1016/j.jaac.2017.08.008. Epub 2017 Aug 19.

Reduced Inferior and Orbital Frontal Thickness in Adolescent Bulimia Nervosa Persists Over Two-Year Follow-Up.

Author information

1
Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute and College of Physicians and Surgeons, Columbia University, New York. Electronic address: marilyn.cyr@nyspi.columbia.edu.
2
Stony Brook University, Stony Brook, NY.
3
College of Physicians and Surgeons, Columbia University, San Diego.
4
Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute and College of Physicians and Surgeons, Columbia University, New York.
5
University of California, San Diego.

Abstract

OBJECTIVE:

Cross-sectional data suggest functional and anatomical disturbances in inferior and orbital frontal regions in bulimia nervosa (BN). Using longitudinal data, we investigated whether reduced cortical thickness (CT) in these regions arises early and persists over adolescence in BN, independent of symptom remission, and whether CT reductions are markers of BN symptoms.

METHOD:

A total of 33 adolescent females with BN symptoms (BN or other specified feeding or eating disorder) and 28 healthy adolescents participated in this study. Anatomical magnetic resonance imaging and clinical data were acquired at 3 time points within 2-year intervals over adolescence, with 31% average attrition between assessments. Using a region-of-interest approach, we assessed group differences in CT at baseline and over time, and tested whether between- and within-subject variations in CT were associated with the frequency of BN symptoms.

RESULTS:

Reduced CT in the right inferior frontal gyrus persisted over adolescence in BN compared to healthy adolescents, even in those who achieved full or partial remission. Within the BN group, between-subject variations in CT in the inferior and orbital frontal regions were inversely associated with specific BN symptoms, suggesting, on average over time, greater CT reductions in individuals with more frequent BN symptoms.

CONCLUSION:

Reduced CT in inferior frontal regions may contribute to illness persistence into adulthood. Reductions in the thickness of the inferior and orbital frontal regions may be markers of specific BN symptoms. Because our sample size precluded correcting for multiple comparisons, these findings should be replicated in a larger sample. Future study of functional changes in associated fronto-striatal circuits could identify potential circuit-based intervention targets.

KEYWORDS:

bulimia nervosa; cortical thickness; longitudinal design; magnetic resonance imaging (MRI)

PMID:
28942809
PMCID:
PMC5648351
DOI:
10.1016/j.jaac.2017.08.008
[Indexed for MEDLINE]
Free PMC Article

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