Cerebral gray matter and white matter volume deficits in adolescent girls with anorexia nervosa☆,☆☆,★,★★
Section snippets
Subjects
We studied 13 adolescent girls who were receiving inpatient treatment for AN at the Hospital for Sick Children in Toronto, Canada (mean age, 15.2 years; SD, 1.2 years; range, 13.3 to 17.0 years). Twelve of the subjects were white and one subject was of Asian origin; all subjects were right-handed. Patients were included if they met the criteria for AN, restricting type, as defined by the Diagnostic and Statistical Manual of Mental Disorders (third revised edition, 1987).12 Exclusion criteria
RESULTS
Descriptive data for the AN and control groups are shown in Table I.
Empty Cell Control group (n = 8) AN group (n = 13) Age at MRI (yr) 15.4 ± 1.5 15.2 ± 1.2 13.4-17.3 13.3-17.0 Weight at MRI (kg) 60.2 ± 10.2 40.8 ± 6.6* 42.8-74.2 32.4-54.4 Height at MRI (cm) 161.7 ± 8.3 161.6 ± 7.4 147.0-175.5 151.0-180.0 BMI at MRI (kg/m2) 22.9 ± 2.3 15.6 ± 1.7* 18.7-25.0 12.7-17.8 Lowest reported BMI (kg/m2) NA 14.3 ± 1.7 10.5-17.2 Menarche (yr) 12.4 ± 1.0 12.6 ± 0.8 11.0-14.0 11.0-13.5 Duration of amenorrhea (mo) NA 9.5 ± 4.7
DISCUSSION
This study clearly established that structural brain abnormalities are present in adolescents with AN. These abnormalities include larger CSF volumes in ventricles and sulci and reduced volumes of both gray matter and white matter. Larger CSF volumes and smaller gray matter volumes were significantly correlated with the severity of weight loss (as reflected by BMI) and with increased cortisol production. These abnormalities are present within months of the patients' having fulfilled diagnostic
Acknowledgements
We acknowledge the assistance of Cynthia Kirsh, the staff of the Eating Disorders Program at the Hospital for Sick Children, and the staff of the MRI Centre at the Toronto Hospital-Western Division. We also thank Allan L. Reiss for making Brain Image (National Institute of Child Health and Human Development, Human Brain Project, HD31715) available to us and Edmond Chong for his assistance with all facets of image processing. This article was prepared with the assistance of the Hospital for Sick
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From the Hospital for Sick Children; Clarke Institute of Psychiatry; The Toronto Hospital—Western Division; and the Departments of Pediatrics, Psychiatry, and Medical Imaging, University of Toronto School of Medicine, Toronto, Ontario, Canada
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Supported by the Ontario Mental Health Foundation and the Deans Fund, University of Toronto School of Medicine.
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Reprint requests: Robert B. Zipursky, MD, Clarke Institute of Psychiatry, 250 College St., Toronto, ON M5T 1R8, Canada.
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0022-3476/96/$5.00 + 0 9/21/75817