Morphological Changes in the Brain of Acutely Ill and Weight-Recovered Patients with Anorexia Nervosa A Meta-Analysis and Qualitative Review
Morphological Changes in the Brain of Acutely Ill and Weight-Recovered Patients with Anorexia Nervosa A Meta-Analysis and Qualitative Review
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DOI：
10.1024/1422-4917/a000265
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发表时间：
2014-01-01
影响因子：
1.2
通讯作者：
Konrad, Kerstin
中科院分区：
文献类型：
--
作者：
Seitz, Jochen;Buehren, Katharina;Konrad, Kerstin
目的：急性神经性厌食症(AN)导致脑内灰质(GM)和白质(WM)体积减少，但在体重恢复后又有所改善。然而，我们对这些大脑变化的范围和临床相关性知之甚少，也不太了解它们恢复的时间进程和完整性。方法：我们对急性期和恢复期的所有涉及脑容量分析的磁共振成像研究进行了荟萃分析和定性综述。结果：我们确定了总共214名急性AN患者和177名体重恢复的AN患者的结构神经成像研究。与健康对照组(HC)相比，急性AN组GM减少5.6%，WM减少3.8%。入院后2-5个月的短期体重恢复导致大约一半的GM畸形恢复，几乎完全恢复WM。经过2-8年的缓解，GM和WM接近正常化，与HC(GM：-1.0%，WM：-0.7%)的差异不再显著，尽管不能排除微小的残留变化。在定性综述中，一些研究发现GM体积丢失与认知障碍和临床预后有关。结论：急性AN患者GM、WM明显减少。脑容量恢复的完备性仍不明确。
Objective: Acute anorexia nervosa (AN) leads to reduced gray (GM) and white matter (WM) volume in the brain, which however improves again upon restoration of weight. Yet little is known about the extent and clinical correlates of these brain changes, nor do we know much about the time-course and completeness of their recovery. Methods: We conducted a meta-analysis and a qualitative review of all magnetic resonance imaging studies involving volume analyses of the brain in both acute and recovered AN. Results: We identified structural neuroimaging studies with a total of 214 acute AN patients and 177 weight-recovered AN patients. In acute AN, GM was reduced by 5.6% and WM by 3.8% compared to healthy controls (HC). Short-term weight recovery 2-5 months after admission resulted in restitution of about half of the GM aberrations and almost full WM recovery. After 2-8 years of remission GM and WM were nearly normalized, and differences to HC (GM: -1.0%, WM: -0.7%) were no longer significant, although small residual changes could not be ruled out. In the qualitative review some studies found GM volume loss to be associated with cognitive deficits and clinical prognosis. Conclusions: GM and WM were strongly reduced in acute AN. The completeness of brain volume rehabilitation remained equivocal.