Anorexia nervosa (AN) is a serious eating disorder characterized by self-starvation and extreme weight loss. Pseudoatrophic brain changes are often readily visible in individual brain scans, and AN may be a valuable model disorder to study structural neuroplasticity. Structural magnetic resonance imaging studies have found reduced gray matter volume and cortical thinning in acutely underweight patients to normalize following successful treatment. However, some well-controlled studies have found regionally greater gray matter and persistence of structural alterations following long-term recovery. Findings from diffusion tensor imaging studies of white matter integrity and connectivity are also inconsistent. Furthermore, despite the severity of AN, the number of existing structural neuroimaging studies is still relatively low, and our knowledge of the underlying cellular and molecular mechanisms for macrostructural brain changes is rudimentary. We critically review the current state of structural neuroimaging in AN and discuss the potential neurobiological basis of structural brain alterations in the disorder, highlighting impediments to progress, recent developments, and promising future directions. In particular, we argue for the utility of more standardized data collection, adopting a connectomics approach to understanding brain network architecture, employing advanced magnetic resonance imaging methods that quantify biomarkers of brain tissue microstructure, integrating data from multiple imaging modalities, strategic longitudinal observation during weight restoration, and large-scale data pooling. Our overarching objective is to motivate carefully controlled research of brain structure in eating disorders, which will ultimately help predict therapeutic response and improve treatment.

中文翻译：

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神经性厌食症的结构性神经影像学：探索动态改变背后机制的未来方向

神经性厌食症 (AN) 是一种严重的饮食失调症，其特征是自我饥饿和极度减肥。在个体脑部扫描中，假性萎缩性脑部变化通常很容易看到，而 AN 可能是研究结构神经可塑性的一种有价值的模型疾病。结构性磁共振成像研究发现，在成功治疗后，体重严重不足的患者的灰质体积减少和皮质变薄可恢复正常。然而，一些控制良好的研究发现，在长期恢复后，区域性更大的灰质和结构改变的持续性。白质完整性和连通性的扩散张量成像研究结果也不一致。此外，尽管 AN 的严重性，现有的结构神经影像学研究的数量仍然相对较少，我们对大脑宏观结构变化的潜在细胞和分子机制的了解还很初级。我们批判性地回顾了 AN 结构性神经影像学的现状，并讨论了该疾病中结构性大脑改变的潜在神经生物学基础，强调了进展的障碍、最近的发展和有希望的未来方向。特别是，我们主张使用更标准化的数据收集，采用连接组学方法来理解大脑网络架构，采用先进的磁共振成像方法量化脑组织微观结构的生物标志物，整合来自多种成像模式的数据，在体重期间进行战略性纵向观察恢复和大规模数据池化。