Martin Monzon B, Hay P, Foroughi N, Touyz S. White matter alterations in anorexia nervosa: A systematic review of diffusion tensor imaging studies. World J Psychiatr 2016; 6(1): 177-186 [PMID: 27014606 DOI: 10.5498/wjp.v6.i1.177]
Corresponding Author of This Article
Phillipa Hay, Foundation Chair of Mental Health, Centre for Health Research, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, Sydney 2751, Australia. p.hay@westernsydney.edu.au
Research Domain of This Article
Psychiatry
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Psychiatr. Mar 22, 2016; 6(1): 177-186 Published online Mar 22, 2016. doi: 10.5498/wjp.v6.i1.177
White matter alterations in anorexia nervosa: A systematic review of diffusion tensor imaging studies
Beatriz Martin Monzon, Phillipa Hay, Nasim Foroughi, Stephen Touyz
Beatriz Martin Monzon, Phillipa Hay, Nasim Foroughi, Centre for Health Research, School of Medicine, Western Sydney University, Sydney 2751, Australia
Stephen Touyz, School of Psychology, Faculty of Science, University of Sydney, Sydney 2006, Australia
Author contributions: Martin Monzon B and Hay P designed the study purpose; Martin Monzon B and Foroughi N collected the studies; Martin Monzon B analysed the data and wrote the paper; all authors contributed with the revisions and approved the final manuscript.
Conflict-of-interest statement: Professor Touyz has received fees for serving as consultant to Shire Pharmaceuticals advisory board member. Professor Hay receives Honoraria from PLOS Medicine. In the past Professor Hay has received reimbursement of expenses for speaking at medical meetings and attending symposia from Astra-Zeneca, Solvay Pharmaceuticals, Bristol-Myers Squibb, and Pfizer Pharmaceuticals, and for educational training for family doctors fromBristol-Myers Squibb, Pfizer Pharmaceuticals and Lundbeck and has been funded by Jansen-Cilag to attend educational symposia (none in the past 10 years). Professor Touyz and Professor Hay receive royalties from Hogrefe Publications, McGraw Hill Pubs and honoraria from Biomed Central. Beatriz Martin Monzon receives research funding and support from the Western Sydney University in the form of an International Scholarship.
Data sharing statement: Technical appendix, statistical code, and dataset are available from the corresponding author at p.hay@westernsydney.edu.au. As this was a systematic review of published data there were no participants to be approached for informed consent for data sharing. No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Phillipa Hay, Foundation Chair of Mental Health, Centre for Health Research, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, Sydney 2751, Australia. p.hay@westernsydney.edu.au
Telephone: +61-02-46203838 Fax: +61-02-46203891
Received: July 7, 2015 Peer-review started: July 11, 2015 First decision: October 30, 2015 Revised: November 19, 2015 Accepted: December 29, 2015 Article in press: January 4, 2016 Published online: March 22, 2016 Processing time: 253 Days and 9 Hours
Abstract
AIM: To identify findings concerning white matter (WM) fibre microstructural alterations in anorexia nervosa (AN).
METHODS: A systematic electronic search was undertaken in several databases up to April 2015. The search strategy aimed to locate all studies published in English or Spanish that included participants with AN and which investigated WM using diffusion tensor imaging (DTI). Trials were assessed for quality assessment according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist and a published quality index guideline.
RESULTS: A total of 6 studies met the inclusion criteria, four of people in the acute state of the illness, one included both recovered and unwell participants, and one included people who had recovered. Participants were female with ages ranging from 14 to 29 years. All studies but one measured a range of psychopathological features. Fractional anisotropy and mean diffusivity were the main DTI correlates reported. Alterations were reported in a range of WM structures of the limbic system, most often of the fornix and cingulum as well as the fronto-occipital fibre tracts, i.e., regions associated with anxiety, body image and cognitive function. Subtle abnormalities also appeared to persist after recovery.
CONCLUSION: This diversity likely reflects the symptom complexity of AN. However, there were few studies, they applied different methodologies, and all were cross-sectional.
Core tip: The present systematic review identifies the latest research on white matter (WM) brain alterations in anorexia nervosa (AN). The WM architecture has been poorly understood due to its structure forming deep parts of the brain. It transmits information between cortical and subcortical structures. New advances in imaging methods with diffusion tensor imaging, allow its characterization and integrity analysis. Alterations in areas of fornix, cingulum, corpus callosum, cerebellum, superior longitudinal fasciculus and thalamus have been found in AN. They could be related to symptoms like anxiety, body image perception, reward processing and cognitive abilities.
