Altered White Matter Connectivity in Young Acutely Underweight Patients With Anorexia Nervosa.

Abstract Objective Reductions of gray matter volume and cortical thickness in anorexia nervosa (AN) are well documented. However, findings regarding the integrity of white matter (WM) as studied via diffusion weighted imaging (DWI) are remarkably heterogeneous and WM connectivity has only been examined in small samples using a limited number of regions of interest. The present study investigated whole-brain WM connectivity for the first time in a large sample of acutely underweight patients with AN. Method DWI data from predominantly adolescent patients with acute AN (n=96, mean age=16.3) and age-matched healthy control participants (n=96, mean age=17.2) were analyzed. WM connectivity networks were generated from fiber-tractography derived streamlines connecting 233 cortical/subcortical regions. To identify group differences, network-based statistics were employed while taking head motion, WM and ventricular volume into account. Results Patients with AN were characterized by six WM subnetworks with abnormal architecture as indicated by increased fractional anisotropy located primarily in parietal-occipital regions and accompanied by reduced radial diffusivity. Group differences based on number of streamlines only reached nominal significance. Conclusion Our study reveals pronounced alterations in the WM connectome in young patients with AN. In contrast to known reductions in gray matter in the acutely underweight state of AN, this pattern does not necessarily indicate a deterioration of the WM network. Future studies employing advanced MRI sequences will have to clarify interrelations with axonal packing or myelination and whether the changes should be considered a consequence of undernutrition or a vulnerability for developing or maintaining AN.