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
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FA: Lower in fornix, cingulum and corpus callosum (corona radiata and forceps mayor)
Abnormal fornix integrity could lead to altered feedback between limbic and higher-order brain structures. The corpus callosum could be implicated in taste processing
WM abnormalities in the fornix and the cerebellum may be neural substrates of the pathophysiology of AN. The fornix is one of the important components of the Papez circuit, which links the limbic system with other brain structures. The correlation of WM alteration with physical severity, including BMI and duration of illness may indicate that WM alteration is more relevant with regard to physical severity rather than psychological severity
FA: Lower in the parietal part of the left SLF and the fornix.
The left SLF seem relevant to body image distortion as well as other cognitive processes like the called weak central coherence. The fornix is a key structure involved in the regulation of body-energy balance and processing of reward responses
MD: Higher in the SLF and the fornix. They also reported significantly increased MD in the fornix, accompanied by decreased FA and increased RD and AD
Current AN with NS subtype and recovered women from AN
FA (AN and recAN): Lower in the posterior thalamic radiation bilaterally (which includes the of optic radiation) and the left mediodorsal thalamus
The posterior thalamic radiation fibres project to areas involved in the processing of the body image, whose alteration could explain the AN body image distortion. The left mediodorsal thalamic nucleus is connected to regions contributing to impairments in cognitive domains, especially set/shifting ability, executive control, habit learning and reward processing
Lower MD was associated with harm avoidance, suggesting a possible underlying trait associated with AN. Localization of disturbances in frontal-parietal and cingulum WM suggests that these pathways, which are important for cognitive control, may be susceptible to core AN pathology. Malnutrition seems to have potentially lasting effects on WM integrity and degree of recovery
MD: Lower in frontal, parietal and cingulum
Table 4 Quality assessment of the retrieved studies
Ref.
Q1
Q2
Q3
Q5
Q6
Q15
Q18
Q25
Hypothesis clearly described
Main outcomes clearly described in the introduction or methods section
Participants characteristics clearly described
Distributions of confounders in each group of subjects clearly described
Citation: 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