Subcallosal Cingulate Connectivity in Anorexia Nervosa Patients Differs From Healthy Controls: A Multi-tensor
Dave J Hayes1, Nir Lipsman1, David Q Chen1
1Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Toronto Western Research Institute, Division of Brain, Imaging and Behaviour - Systems Neuroscience, University Health Network, Toronto, Ontario M5T 2S8, Canada; Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada.
Brain Stimulation
|June 16, 2015
Summary
Anorexia nervosa patients show altered brain connectivity and white matter microstructure in the subcallosal cingulate region. These changes correlate with clinical symptoms, suggesting potential targets for deep brain stimulation (DBS).
Area of Science:
- Neuroscience
- Psychiatry
- Medical Imaging
Background:
- Anorexia nervosa (AN) is marked by low body weight and affect processing deficits.
- The subcallosal cingulate (SCC) region, crucial for affect regulation, is implicated in AN pathophysiology.
- Deep brain stimulation (DBS) targets the SCC white matter (SCC) for treatment-refractory AN.
Purpose of the Study:
- To investigate anatomical connectivity of the SCC in treatment-refractory AN patients undergoing DBS.
- To identify white matter microstructural changes in AN patients.
- To correlate microstructural changes with clinical affect assessments.
Main Methods:
- Diffusion MRI (dMRI) and tractography were used to assess SCC white matter tracts.
- Eight women with treatment-refractory AN were compared to eight healthy controls.
- Clinical affect assessments were conducted pre- and post-surgery.
Main Results:
- AN patients exhibited altered SCC connectivity, with both increased and decreased connections compared to controls.
- Significant white matter microstructural differences were found in tracts including the fornix and internal capsule.
- Pre-surgical fractional anisotropy in the fornix and right ALIC correlated with post-DBS improvements in quality-of-life and depressive symptoms.
Conclusions:
- Widely distributed SCC connectivity differences in AN patients align with heterogeneous clinical presentations.
- Microstructural changes in specific white matter tracts are associated with AN and treatment outcomes.
- Further research on affect-related connectivity is recommended for optimizing DBS target selection.
Keywords:
DTIDeep brain stimulationDiffusion tensor imagingEating disorderFractional anisotropyMood disorder
