Research Article: Small-world properties of brain morphological characteristics in Anorexia Nervosa

Date Published: May 9, 2019

Publisher: Public Library of Science

Author(s): Enrico Collantoni, Paolo Meneguzzo, Elena Tenconi, Renzo Manara, Angela Favaro, Hengyi Rao.


Cortical thickness and gyrification abnormalities in anorexia nervosa (AN) have been recently described, but no attempt has been made to explore their organizational patterns to characterize the neurobiology of the disorder in the different stages of its course. The aim of this study was to explore cortical thickness and gyrification patterns by means of graph theory tools in 38 patients with AN, 20 fully recovered patients, and 38 healthy women (HC). All participants underwent high-resolution magnetic resonance imaging. Connectome properties were compared between: 1) AN patients and HC, 2) fully recovered patients and HC, 3) patients with a full remission at a 3-year follow-up assessment and patients who had not recovered. Small-worldness was greater in patients with acute AN in comparison to HC in both cortical thickness and gyrification networks. In the cortical thickness network, patients with AN also showed increased Local Efficiency, Modularity and Clustering coefficients, whereas integration measures were lower in the same group. Patients with a poor outcome showed higher segregation measures and lower small-worldness in the gyrification network, but no differences emerged for the cortical thickness network. For both cortical thickness and gyrification patterns, regional analyses revealed differences between patients with different outcomes. Different patterns between cortical thickness and gyrification networks are probably due to their peculiar developmental trajectories and sensitivity to environmental influences. The role of gyrification network alterations in predicting the outcome suggests a role of early maturational processes in the prognosis of AN.

Partial Text

Anorexia Nervosa (AN) is a disabling psychiatric disorder that typically develops in female individuals during adolescence or early adulthood and is characterized by important psychopathological, cognitive, medical and neurobiological abnormalities [1].

The sample included was the same as a previous study [13]. A total of 58 patients with AN (38 with acute AN and 20 fully recovered (AN-REC)) and 38 HC participated.

Table 1 shows the main clinical characteristics of the 3 groups involved in the study, including average cortical thickness and gyrification index as found in Favaro et al. [13]. Differences in vertex-wise analyses were reported in our previous paper [13].

In the last decade many advances have been made in the description of the organizational principles that govern the anatomy and the topology of brain structural covariance networks and in establishing the relationship between them and functional connectivity patterns [15]. Regional and global structural brain features undergo profound modifications during development and establish their covariance properties following complex trajectories that are influenced by both genetic predisposition and environmental influences. The biological mechanisms underlying thickness and gyrification correlation among cortical areas might impact at different developmental stages and their properties should reflect the different mechanisms that influence the cortical connective architecture. Several studies have examined thickness and gyrification covariance patterns in psychiatric diseases in order to understand whether disruptions in segregation and integration properties are measurable and to investigate the candidate biological and developmental underpinnings that may explain such alterations [32–37].




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