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Anastasia Haidar, BS



Research Staff


Brigham and Women's Hospital




Anastasia Haidar*, Elana Kotler, Felicia Petterway, Holly Carrington, Yaen Chen, Kendra Becker, Franziska Plessow, Jennifer J. Thomas, Madhusmita Misra, Kamryn T. Eddy, Elizabeth A. Lawson, Laura M. Holsen, Lauren Breithaupt, Amanda E. Lyall*

Principal Investigator

Dr. Amanda E. Lyall


Investigating the impact of Cortisol on White Matter Microstructure in Young Women with Eating Disorders


Cortisol is directly related to stress, a known risk factor for the development of eating disorders. Studies show elevated cortisol levels in individuals with eating disorders are associated with reduced grey and white matter. Yet, diffusion imaging studies remain divided on white matter changes. We use Free Water Imaging to determine if elevated cortisol is present in young women with eating disorders and examine the relationship between cortisol and average whole-brain measures of white matter microstructure. We hypothesize that individuals with eating disorders (ED) will have higher cortisol levels than healthy controls (HC) which will correlate positively with FW and negatively with FA/FAt.

Diffusion-weighted images were acquired for 63 ED and 30 HC female subjects. Average whole brain values of FW, Fractional Anisotropy (FA), and FAt were extracted from white matter skeletons. ANCOVAs were conducted between groups with body mass index and age as covariates to compare cortisol levels and whole-brain average FA, FAt, and FW. Spearman correlations for cortisol and white matter features were conducted for the whole group (HC+ED) and the separated by group (ED vs. HC).

ANCOVAs for cortisol and average whole brain values for FA, FAt, and FW showed no significant difference. Whole group correlations between cortisol and FA, FAt, and FW were non-significant. When separated by group, only the relationship between cortisol and FAt in healthy controls was significant (p = 0.046).

This is the first study using FW to investigate relationships between cortisol and white matter microstructure. Non-significant relationships between cortisol levels and white matter may be attributed to morning cortisol levels, while integrated measures of cortisol secretion (e.g. hair cortisol) are more informative. In the future, we aim to explore hair cortisol and white matter microstructure among eating disorder subtypes, as they may have differing neurobiology.

Research Context

The incidence of eating disorders continues to rise globally, disproportionally affecting adolescent and young adult women. During these critical developmental periods, the endocrine system drastically changes which impacts the brain and its structure. Yet, the role of hormones (e.g. cortisol) in brain development and function have not been thoroughly explored in females as compared to males. It is thus crucial to understand the underlying mechanisms and associations between these two biological systems. This study utilized newer methods of Diffusion Imaging, known as Free Water Imaging, to gain deeper understanding of the implications of heightened cortisol levels on white matter microstructure in young women with eating disorders. By studying the effects of hormones on the brain, we can hopefully uncover more about the neurobiology of eating disorders and their lasting effect on women’s health.