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Elana Kotler




Research Staff


Massachusetts General Hospital




Elana Kotler, Anastasia Haidar, Chunni Ji, Amanda Lyall, Ziyu (Ivan) Zhao, Franziska Plessow, Adrienne Romer, Poornima Kumar, Felicia Petterway, Lauren Lindman, Jason N. Scott Jr., Meghan Slattery, Nour Shamseddine, Tara Kyaw, Caroline Judson, David J. Alperovitz, Judith Halperin, Kristin N. Javaras, Esther Dechant, Jennifer Thomas, Diego A. Pizzagalli, Madhusmita Misra, Kamryn T. Eddy, Lauren Breithaupt

Principal Investigator


Exploring Lobar Gray Matter Volume in Women with Current and Lifetime Anorexia Nervosa and Atypical Anorexia Nervosa


Atypical anorexia nervosa (AT-AN) is a variant of anorexia nervosa (AN) where individuals remain at or above a BMI of 18.5 kg/m^2 despite restriction. Our recent research suggests lower gray matter volume (GMV) in frontal, temporal, and parietal areas in adolescents with AN and AT-AN compared to healthy controls. However, past analyses were limited, focusing only on acute weight presentation. This study investigates differences in GMV between females with AN and AT-AN, considering both acute and historic weights.
Structural MRI data from 67 females (14-35y) were processed using Freesurfer to extract GMV of lobes and cortical regions of interest (ROI). Subjects were diagnosed with current AN or AT-AN based on DSM-V-TR criteria. A lifetime diagnosis was created to re-classify individuals into lifetime AN or AT-AN based on self-reported lifetime BMI. Primary analyses used linear mixed effect models to compare group differences in lobar GMV, with secondary ROI analyses conducted for significant lobes.
BMI was significantly lower in current (p<0.01) and lifetime (p<0.01) AN vs AT-AN. Primary analyses revealed significantly lower GMV in the frontal lobe in AN vs AT-AN for current (FDR=0.04) and lifetime (FDR=0.04) groups. ROI-based analyses within the frontal lobe were not significant. We observed lower GMV in the frontal lobe of individuals with AN vs AT-AN for current and lifetime diagnoses. This suggests frontal lobe deficits may be unique to AN and sensitive to low-weight status, implying the potential relevance of executive functions in the disorder. These neurobiological alterations should be further explored through prospective longitudinal analyses.

Research Context

Eating disorders, such as Anorexia Nervosa and Atypical Anorexia Nervosa, disproportionately affect women compared to men. While extensive research has focused on the behavioral aspects of these disorders, there is a critical need for more comprehensive investigations into their neurobiological mechanisms. Particularly, research on the neurobiology of Atypical Anorexia Nervosa remains limited despite its emerging prominence in healthcare contexts. Understanding how low-weight and non-low-weight restriction impact female neurobiology, especially during developmental stages, is crucial. This analysis aims to shed light on anatomical differences in the brain between individuals with Anorexia and Atypical Anorexia, focusing exclusively on changes in lobar volume. This research, particularly relevant for adolescent and young adult females, has the potential to inform more accurate diagnoses and effective treatment strategies.