Multimodal Investigations of Structural and Functional Brain Alterations in Anorexia and Bulimia Nervosa and Their Relationships to Psychopathology

Xinyang Yu; Lauren Robinson; Marina Bobou; Zuo Zhang; Tobia Banaschewsk; Gareth Barker; Arun L.W.  Bokde; Herta Flor; Antoine Grigis; Hugh  Garavan; Penny Gowland; Andreas Heinz; Rüdiger Brühl; Jean-Luc Martinot; Marie-Laure  Paillère Martinot; Eric Artiges; Frauke  Nees; Dimitri  Papadopoulos Orfanos; Herve Lemaire; Luise  Poustka; Sarah Hohmann; Nathalie E. Holz; Christian Baeuchl; Michael N. Smolka; Argyris Stringaris; Henrik  Walter; Robert Whelan; Julia Sinclair; Gunter Schumann; Ulrike Schmidt; Sylvane Desrivieres; IMAGEN Consortium; STRATIFY/ESTRA Consortium

doi:10.1016/j.biopsych.2024.11.008

Multimodal Investigations of Structural and Functional Brain Alterations in Anorexia and Bulimia Nervosa and Their Relationships to Psychopathology

Xinyang Yu
, Lauren Robinson
, Marina Bobou
, Zuo Zhang
, Tobia Banaschewsk
, Gareth Barker
, Arun L.W. Bokde
, Herta Flor
, Antoine Grigis
, Hugh Garavan
, Penny Gowland
, Andreas Heinz
, Rüdiger Brühl
, Jean-Luc Martinot
, Marie-Laure Paillère Martinot
, Eric Artiges
, Frauke Nees
, Dimitri Papadopoulos Orfanos
, Herve Lemaire
, Luise Poustka

Sarah Hohmann, Nathalie E. Holz, Christian Baeuchl, Michael N. Smolka, Argyris Stringaris, Henrik Walter, Robert Whelan, Julia Sinclair, Gunter Schumann, Ulrike Schmidt, Sylvane Desrivieres^*, IMAGEN Consortium, STRATIFY/ESTRA Consortium

^*Corresponding author for this work

Universitatsklinikum Mannheim
Heidelberg University
University of Nottingham
Institute for Radiology, CCM
Physikalisch-Technische Bundesanstalt
INSERM
University Medical Center Göttingen
Donders Institute for Brain, Cognition and Behaviour
Department of Neurology
University Medical Center Schleswig-Holstein
TU Dresden
University College London, UK.
Department of Urology

Research output: Contribution to journal › Article › peer-review

9 Citations (Scopus)

21 Downloads (Pure)

Abstract

Background: Neurobiological understanding of eating disorders (EDs) is limited. This study presents the first comparative multimodal magnetic resonance imaging assessments of anorexia nervosa and bulimia nervosa and uncovers neurobiological differences associated with these disorders. Methods: This case-control study included 57 healthy female control participants and 130 female participants with EDs (bulimia nervosa and anorexia nervosa subtypes). Structural and functional magnetic resonance imaging assessed gray matter volume (GMV), cortical thickness, and task-based activities related to reward processing, socioemotional functioning, and response inhibition. Whole-brain group differences were correlated with ED psychopathology. Results: Significant structural differences were observed in the ED group compared with healthy control participants, including reduced GMV in the left lateral orbitofrontal cortex and lower cortical thickness in the left rostral middle frontal gyrus and precuneus after adjusting for body mass index. Specific structural alterations were only evident in anorexia nervosa subgroups. GMV reductions in the orbitofrontal cortex were linked to impulsivity, while lower cortical thickness in the frontal gyrus correlated with cognitive restraint in eating, suggesting that these regions may play key roles in ED psychopathology. Functional magnetic resonance imaging also revealed notable differences. During reward anticipation, participants with EDs exhibited deactivations in the cerebellum and right superior frontal gyrus together with reduced activation in the left lingual gyrus. These functional changes were associated with heightened neuroticism. Mediation analyses suggested that starvation-related GMV reductions in EDs disrupt reward-related brain function, increase neuroticism, and reinforce cognitive restraint, likely contributing to the persistence of ED symptoms. Conclusions: These findings illuminate key neurobehavioral mechanisms that underlie EDs and point to potential brain-based targets for developing specialized treatment.

Original language	English
Journal	Biological psychiatry
Early online date	22 Nov 2024
DOIs	https://doi.org/10.1016/j.biopsych.2024.11.008 https://doi.org/10.1016/j.biopsych.2024.11.008
Publication status	Published - 1 Aug 2025

Keywords

Anorexia nervosa
Bulimia nervosa
Cognitive restraint
Eating disorder
Magnetic resonance imaging
Reward processing

Access to Document

ManuscriptAccepted author manuscript, 7.44 MBLicence: CC BY

Cite this

Yu, X., Robinson, L., Bobou, M., Zhang, Z., Banaschewsk, T., Barker, G., Bokde, A. L. W., Flor, H., Grigis, A., Garavan, H., Gowland, P., Heinz, A., Brühl, R., Martinot, J.-L., Paillère Martinot, M.-L., Artiges, E., Nees, F., Papadopoulos Orfanos, D., Lemaire, H., ... Consortium, STRATIFYESTRA. (2025). Multimodal Investigations of Structural and Functional Brain Alterations in Anorexia and Bulimia Nervosa and Their Relationships to Psychopathology. Biological psychiatry. https://doi.org/10.1016/j.biopsych.2024.11.008, https://doi.org/10.1016/j.biopsych.2024.11.008

@article{dac9657d6f744b3091c851a9d339d6ac,

title = "Multimodal Investigations of Structural and Functional Brain Alterations in Anorexia and Bulimia Nervosa and Their Relationships to Psychopathology",

abstract = "Background: Neurobiological understanding of eating disorders (EDs) is limited. This study presents the first comparative multimodal magnetic resonance imaging assessments of anorexia nervosa and bulimia nervosa and uncovers neurobiological differences associated with these disorders. Methods: This case-control study included 57 healthy female control participants and 130 female participants with EDs (bulimia nervosa and anorexia nervosa subtypes). Structural and functional magnetic resonance imaging assessed gray matter volume (GMV), cortical thickness, and task-based activities related to reward processing, socioemotional functioning, and response inhibition. Whole-brain group differences were correlated with ED psychopathology. Results: Significant structural differences were observed in the ED group compared with healthy control participants, including reduced GMV in the left lateral orbitofrontal cortex and lower cortical thickness in the left rostral middle frontal gyrus and precuneus after adjusting for body mass index. Specific structural alterations were only evident in anorexia nervosa subgroups. GMV reductions in the orbitofrontal cortex were linked to impulsivity, while lower cortical thickness in the frontal gyrus correlated with cognitive restraint in eating, suggesting that these regions may play key roles in ED psychopathology. Functional magnetic resonance imaging also revealed notable differences. During reward anticipation, participants with EDs exhibited deactivations in the cerebellum and right superior frontal gyrus together with reduced activation in the left lingual gyrus. These functional changes were associated with heightened neuroticism. Mediation analyses suggested that starvation-related GMV reductions in EDs disrupt reward-related brain function, increase neuroticism, and reinforce cognitive restraint, likely contributing to the persistence of ED symptoms. Conclusions: These findings illuminate key neurobehavioral mechanisms that underlie EDs and point to potential brain-based targets for developing specialized treatment.",

keywords = "Anorexia nervosa, Bulimia nervosa, Cognitive restraint, Eating disorder, Magnetic resonance imaging, Reward processing",

author = "Xinyang Yu and Lauren Robinson and Marina Bobou and Zuo Zhang and Tobia Banaschewsk and Gareth Barker and Bokde, \{Arun L.W.\} and Herta Flor and Antoine Grigis and Hugh Garavan and Penny Gowland and Andreas Heinz and R{\"u}diger Br{\"u}hl and Jean-Luc Martinot and \{Paill{\`e}re Martinot\}, Marie-Laure and Eric Artiges and Frauke Nees and \{Papadopoulos Orfanos\}, Dimitri and Herve Lemaire and Luise Poustka and Sarah Hohmann and \{E. Holz\}, Nathalie and Christian Baeuchl and Smolka, \{Michael N.\} and Argyris Stringaris and Henrik Walter and Robert Whelan and Julia Sinclair and Gunter Schumann and Ulrike Schmidt and Sylvane Desrivieres and IMAGEN Consortium and STRATIFY/ESTRA Consortium",

note = "Publisher Copyright: {\textcopyright} 2024 Society of Biological Psychiatry",

year = "2025",

month = aug,

day = "1",

doi = "10.1016/j.biopsych.2024.11.008",

language = "English",

journal = "Biological psychiatry",

issn = "0006-3223",

publisher = "Elsevier Inc.",

}

Yu, X , Robinson, L , Bobou, M , Zhang, Z, Banaschewsk, T, Barker, G, Bokde, ALW, Flor, H, Grigis, A, Garavan, H, Gowland, P, Heinz, A, Brühl, R, Martinot, J-L, Paillère Martinot, M-L, Artiges, E, Nees, F, Papadopoulos Orfanos, D, Lemaire, H, Poustka, L, Hohmann, S, E. Holz, N, Baeuchl, C, Smolka, MN, Stringaris, A, Walter, H, Whelan, R, Sinclair, J, Schumann, G , Schmidt, U , Desrivieres, S, Consortium, IMAGEN & Consortium, STRATIFYESTRA 2025, 'Multimodal Investigations of Structural and Functional Brain Alterations in Anorexia and Bulimia Nervosa and Their Relationships to Psychopathology', Biological psychiatry. https://doi.org/10.1016/j.biopsych.2024.11.008, https://doi.org/10.1016/j.biopsych.2024.11.008

TY - JOUR

T1 - Multimodal Investigations of Structural and Functional Brain Alterations in Anorexia and Bulimia Nervosa and Their Relationships to Psychopathology

AU - Yu, Xinyang

AU - Robinson, Lauren

AU - Bobou, Marina

AU - Zhang, Zuo

AU - Banaschewsk, Tobia

AU - Barker, Gareth

AU - Bokde, Arun L.W.

AU - Flor, Herta

AU - Grigis, Antoine

AU - Garavan, Hugh

AU - Gowland, Penny

AU - Heinz, Andreas

AU - Brühl, Rüdiger

AU - Martinot, Jean-Luc

AU - Paillère Martinot, Marie-Laure

AU - Artiges, Eric

AU - Nees, Frauke

AU - Papadopoulos Orfanos, Dimitri

AU - Lemaire, Herve

AU - Poustka, Luise

AU - Hohmann, Sarah

AU - E. Holz, Nathalie

AU - Baeuchl, Christian

AU - Smolka, Michael N.

AU - Stringaris, Argyris

AU - Walter, Henrik

AU - Whelan, Robert

AU - Sinclair, Julia

AU - Schumann, Gunter

AU - Schmidt, Ulrike

AU - Desrivieres, Sylvane

AU - Consortium, IMAGEN

AU - Consortium, STRATIFY/ESTRA

PY - 2025/8/1

Y1 - 2025/8/1

N2 - Background: Neurobiological understanding of eating disorders (EDs) is limited. This study presents the first comparative multimodal magnetic resonance imaging assessments of anorexia nervosa and bulimia nervosa and uncovers neurobiological differences associated with these disorders. Methods: This case-control study included 57 healthy female control participants and 130 female participants with EDs (bulimia nervosa and anorexia nervosa subtypes). Structural and functional magnetic resonance imaging assessed gray matter volume (GMV), cortical thickness, and task-based activities related to reward processing, socioemotional functioning, and response inhibition. Whole-brain group differences were correlated with ED psychopathology. Results: Significant structural differences were observed in the ED group compared with healthy control participants, including reduced GMV in the left lateral orbitofrontal cortex and lower cortical thickness in the left rostral middle frontal gyrus and precuneus after adjusting for body mass index. Specific structural alterations were only evident in anorexia nervosa subgroups. GMV reductions in the orbitofrontal cortex were linked to impulsivity, while lower cortical thickness in the frontal gyrus correlated with cognitive restraint in eating, suggesting that these regions may play key roles in ED psychopathology. Functional magnetic resonance imaging also revealed notable differences. During reward anticipation, participants with EDs exhibited deactivations in the cerebellum and right superior frontal gyrus together with reduced activation in the left lingual gyrus. These functional changes were associated with heightened neuroticism. Mediation analyses suggested that starvation-related GMV reductions in EDs disrupt reward-related brain function, increase neuroticism, and reinforce cognitive restraint, likely contributing to the persistence of ED symptoms. Conclusions: These findings illuminate key neurobehavioral mechanisms that underlie EDs and point to potential brain-based targets for developing specialized treatment.

AB - Background: Neurobiological understanding of eating disorders (EDs) is limited. This study presents the first comparative multimodal magnetic resonance imaging assessments of anorexia nervosa and bulimia nervosa and uncovers neurobiological differences associated with these disorders. Methods: This case-control study included 57 healthy female control participants and 130 female participants with EDs (bulimia nervosa and anorexia nervosa subtypes). Structural and functional magnetic resonance imaging assessed gray matter volume (GMV), cortical thickness, and task-based activities related to reward processing, socioemotional functioning, and response inhibition. Whole-brain group differences were correlated with ED psychopathology. Results: Significant structural differences were observed in the ED group compared with healthy control participants, including reduced GMV in the left lateral orbitofrontal cortex and lower cortical thickness in the left rostral middle frontal gyrus and precuneus after adjusting for body mass index. Specific structural alterations were only evident in anorexia nervosa subgroups. GMV reductions in the orbitofrontal cortex were linked to impulsivity, while lower cortical thickness in the frontal gyrus correlated with cognitive restraint in eating, suggesting that these regions may play key roles in ED psychopathology. Functional magnetic resonance imaging also revealed notable differences. During reward anticipation, participants with EDs exhibited deactivations in the cerebellum and right superior frontal gyrus together with reduced activation in the left lingual gyrus. These functional changes were associated with heightened neuroticism. Mediation analyses suggested that starvation-related GMV reductions in EDs disrupt reward-related brain function, increase neuroticism, and reinforce cognitive restraint, likely contributing to the persistence of ED symptoms. Conclusions: These findings illuminate key neurobehavioral mechanisms that underlie EDs and point to potential brain-based targets for developing specialized treatment.

KW - Anorexia nervosa

KW - Bulimia nervosa

KW - Cognitive restraint

KW - Eating disorder

KW - Magnetic resonance imaging

KW - Reward processing

UR - https://www.scopus.com/pages/publications/85218089910

U2 - 10.1016/j.biopsych.2024.11.008

DO - 10.1016/j.biopsych.2024.11.008

M3 - Article

C2 - 39581292

AN - SCOPUS:85218089910

SN - 0006-3223

JO - Biological psychiatry

JF - Biological psychiatry

ER -

Multimodal Investigations of Structural and Functional Brain Alterations in Anorexia and Bulimia Nervosa and Their Relationships to Psychopathology

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this