J Psychiatry Neurosci 2018;43(2):79-86
Malin Björnsdotter, MSc, PhD;* Monika Davidovic, MSc, MD, PhD;* Louise Karjalainen, MSc, PhD; Göran Starck, MSc, PhD; Håkan Olausson, MD, PhD; Elisabet Wentz, MD, PhD
Background: Patients with anorexia nervosa exhibit higher levels of behaviours typically associated with autism-spectrum disorder (ASD), but the neural basis is unclear. We sought to determine whether elevated autistic traits in women with anorexia nervosa may be reflected in cortical morphology.
Methods: We used voxel-based morphometry (VBM) to examine regional grey matter volumes in high-resolution MRI structural brain scans in women with anorexia nervosa and matched healthy controls. The Autism-spectrum Quotient (AQ) scale was used to assess autistic traits.
Results: Women with anorexia nervosa (n = 25) had higher AQ scores and lower bilateral superior temporal sulcus (STS) grey matter volumes than the control group (n = 25). The AQ scores correlated negatively with average left STS grey matter volume in women with anorexia nervosa.
Limitations: We did not control for cognitive ability and examined only women with ongoing anorexia nervosa.
Conclusion: Elevated autistic traits in women with anorexia nervosa are associated with morphometric alterations of brain areas linked to social cognition. This finding provides neurobiological support for the behavioural link between anorexia nervosa and ASD and emphasizes the importance of recognizing autistic traits in preventing and treating anorexia nervosa.
*These authors contributed equally to this work.
Submitted Apr. 7, 2017; Revised June 27, 2017; Accepted July 11, 2017; Online first Dec. 7, 2017
Acknowledgements: The authors thank the participants for making this study possible. They also thank the staff at the Anorexia-Bulimia Unit, Queen Silvia Children’s Hospital for their continuous support. M. Björnsdotter was supported by the European Union Seventh Framework Program (FP7/2007-2013) under grant agreement PIOFGA- 2012-302896, The Söderström König Foundation, Linnea and Joself Carlsson’s Foundation, the Fredrik och Ingrid Thuring Foundation and O. E. och Edla Johanssons’ Foundation. L. Karjalainen was supported by the Wilhelm och Martina Lundgren Foundation. The study was supported by ALF-Västra Götaland.
Affiliations: From the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Björnsdotter); the Centre for Social and Affective Neuroscience, Linköping University, Linköping, Sweden (Björnsdotter, Olausson); the Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Davidovic, Olausson); the Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (Karjalainen, Wentz); the Department of Radiation Physics at the Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden (Starck); and the Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden (Starck).
Competing interests: None declared.
Contributors: M. Davidovic, G. Starck, H. Olausson and E. Wentz designed the study. M. Davidovic and L. Karjalainen acquired the data, which M. Björnsdotter and M. Davidovic analyzed. M. Björnsdotter wrote the article, which all authors critically reviewed. All authors approved the final version to be published and can certify that no other individuals not listed as authors have made substantial contributions to the paper.
Correspondence to: M. Björnsdotter, Department of Clinical Neuroscience, Karolinska Institutet, Nobels Väg 9, 171 77 Stockholm, Sweden; firstname.lastname@example.org