Investigation of brain iron in anorexia nervosa, a quantitative susceptibility mapping study

Parsa Ravanfar; R Jarrett Rushmore; Amanda E Lyall; Vanessa Cropley; Nikos Makris; Patricia Desmond; Dennis Velakoulis; Martha E Shenton; Ashley I Bush; Susan L Rossell; Christos Pantelis; Warda T Syeda; Andrea Phillipou

doi:10.1186/s40337-023-00870-4

Investigation of brain iron in anorexia nervosa, a quantitative susceptibility mapping study

J Eat Disord. 2023 Aug 21;11(1):142. doi: 10.1186/s40337-023-00870-4.

Authors

Parsa Ravanfar^{1

2}, R Jarrett Rushmore^{3

4

5}, Amanda E Lyall^{3

6

7}, Vanessa Cropley⁸, Nikos Makris^{3

4}, Patricia Desmond⁹, Dennis Velakoulis^{8

10}, Martha E Shenton^{3

7

11}, Ashley I Bush¹², Susan L Rossell^{13

14}, Christos Pantelis^{8

15}, Warda T Syeda^#⁸, Andrea Phillipou^#^{14

16

17

18

19}

Affiliations

¹ Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Royal Melbourne Hospital, Level 3, Alan Gilbert Building, 161 Barry ST, Carlton South, VIC, 3053, Australia. sravanfar@student.unimelb.edu.au.
² Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. sravanfar@student.unimelb.edu.au.
³ Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
⁴ Center for Morphometric Analysis (CMA), Massachusetts General Hospital, Charlestown, MA, USA.
⁵ Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA.
⁶ Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
⁷ Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
⁸ Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Royal Melbourne Hospital, Level 3, Alan Gilbert Building, 161 Barry ST, Carlton South, VIC, 3053, Australia.
⁹ Department of Radiology, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia.
¹⁰ Neuropsychiatry, The Royal Melbourne Hospital, Parkville, VIC, Australia.
¹¹ Department of Radiology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA.
¹² Melbourne Dementia Research Centre, The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia.
¹³ Centre for Mental Health and Brain Sciences, Swinburne University, Hawthorn, VIC, Australia.
¹⁴ Department of Mental Health, St Vincent's Hospital, Melbourne, VIC, Australia.
¹⁵ The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia.
¹⁶ Orygen, Melbourne, Australia.
¹⁷ Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.
¹⁸ Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia.
¹⁹ Department of Mental Health, Austin Health, Melbourne, Australia.

^# Contributed equally.

Abstract

Background: Anorexia nervosa (AN) is a potentially fatal psychiatric condition, associated with structural brain changes such as gray matter volume loss. The pathophysiological mechanisms for these changes are not yet fully understood. Iron is a crucial element in the development and function of the brain. Considering the systemic alterations in iron homeostasis in AN, we hypothesized that brain iron would be altered as a possible factor associated with structural brain changes in AN.

Methods: In this study, we used quantitative susceptibility mapping (QSM) magnetic resonance imaging to investigate brain iron in current AN (c-AN) and weight-restored AN compared with healthy individuals. Whole-brain voxel wise comparison was used to probe areas with possible group differences. Further, the thalamus, caudate nucleus, putamen, nucleus accumbens, hippocampus, and amygdala were selected as the regions of interest (ROIs) for ROI-based comparison of mean QSM values.

Results: Whole-brain voxel-wise and ROI-based comparison of QSM did not reveal any differences between groups. Exploratory analyses revealed a correlation between higher regional QSM (higher iron) and lower body mass index, higher illness severity, longer illness duration, and younger age at onset in the c-AN group.

Conclusions: This study did not find evidence of altered brain iron in AN compared to healthy individuals. However, the correlations between clinical variables and QSM suggest a link between brain iron and weight status or biological processes in AN, which warrants further investigation.

Keywords: Anorexia nervosa; Brain; Iron; Magnetic resonance imaging; Quantitative susceptibility mapping.

Abstract

Grants and funding