SynthesisBiological psychiatry2022
Brain Structure in Acutely Underweight and Partially Weight-Restored Individuals With Anorexia Nervosa: A Coordinated Analysis by the ENIGMA Eating Disorders Working Group.
Open access · bronzeAbstract readMeta-Analysis
In one paragraph
Synthesis in Biological psychiatry, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 78 papers, 2 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
78citing papers in PubMed, 2 pooled it
20.9field-weighted citation impact, top 1% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
78 citing papers in PubMed, 2 syntheses or guidelines pooled it, 120 citations in OpenAlex.
- Cortical complexity in eating disorders: a systematic review and qualitative synthesis.European archives of psychiatry and clinical neuroscience · 2026Pooled it
- Psilocybin in the treatment of eating disorders: a systematic review of the literature and registered clinical trials.Eating and weight disorders : EWD · 2025Pooled it
- Digital augmentation of aftercare for patients with anorexia nervosa: the TRIANGLE RCT and economic evaluation.Health technology assessment (Winchester, England) · 2025Trial
- Care approaches for people with longstanding eating disorders: a lived experience perspective on the need for recovery-fostering care.Journal of eating disorders · 2026Article
- Nutritional state-dependent changes in subcortical limbic structures in anorexia nervosa are linked to leptin, ghrelin, and neurofilament light.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026Article
- Brain Connectivity and Machine Learning Approaches to assess the underlying neurobiology and prediction accuracy of anorexia nervosa: A replication study.Psychiatry research. Neuroimaging · 2026Article
- Differences Among Purging Presentations at Admission to Treatment: Eating Disorder and General Psychopathology Symptoms.The International journal of eating disorders · 2026Article
- Clinical staging for eating disorders: A scoping review and update.European psychiatry : the journal of the Association of European Psychiatrists · 2026Article
- Famine, plague, and slaughters: The fleeing famine hypothesis of anorexia nervosa reconsidered.Psychological review · 2026Article
- Regional gray matter alterations in anorexia nervosa: implications for subtype heterogeneity and clinical severity.Molecular psychiatry · 2026Article
- Transcriptome-informed brain cartography of polygenic risk and association with brain structure in major psychiatric disorders.Molecular psychiatry · 2026Article
- Dynamic white matter microstructure in anorexia nervosa: associations with neurofilament light and leptin across early weight restoration.Research square · 2026Article
- The impact of BMI on mechanical thrombectomy outcomes, insights from a comprehensive stroke center.Neurosurgical review · 2026Article
- Disrupted Salience Network and Its Deteriorated Interaction With the Central Executive Network in Anorexia Nervosa: A Multicenter Study.Biological psychiatry global open science · 2026Article
- Reduced Oligodendrocyte Density and Axonal Caliber Associated With Mitochondrial Alterations in the White Matter of Chronically-Starved Mice.The International journal of eating disorders · 2026Article
- Brain morphology in Anorexia Nervosa and its subtypes: A multi-cohort study of individual participant data.PLoS medicine · 2026Article
- Increasing visibility of the neurobiology of eating disorders in youth - a commentary on Hagan et al. (2025).Journal of child psychology and psychiatry, and allied disciplines · 2026Article
- Annual Research Review: Neural mechanisms of eating disorders in youth - from current theory and findings to future directions.Journal of child psychology and psychiatry, and allied disciplines · 2026Review
- Eating and Mental Health Disorders.Nutrients · 2026Article
- Spatial alignment of chemoarchitecture and resting-state functional connectivity predicts short term weight restoration in anorexia nervosa.Translational psychiatry · 2026Article
18 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
59 authors at 20 institutions in 10 countries.
Esther WaltonDepartment of Psychology, University of Bath, Bath, United Kingdom.
Fabio BernardoniTranslational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
Victoria-Luise BaturyTranslational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
Klaas BahnsenTranslational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
Sara LarivièreMultimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec.
Giovanni Abbate-DagaEating Disorders Center for Treatment and Research, University of Turin, Turin, Italy.
Susana Andres-PerpiñaDepartment of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Centro de Investigación Biomédica en Red de Salud Mental, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain.
Lasse BangNorwegian Institute of Public Health, Oslo; Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
Amanda Bischoff-GretheDepartment of Psychiatry, University of California San Diego, La Jolla, California; Eating Disorders Center for Treatment and Research, University of California San Diego, La Jolla, California.
Samantha J BrooksSchool of Psychology, Faculty of Health Sciences, Liverpool John Moores University, Liverpool, United Kingdom; Department of Neuroscience, Uppsala University, Sweden.
Iain C CampbellInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Eating Disorders Unit, Department of Psychological Medicine, King's College London, London, United Kingdom.
Giammarco CascinoSection of Neurosciences, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno, Italy.
Josefina Castro-FornielesDepartment of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Centro de Investigación Biomédica en Red de Salud Mental, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain.
Enrico CollantoniDepartment of Neuroscience, University of Padova, Padova, Italy.
Federico D'AgataDepartment of Neuroscience, University of Turin, Turin, Italy.
Brigitte DahmenDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany.
Unna N DannerAltrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, the Netherlands; Faculty of Social Sciences, Utrecht University, Utrecht, the Netherlands.
Angela FavaroDepartment of Neuroscience, University of Padova, Padova, Italy; Padova Neuroscience Center, University of Padova, Padova, Italy.
Jamie D FeusnerCentre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, California.
Guido K W FrankDepartment of Psychiatry, University of California San Diego, La Jolla, California; Eating Disorders Center for Treatment and Research, University of California San Diego, La Jolla, California.
Hans-Christoph FriederichCentre for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany.
John L GranerCenter for Cognitive Neuroscience, Duke University, Durham, North Carolina.
Beate Herpertz-DahlmannDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany.
Andreas HessInstitute for Pharmacology and Toxicology, University Erlangen-Nuremberg, Erlangen, Germany.
Stefanie HorndaschDepartment of Child and Adolescent Psychiatry, University Clinic Erlangen, Erlangen, Germany.
Allan S KaplanCentre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.
Lisa-Katrin KaufmannDepartment of Consultation-Liaison Psychiatry and Psychosomatics, University Hospital Zurich, University of Zurich; Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland.
Walter H KayeDepartment of Psychiatry, University of California San Diego, La Jolla, California; Eating Disorders Center for Treatment and Research, University of California San Diego, La Jolla, California.
Sahib S KhalsaLaureate Institute for Brain Research, University of Tulsa, Tulsa, Oklahoma; Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma.
Kevin S LaBarCenter for Cognitive Neuroscience, Duke University, Durham, North Carolina.
Luca LavagninoLouis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston Texas.
Luisa LazaroDepartment of Child and Adolescent Psychiatry and Psychology, Institut Clinic de Neurociències, Hospital Clínic Universitari, Centro de Investigación Biomédica en Red de Salud Mental, Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain.
Renzo ManaraDepartment of Neuroscience, University of Padova, Padova, Italy.
Amy E MilesCentre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.
Gabriella F MilosDepartment of Consultation-Liaison Psychiatry and Psychosomatics, University Hospital Zurich, University of Zurich.
Alessio Maria MonteleoneDepartment of Psychiatry, University of Campania L. Vanvitelli, Naples, Italy.
Palmiero MonteleoneSection of Neurosciences, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno, Italy.
Benson MwangiLouis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston Texas.
Owen O'DalyCentre for Neuroimaging Studies, King's College London, London, United Kingdom; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
Jose ParienteMagnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.
Julie RoeschDepartment of Neuroradiology, University Clinic Erlangen, Erlangen, Germany.
Ulrike H SchmidtInstitute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Eating Disorders Unit, Department of Psychological Medicine, King's College London, London, United Kingdom.
Jochen SeitzDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany.
Megan E ShottDepartment of Psychiatry, University of California San Diego, La Jolla, California; Eating Disorders Center for Treatment and Research, University of California San Diego, La Jolla, California.
Joe J SimonCentre for Psychosocial Medicine, Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany.
Paul A M SmeetsUMC Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands; Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands.
Christian K TamnesNorwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.
Elena TenconiDepartment of Neuroscience, University of Padova, Padova, Italy; Padova Neuroscience Center, University of Padova, Padova, Italy.
Sophia I ThomopoulosImaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California.
Annemarie A van ElburgAltrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, the Netherlands; Faculty of Social Sciences, Utrecht University, Utrecht, the Netherlands.
Aristotle N VoineskosCampbell Family Mental Health Research Institute, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
Georg G von PolierDepartment of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany; Institute for Neuroscience and Medicine: Brain and Behaviour, Forschungszentrum Jülich, Jülich, Germany; Department of Child and Adolescent Psychiatry, University Hospital Frankfurt, Goethe University, Frankfurt, Germany.
Christina E WierengaDepartment of Psychiatry, University of California San Diego, La Jolla, California; Eating Disorders Center for Treatment and Research, University of California San Diego, La Jolla, California.
Nancy L ZuckerDepartment of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.
Neda JahanshadImaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California.
Joseph A KingTranslational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
Paul M ThompsonImaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, California.
Laura A BernerDepartment of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York.
Stefan EhrlichTranslational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; Eating Disorders Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany. Electronic address: transden.lab@uniklinikum-dresden.de.
University of California San Diego · USTechnische Universität Dresden · DEUniversity of Padua · ITCentre for Addiction and Mental Health · CACentro de Investigación Biomédica en Red de Salud Mental · ESRWTH Aachen University · DEUniversity of Southern California · USUtrecht University · NLDuke University · USHeidelberg University · DEKing's College London · GBOslo University Hospital · NOThe University of Texas Health Science Center at Houston · USUniversitätsklinikum Erlangen · DEUniversity of Salerno · ITUniversity of Turin · ITUniversity of Zurich · CHConsorci Institut D'Investigacions Biomediques August Pi I Sunyer · ESDuke Medical Center · USFriedrich-Alexander-Universität Erlangen-Nürnberg · DE
Funding
Training U54EB020403 · NIBIB · UNIVERSITY OF SOUTHERN CALIFORNIA · PI THOMPSON, PAUL M · 2014 to 2018
$10.1MNeurobiology of Feeding &Other Behaviors in BulimiaR01MH042984 · NIMH · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI KAYE, WALTER H · 1988 to 2013
$6.3MNeurocircuitry of Temperament and Motivated Behavior in Adolescent Eating DisordersR01MH113588 · NIMH · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI GRETHE, AMANDA BISCHOFF, WIERENGA, CHRISTINA E · 2017 to 2021
$3.3MAnxiety and reward interaction and prediction of outcomes in anorexia nervosaR01MH105662 · NIMH · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI FEUSNER, JAMIE · 2015 to 2019
$2.3MCommon and Distinct Phenotypes of Body Dysmorphic Disorder and Anorexia NervosaR01MH093535 · NIMH · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI FEUSNER, JAMIE · 2011 to 2015
$2.0MBrain Reward Circuits and Computational Modeling in Adolescent Anorexia NervosaR01MH096777 · NIMH · UNIVERSITY OF COLORADO DENVER · PI FRANK, GUIDO KW · 2012 to 2016
$1.5MNeural Basis of Meal Related Interoceptive Dysfunction in Anorexia NervosaK23MH112949 · NIMH · LAUREATE INSTITUTE FOR BRAIN RESEARCH · PI KHALSA, SAHIB · 2017 to 2021
$994kBiomarkers of Interoceptive Awareness in Adolescent Anorexia NervosaRC1MH088678 · NIMH · DUKE UNIVERSITY · PI LABAR, KEVIN S, ZUCKER, NANCY L · 2009 to 2010
$993kThe Influences of Eating and Fasting on Inhibitory Control in Bulimia Nervosa: A Computational Neuroimaging StudyK23MH118418 · NIMH · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI BERNER, LAURA A. · 2019 to 2023
$963kBrain Reward-Pathway Function and Neurocomputational Modeling in Anorexia NervosaK23MH080135 · NIMH · UNIVERSITY OF COLORADO DENVER · PI FRANK, GUIDO KW · 2008 to 2012
$840kNeural Dysfunction of Interoception in Adolescents Diagnosed with Anorexia NervosR21MH086017 · NIMH · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI GRETHE, AMANDA BISCHOFF · 2009 to 2010
$425kDepartment of HealthNIBIB NIH HHS U54 EB020403NIMH NIH HHS K23 MH080135NIMH NIH HHS K23 MH112949NIMH NIH HHS K23 MH118418NIMH NIH HHS R01 MH042984NIMH NIH HHS R01 MH093535NIMH NIH HHS R01 MH096777NIMH NIH HHS R01 MH105662NIMH NIH HHS R01 MH113588NIMH NIH HHS R21 MH086017NIMH NIH HHS RC1 MH088678
Abstract
backgroundThe pattern of structural brain abnormalities in anorexia nervosa (AN) is still not well understood. While several studies report substantial deficits in gray matter volume and cortical thickness in acutely underweight patients, others find no differences, or even increases in patients compared with healthy control subjects. Recent weight regain before scanning may explain some of this heterogeneity. To clarify the extent, magnitude, and dependencies of gray matter changes in AN, we conducted a prospective, coordinated meta-analysis of multicenter neuroimaging data.
methodsWe analyzed T1-weighted structural magnetic resonance imaging scans assessed with standardized methods from 685 female patients with AN and 963 female healthy control subjects across 22 sites worldwide. In addition to a case-control comparison, we conducted a 3-group analysis comparing healthy control subjects with acutely underweight AN patients (n = 466) and partially weight-restored patients in treatment (n = 251).
resultsIn AN, reductions in cortical thickness, subcortical volumes, and, to a lesser extent, cortical surface area were sizable (Cohen's d up to 0.95), widespread, and colocalized with hub regions. Highlighting the effects of undernutrition, these deficits were associated with lower body mass index in the AN sample and were less pronounced in partially weight-restored patients.
conclusionsThe effect sizes observed for cortical thickness deficits in acute AN are the largest of any psychiatric disorder investigated in the ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis) Consortium to date. These results confirm the importance of considering weight loss and renutrition in biomedical research on AN and underscore the importance of treatment engagement to prevent potentially long-lasting structural brain changes in this population.
Indexed as
Anorexia NervosaBrainCerebral CortexFemaleHumansMagnetic Resonance ImagingMulticenter Studies as TopicProspective StudiesThinnessBMICortical thicknessMRISubcortical volumeSurface area
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