2007 issue 3

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Volume 16, issue 3

Original article

Brain choline level changes in female patients with anorexia nervosa measured by proton MR spectroscopy (1H-MRS)

Piotr Grzelak1, Witold Gajewicz1, Dominik Strzelecki2, Agata Majos1, Marek Olszycki1, Ludomir Stefańczyk1, Jolanta Rabe-Jabłońska2
1. Zakład Radiologii - Diagnostyki Obrazowej Uniwersytetu Medycznego w Łodzi
2. Klinika Zaburzeń Afektywnych i Psychiatrii Młodzieżowej Katedry Psychiatrii Uniwersytetu Medycznego w Łodzi
Postępy Psychiatrii i Neurologii 2007; 16 (3): 193-199
Keywords: anorexia nervosa, proton MR spectroscopy, choline

Abstract

Objectives. Proton MR spectroscopy (1H-MRS) allows measurement in vivo of changes in some metabolites level in the brain tissue. The technique may be used to seek relationships between macroscopically and microscopically observed alterations and the underlying metabolic abnormalities. The purpose of the study was to analyze changes in the choline levels measured using the 1H-MRS in anorexia nervosa (AN) patients with acute nutritional deficit on admission, and post-treatment.
Method. Participants in the study were 15 young women diagnosed with AN, examined on their first admission. Nine them were reexamined on treatment completion. The reference group consisted of 10 female volunteers. Single voxel proton magnetic resonance spectroscopy (1H MRS) was conducted using the 1.5TMR scanner Acquisition was made in two sites: the parietal lobes (white matter) and the occipital lobes (gray matter). Spectrum analysis was focused on the choline resonance lines (3.22 p.p.m.).
Results. In AN patients in the acute stage a reduced choline signal was found in both acquisition areas as compared to the controls. Moreover, a tendency to regression of the changes after successful treatment was noted. The reduced choline signal in the white matter in the AN group with no simultaneous changes in the neuronal marker (NAA) signal suggests glial character of the disorder. The observed choline compounds signal reduction in AN patients may result from systemic metabolic disorders affecting sterol compounds. The findings seem to support the view that regulatory disturbances in the cell membrane renewal process affect the functional status of neurons and may be an important factor in thepathomechanism of the disease development. The tendency to choline signal normalization observed in the study after successful treatment indicates that the disorder is transient, at least in an early stage of the disease.
Conclusions. The obtained data suggest a significant choline signal reduction in both the white and gray matter in female patients in an acute stage of AN. In those who underwent successful treatment a tendency to recovery from choline signal disturbances was found.

Address for correspondence:
Dr Piotr Grzelak
Zakład Radiologii - Diagnostyki Obrazowej Uniwersytetu Medycznego
Uniwersytecki Szpital Kliniczny nr 1 im. N. Barlickiego
ul. Kopcińskiego 22, 90-153 Łódź
tel. (42) 6786734, 501772971
e-mail:piotr.grzelak@insrad.am.lodz.pl