By analyzing brain images obtained by magnetic resonance (MRI) of a sample of 290 children aged 7 to 13 years, Ms. Moreau observed in anorexic children a significant and generalized thinning of the cerebral cortex.
This phenomenon had recently been documented in adolescents and adults suffering from anorexia, she specifies, which suggests a significant impact on the brain, regardless of age.
“We wanted to look at if anorexia was associated with anything at the cerebral level. Because radiologists tend to think that not. And then finally, we found strong alterations. When I say hard, it is one of the strongest that we find in psychiatry, stronger than in autism or in schizophrenia, “said the researcher.
The thinning of the cerebral cortex will have impacts in the lives of young people suffering from anorexia, but this phenomenon can be reversible provided that you do not do too many relapses.
“In fact, the brain, the structures, they are still there, they are not destroyed, but on the other hand, all the fat is removed (the brain is composed of many fat). […] The child is not necessarily going to have memory problems, but rather difficulties to quickly learn things, concentration, “explains Ms. Moreau, who is also Deputy professor at the Faculty of Medicine at the University of Montreal.
The child will have to work twice as long as another to learn the same thing, because his brain is going to slow down, she illustrates.
“What we see is that even if there is a big rapid weight loss, the brain, in a young child, can recover really quickly. On the other hand, if this anorexia lasts, that it becomes chronic, and that there are several episodes, and that it lasts until adulthood, there, we may not have the recovery that we necessarily hope, because the brain must get used to this state of continuous deficiency. And so, it can alter its general development, ”warns Ms. Moreau.
Loss of gray matter
Clara Moreau has also analyzed the repercussions on the brain of another eating disorder: selective or avoidance food disorder (Tase), which is better known by its English acronym ARFID (Avoid/Restrictive Food Intake Disorder).
The Arfid consists in limiting food intake or eating only certain types of food, but without desire to lose weight and in the absence of a distorted body image. Ms. Moreau specifies that this disorder usually occurs in young children and that it touches the boys more in comparison with anorexia where girls are more numerous.
With her team, Ms. Moreau discovered that the thickness of the cerebral cortex remains intact in children with Arfid, but there is a decrease in intracranial volume and gray matter.
Children as young as 5 or 6 years old can be affected by Arfid.
“It starts early in development, and therefore, we think there is an adaptation of the brain to this low contribution of calories over the years. Basically, the child remains below the weight curve of a normal child. The child with Arfid will always be below, so the development of his brain will also be below, ”popularizes Ms. Moreau.
The two eating disorders have very distinct effects, specifies the researcher. “In anorexia, suddenly, the child will lose 10 pounds in three months. So, the brain, it will be amazed a lot at a time as an almost inflammatory reaction. While in the Arfid, it’s progressive, it lasts over years. We have an adaptation of the whole body which is not necessarily good, but in any case which is there, ”she explains.
However, the effects on the brain are difficult to reversible for Arfid, even if children gain weight. “It is as if these volumes of gray matter, they were more difficult to be recovered, points Ms. Moreau. On the other hand, Arfid children tend to work better in cognitive terms than anorexia. ”
A third of patients relapse without being known why
Ms. Moreau’s research could help better support children who relapse. About 35 % of patients at Sainte-Justine hospital return to the hospital after a first episode of anorexia. “It was done to go better, they recovered weight, they are on a beautiful recovery curve and they relapse. We have a third of patients who will relapse. We do not know at present why these patients relapse and not others. What differentiates them? There is no clinical trait that differentiates them so that these patients can be known upstream, ”says the expert.
His study, recently published in the scientific journal Mental health, gives tracks to explore these issues. Patients who have not completely recovered in the cerebral level, even if they have recovered at the weight level, could thus be more likely to relapse.
Ms. Moreau wants to shed light on this specific aspect. She first did a transversal study, which followed patients from a hospital in Paris, in France, who were at different stages of relapses. “We were able to hypothesize that there is indeed recovery, that it goes pretty well, especially among the youngest. But what we want to do now is to confirm that, ” scanner ” Patients several times from their recovery and follow them for those who will relapse, “she explains.
Ms. Moreau is now embarking on a longitudinal study that will follow patients from this same hospital in Paris in addition to a cohort at Sainte-Justine hospital.
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