Prefrontal brain metabolites in short-term weight-recovered adolescent anorexia nervosa patients Josefina Castro-Fornieles a,b,d,e, ⁎, Ana Isabel Garcia b , Luisa Lazaro a,b,d,e , Susana Andrés-Perpiñá a,b,e , Carles Falcón e,f , Maria Teresa Plana a , Nuria Bargallo b,c,e a Department of Child and Adolescent Psychiatry and Psychology, Hospital Clínic of Barcelona, Spain b CIBERSAM Research Network, Spain c Image Diagnostic Center, Hospital Clinic, University of Barcelona, Spain d Department of Psychiatry and Clinical Psychobiology, Health Sciences Division, University of Barcelona, Spain e IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Barcelona, Spain f CIBER-BBN Research Network, Spain a b s t r a c t a r t i c l e i n f o Article history: Received 21 January 2010 Received in revised form 19 May 2010 Accepted 19 May 2010 Available online 23 May 2010 Keywords: Adolescents Anorexia nervosa Choline Creatine Proton magnetic resonance spectroscopy Various neuroimaging techniqueshave revealed morphologicaland functional alterationsin anorexia nervosa (AN),although few spectroscopic magnetic resonance studies have examined short-term weight- recovered AN patients. Subjects were 32 female adolescent patients (between 13 and 18 years old) seen consecutively in our department and who met DSM-IV diagnostic criteria for AN. All of them had received a minimum of six months of treatment and were short-term weight-recovered (for one to three months) with a body mass index ranging from 18 to 23. A group of 20 healthy female volunteer controls of similar age we also included. All subjects were assessed with psychopathologicalscales and magnetic resonance spectroscopy. Total choline (Cho) (p = 0.007) and creatine (Cr) (p = 0.008) levels were significantly higher in AN patients than in controls. AN patients receiving psychopharmacological treatment with SSRIs (N = 9) had metabolite levels similar to control subjects, but patients without this treatment did not. The present study shows abnormalities in brain neurometabolites related to Cho compounds and Cr in the prefrontal cortex in short-term weight-recovered adolescent AN patients, principally in patients not undergoing psychopharmacological treatment.More studies with larger samples are necessary to testhe general- izability of the present results. © 2010 Elsevier Inc. All rights reserved. 1. Introduction Anorexia nervosa (AN) is a severe psychiatric disorder that usually emerges during childhood or adolescence. The disorder is associated with high physical morbidity and can cause severe medical complica- tions in adolescent patients as well as adults. There is also evidence of brain abnormalities related to this condition: studies using magnetic resonance imaging show that AN patients, while underweight,have decreased brain grey and white matter in different cerebral areas (Katzman et al.,1996; Castro-Fornieles et al.,2009) including the frontal region (Mühlau et al.,2007).With weight restoration these abnormalities tend to improve, but it is still not clear whether they normalize completely.Although some studies have found cerebral changes to be completely reversible with weight restoration (Golden et al., 1996; Wagner et al., 2006; Castro-Fornieles et al., 2009 ), others have not (Kingston et al.,1996; Lambe et al.,1997; Swayze et al., 2003).Of the few studies that have used proton magnetic resonance spectroscopy (1H MRS) in AN patients, the majority have been carried out in underweight patients.Schlemmer etal. (1998) found high signal intensity of choline-containing compounds (Cho) relative to total creatine (Cr) and low N-acetyl-aspartate (NAA) in the parieto- occipitalwhite matter.Roser et al.(1999)) found lower concentra- tions of the myo-Inositol (mI)/Cr and lipid compounds/Cr ratios in the frontal and occipital areas.Other authors (Ohrmann et al., 2004) studied frontal gray matter and reported significantly lower levels of Cr and mI. In a more recent study with adolescent AN patients (Castro-Fornieleset al., 2007), lower levels of NAA, glutamate/ glutamine (Glx) and mI were found than in control subjects. In the only study carried out after weight recovery, metabolite concentra- tions appeared to improve in adolescent patients, and the diminished NAA, Glx and mI normalized after renutrition (Castro-Fornieles et al., 2007). 1H MRS studies play an important role in advancing our under- standing of the pathophysiology of disorders and in developing Progress in Neuro-Psychopharmacology & Biological Psychiatry 34 (2010) 1049–1053 ⁎ Corresponding author. Department of Child and Adolescent Psychiatry and Psychology,Hospital Clinic,University of Barcelona, Villarroel,170,Barcelona 08036, Spain.Tel.: +34 93 2279974; fax: +34 93 2279172. E-mail address: jcastro@clinic.ub.es (J. Castro-Fornieles). 0278-5846/$ – see front matter © 2010 Elsevier Inc. All rights reserved. doi:10.1016/j.pnpbp.2010.05.020 Contents lists available at ScienceDirect Progress in Neuro-Psychopharmacology & Biological Psychiatry j o u r n a l h o m e p a g e : w w w. e l s ev i e r. c o m / l o c a t e / p n p