Evaluation of Brain Metabolites in Children With Anorexia Nervosa Using 7T Ultra-High-Field Magnetic Resonance Spectroscopy

Anorexia nervosa (AN) is a disorder characterized by extreme food restriction that leads to significant weight loss and malnutrition.AN has effects on the central nervous system and may be associated with reduced brain volume.Magnetic resonance spectroscopy (MRS) is a noninvasive assessment technique that measures metabolic substances in the brain and provides additional value to standard magnetic resonance imaging.MRS studies of pediatric patients with AN have been limited to 1.5T and 3T systems, and the findings have been inconsistent.Ultra-high-field 7T MRS has detected decreased levels of myoinositol (Ins) and glutamate (Glu) in adults.Our study used 7T MRS to accurately measure brain metabolites in pediatric patients with AN and compared the results with those of a normal control (NC) group.Although the children with AN were obviously malnourished, as evidenced by blood tests, chest radiography, and bone density test results, occipital creatine levels were significantly lower in the AN group; however, this difference may have been influenced by age differences between the groups.No significant differences were observed in other brain metabolites in the early stages of disease.Therefore, no clear disease-specific alterations in brain metabolites could be identified.Because brain metabolic changes may become apparent as chronic malnutrition persists, as seen in adults, prolonged malnutrition associated with AN must be prevented.