BDNF levels in adolescent patients with anorexia nervosa increase continuously to supranormal levels 2.5 years after first hospitalization

Britta Borsdorf; Brigitte Dahmen; Katharina Buehren; Astrid Dempfle; Karin Egberts; Stefan Ehrlich; Christian Fleischhaker; Kerstin Konrad; Reinhild Schwarte; Nina Timmesfeld; Christoph Wewetzer; Ronald Biemann; Wolfgang Scharke; Beate Herpertz-Dahlmann; Jochen Seitz

doi:10.1503/jpn.210049

BDNF levels in adolescent patients with anorexia nervosa increase continuously to supranormal levels 2.5 years after first hospitalization

J Psychiatry Neurosci. 2021 Sep 1;46(5):E568-E578. doi: 10.1503/jpn.210049. Print 2021 Sep-Oct.

Authors

Affiliations

¹ From the Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital, RWTH University Aachen, Germany (Borsdorf, Dahmen, Buehren, Scharke, Herpertz-Dahlmann, Seitz); the kbo-Heckscher Klinikum, Academic Teaching Hospital, Ludwig Maximilian University, Munich, Germany (Buehren); the Institute of Medical Informatics and Statistics, Kiel University, Germany (Dempfle); the Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Wuerzburg, Germany (Egberts); the Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Germany (Ehrlich); the Eating Disorders Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany (Ehrlich); the Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Freiburg, Germany (Fleischhaker); the Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital, RWTH University Aachen (Konrad); the JARA-Institute Molecular Neuroscience and Neuroimaging (INM-11), Juelich Research Centre, Germany (Konrad); the Oberberg Fachklinik Konraderhof, Cologne-Huerth, Germany (Schwarte); the Institute of Medical Biometry and Epidemiology, Philipps-University Marburg, Germany (Timmesfeld); the Department of Medical Informatics, Biometrics and Epidemiology, Ruhr University Bochum, Germany (Timmesfeld); the Department of Child and Adolescent Psychiatry and Psychotherapy, Cologne City Hospitals, Germany (Wewetzer); the Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Germany (Biemann); the Cognitive and Experimental Psychology, Institute of Psychology, RWTH Aachen University, Germany (Scharke).
² From the Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital, RWTH University Aachen, Germany (Borsdorf, Dahmen, Buehren, Scharke, Herpertz-Dahlmann, Seitz); the kbo-Heckscher Klinikum, Academic Teaching Hospital, Ludwig Maximilian University, Munich, Germany (Buehren); the Institute of Medical Informatics and Statistics, Kiel University, Germany (Dempfle); the Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Wuerzburg, Germany (Egberts); the Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Germany (Ehrlich); the Eating Disorders Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany (Ehrlich); the Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Freiburg, Germany (Fleischhaker); the Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital, RWTH University Aachen (Konrad); the JARA-Institute Molecular Neuroscience and Neuroimaging (INM-11), Juelich Research Centre, Germany (Konrad); the Oberberg Fachklinik Konraderhof, Cologne-Huerth, Germany (Schwarte); the Institute of Medical Biometry and Epidemiology, Philipps-University Marburg, Germany (Timmesfeld); the Department of Medical Informatics, Biometrics and Epidemiology, Ruhr University Bochum, Germany (Timmesfeld); the Department of Child and Adolescent Psychiatry and Psychotherapy, Cologne City Hospitals, Germany (Wewetzer); the Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Germany (Biemann); the Cognitive and Experimental Psychology, Institute of Psychology, RWTH Aachen University, Germany (Scharke) jseitz@ukaachen.de.

Abstract

Background: Brain-derived neurotrophic factor (BDNF) influences brain plasticity and feeding behaviour, and it has been linked to anorexia nervosa in numerous studies. Findings in mostly adult patients point to reduced serum BDNF levels in the acute stage of anorexia nervosa and rising levels with weight recovery. However, it is unclear whether this increase leads to normalization or supranormal levels, a difference that is potentially important for the etiology of anorexia nervosa and relapse.

Methods: We measured serum BDNF at admission (n = 149), discharge (n = 130), 1-year follow-up (n = 116) and 2.5-year follow-up (n = 76) in adolescent female patients with anorexia nervosa hospitalized for the first time, and in healthy controls (n = 79). We analyzed associations with body mass index, eating disorder psychopathology and comorbidities.

Results: Serum BDNF was only nominally lower at admission in patients with anorexia nervosa compared to healthy controls, but it increased continuously and reached supranormal levels at 2.5-year follow-up. BDNF was inversely associated with eating disorder psychopathology at discharge and positively associated with previous weight gain at 1-year follow-up.

Limitations: We compensated for attrition and batch effects using statistical measures.

Conclusion: In this largest longitudinal study to date, we found only nonsignificant reductions in BDNF in the acute stage of anorexia nervosa, possibly because of a shorter illness duration in adolescent patients. Supranormal levels of BDNF at 2.5-year follow-up could represent a pre-existing trait or a consequence of the illness. Because of the anorexigenic effect of BDNF, it might play an important predisposing role for relapse and should be explored further in studies that test causality.

MeSH terms

Adolescent
Anorexia Nervosa / metabolism*
Brain-Derived Neurotrophic Factor / metabolism*
Female
Hospitalization*
Humans
Longitudinal Studies
Recurrence

Substances

Brain-Derived Neurotrophic Factor