Local–global breakdown of cortical similarity networks in anorexia nervosa

Abstract

Anorexia nervosa profoundly alters brain structure, yet the large-scale organization of the cortex under severe nutritional stress remains poorly understood. Here we map cortical architecture in 50 patients with anorexia nervosa and 40 healthy controls in this cross-sectional study using Morphometric Inverse Divergence (MIND), a multivariate framework integrating multiple morphometric features into cortical similarity networks. Patients showed a global reduction in morphometric similarity that scaled with nutritional status, with lower body mass index associated with weaker global and network-level connectivity. Disruptions were most prominent in higher-order transmodal networks, with comparatively limited alterations in sensorimotor and visual territories. Region-level effects followed the topology of the structural connectome, and network-based statistics revealed weakened long-range coupling between attentional and limbic–prefrontal circuits. Spatial correspondence with cortical gradients of serotonergic, dopaminergic, μ-opioid and CB1 receptor densities suggests that malnutrition compromises cortical integrity along neurochemically defined axes of vulnerability. This research investigates cortical architecture in patients with anorexia nervosa using Morphometric Inverse Divergence (MIND). Findings reveal reduced morphometric similarity correlating with nutritional status, highlighting disrupted connectivity in higher-order networks and associations with neurochemical receptor densities.