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Published in: BMC Psychiatry 1/2020

Open Access 01-12-2020 | Eating Disorder | Study protocol

Study protocol of comprehensive risk evaluation for anorexia nervosa in twins (CREAT): a study of discordant monozygotic twins with anorexia nervosa

Authors: Maria Seidel, Stefan Ehrlich, Lauren Breithaupt, Elisabeth Welch, Camilla Wiklund, Christopher Hübel, Laura M. Thornton, Androula Savva, Bengt T. Fundin, Jessica Pege, Annelie Billger, Afrouz Abbaspour, Martin Schaefer, Ilka Boehm, Johan Zvrskovec, Emilie Vangsgaard Rosager, Katharina Collin Hasselbalch, Virpi Leppä, Magnus Sjögren, Ricard Nergårdh, Jamie D. Feusner, Ata Ghaderi, Cynthia M. Bulik

Published in: BMC Psychiatry | Issue 1/2020

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Abstract

Background

Anorexia nervosa (AN) is a severe disorder, for which genetic evidence suggests psychiatric as well as metabolic origins. AN has high somatic and psychiatric comorbidities, broad impact on quality of life, and elevated mortality. Risk factor studies of AN have focused on differences between acutely ill and recovered individuals. Such comparisons often yield ambiguous conclusions, as alterations could reflect different effects depending on the comparison. Whereas differences found in acutely ill patients could reflect state effects that are due to acute starvation or acute disease-specific factors, they could also reflect underlying traits. Observations in recovered individuals could reflect either an underlying trait or a “scar” due to lasting effects of sustained undernutrition and illness. The co-twin control design (i.e., monozygotic [MZ] twins who are discordant for AN and MZ concordant control twin pairs) affords at least partial disambiguation of these effects.

Methods

Comprehensive Risk Evaluation for Anorexia nervosa in Twins (CREAT) will be the largest and most comprehensive investigation of twins who are discordant for AN to date. CREAT utilizes a co-twin control design that includes endocrinological, neurocognitive, neuroimaging, genomic, and multi-omic approaches coupled with an experimental component that explores the impact of an overnight fast on most measured parameters.

Discussion

The multimodal longitudinal twin assessment of the CREAT study will help to disambiguate state, trait, and “scar” effects, and thereby enable a deeper understanding of the contribution of genetics, epigenetics, cognitive functions, brain structure and function, metabolism, endocrinology, microbiology, and immunology to the etiology and maintenance of AN.
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Metadata
Title
Study protocol of comprehensive risk evaluation for anorexia nervosa in twins (CREAT): a study of discordant monozygotic twins with anorexia nervosa
Authors
Maria Seidel
Stefan Ehrlich
Lauren Breithaupt
Elisabeth Welch
Camilla Wiklund
Christopher Hübel
Laura M. Thornton
Androula Savva
Bengt T. Fundin
Jessica Pege
Annelie Billger
Afrouz Abbaspour
Martin Schaefer
Ilka Boehm
Johan Zvrskovec
Emilie Vangsgaard Rosager
Katharina Collin Hasselbalch
Virpi Leppä
Magnus Sjögren
Ricard Nergårdh
Jamie D. Feusner
Ata Ghaderi
Cynthia M. Bulik
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2020
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-020-02903-7

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