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

Research output: Contribution to journalJournal articleResearchpeer-review

  • 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
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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.

Original languageEnglish
JournalBMC Psychiatry
Volume20
Issue number1
Pages (from-to)507
ISSN1471-244X
DOIs
Publication statusPublished - 14 Oct 2020

ID: 61287836