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Talebi-Talghian T, Schulz P, Huzij T. Neuropsychiatric considerations in treating anorexia nervosa patients with osteopathic manipulative medicine: a narrative review. J Osteopath Med 2024; 124:543-548. [PMID: 39066999 DOI: 10.1515/jom-2023-0242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 06/28/2024] [Indexed: 07/30/2024]
Abstract
Osteopathic manipulative medicine (OMM) has a growing recognition in serving as an effective treatment to promote adaptation and homeostasis of the body by addressing musculoskeletal, neural, vascular, and lymphatic structures to promote self-healing and regulation. OMM can treat the musculoskeletal tension and sympathetic hyperactivity resulting from the increased cortisol response and hypersensitivity found in varying psychiatric illnesses, including anorexia nervosa (AN). This paper addresses the considerations necessary for treating AN patients with OMM, emphasizing the need to evaluate their abnormal high-level neuronal processing of sensory information, including differences in touch perception compared to the general population. Current literature was gathered utilizing a combination of the following keywords: anorexia nervosa, perception of touch, and osteopathic manipulative medicine/treatment. No literature was found addressing the effects of OMM on treating AN patients. Eight studies addressed the change in perception of touch found in AN patients. Results of the literature review reveal that the perceptions of touch in AN patients are distorted and can lead to reduced perceived pleasantness encountered in social interactions and touch. Specific changes have been found in C-tactile (CT) afferents responsible for the positive effects of touch, thus influencing emotional regulation. The significance of addressing this topic is to provide insight into the pathophysiological processes of AN and to inform physicians of unconventional stimuli that may exacerbate AN symptoms and behaviors. Further study is required to elucidate the role and mechanism of OMM in patients with AN and whether manual therapy could worsen pathological behavior and thinking patterns seen in AN patients. Such studies could include, but are not limited to, examining biological factors such as cortisol levels in AN patients receiving OMM and collecting data about AN patients' thinking patterns and behavior during OMM treatment.
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Affiliation(s)
- Tara Talebi-Talghian
- 149991 College of Osteopathic Medicine, Rocky Vista University , Englewood, CO, USA
| | - Paulyna Schulz
- 149991 College of Osteopathic Medicine, Rocky Vista University , Englewood, CO, USA
| | - Teodor Huzij
- Department of Osteopathic Principles and Practice, Idaho College of Osteopathic Medicine, Meridian, ID, USA
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Stanetzky L, Hartz A, Buettgen K, Dahmen B, Herpertz-Dahlmann B, Konrad K, Seitz J. Longitudinal changes in neural responses to fearful faces in adolescents with anorexia nervosa - A fMRI study. Psychiatry Res Neuroimaging 2024; 345:111904. [PMID: 39368434 DOI: 10.1016/j.pscychresns.2024.111904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 09/11/2024] [Accepted: 09/22/2024] [Indexed: 10/07/2024]
Abstract
OBJECTIVE Although proven neuronal changes are correlated with anorexia nervosa (AN), where these changes occur and how they change during the course of this disease are often unclear; this is especially true regarding emotion processing, e.g., of anxiety, despite a growing body of literature on its importance for the pathophysiology and clinical course of patients with AN. METHODS Twenty-two female adolescent patients with AN were scanned during acute starvation and after short-term weight recovery and were compared to 27 healthy controls. A well-established face-matching paradigm involving individuals with different emotions was used during fMRI. RESULTS Patients with AN selectively showed significantly increasing neural activation in the somatomotor cortex when viewing fearful faces following short-term weight recovery. No differences were found compared to healthy controls or for neutral, angry or surprised faces. Neural activation in response to fearful faces during acute starvation was associated with lower BMI-SDS and greater illness burden. CONCLUSION Higher somatomotor activity could represent anxiety-induced preparations for motor reactions (e.g., fight or flight) that are more pronounced in more affected patients. These results align with recent models of AN that increasingly incorporate anxiety into the pathophysiological and prognostic model of AN and help elucidate its underlying neurological mechanisms.
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Affiliation(s)
- Lukas Stanetzky
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Neuenhofer Weg 22, 52074 Aachen, Germany.
| | - Arne Hartz
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Neuenhofer Weg 22, 52074 Aachen, Germany
| | - Kimberly Buettgen
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Neuenhofer Weg 22, 52074 Aachen, Germany.
| | - Brigitte Dahmen
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Neuenhofer Weg 22, 52074 Aachen, Germany.
| | - Beate Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Neuenhofer Weg 22, 52074 Aachen, Germany.
| | - Kerstin Konrad
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Neuenhofer Weg 22, 52074 Aachen, Germany; Section Child Neuropsychology, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Neuenhofer Weg 22, 52074 Aachen, Germany.
| | - Jochen Seitz
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Neuenhofer Weg 22, 52074 Aachen, Germany; Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LVR University Hospital Essen, Wickenburgstr, 21, 45147 Essen, Germany.
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Monachesi B, Deruti A, Vaes J, Leoni P, Grecucci A. How sexual objectification marks the brain: fMRI evidence of self-objectification and its harmful emotional consequences. Neuroimage 2024; 297:120729. [PMID: 38992451 DOI: 10.1016/j.neuroimage.2024.120729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 07/04/2024] [Accepted: 07/08/2024] [Indexed: 07/13/2024] Open
Abstract
Female Sexual Objectification refers to perceiving and treating women based on their body appearance. This phenomenon may serve as a precursor for dysfunctional behaviors, particularly among females prone to self-objectification and experiencing shame emotions. Understanding this challenging trajectory by disclosing its neural consequences may be crucial for comprehending extreme psychopathological outcomes. However, investigations in this sense are still scarce. The present study explores the neural correlates of female participants' experiences of being objectified and their relationship with self-objectification, emotional responses and individual dispositions in self-esteem, emotion regulation abilities and self-conscious emotion proneness. To this aim, 25 female participants underwent an fMRI experimental session while they were exposed to interpersonal encounters with objectifying or non-objectifying men. Participants' experienced emotions and levels of attention shifted toward their bodies (self-objectification) was reported after each interaction. The results revealed increased brain activity in objectifying contexts, impacting cortical (frontal, occipital and temporal cortex) and subcortical regions (thalamus, and hippocampus) involved in visual, emotion, and social processing. Remarkably, the inferior temporal gyrus emerged as a crucial neural hub associated in opposite ways with self-esteem and the self-conscious emotion of shame, highlighting its role in self-referential processing during social dynamics. This study points out the importance of adopting a neuroscientific perspective for a deeper understanding of sexual objectification, and to shed light on its possible neural consequences.
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Affiliation(s)
- Bianca Monachesi
- Neuroscience and Society Laboratory, Neuroscience Area, SISSA, Via Bonomea, 265, Trieste 34136, Italy; Department of Psychology and Cognitive Sciences, University of Trento, Italy.
| | - Alice Deruti
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Jeroen Vaes
- Department of Psychology and Cognitive Sciences, University of Trento, Italy
| | - Paolo Leoni
- Department of Psychology and Cognitive Sciences, University of Trento, Italy
| | - Alessandro Grecucci
- Department of Psychology and Cognitive Sciences, University of Trento, Italy; Centre for Medical Sciences, CISMed, University of Trento, Italy.
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Sudo Y, Ota J, Takamura T, Kamashita R, Hamatani S, Numata N, Chhatkuli RB, Yoshida T, Takahashi J, Kitagawa H, Matsumoto K, Masuda Y, Nakazato M, Sato Y, Hamamoto Y, Shoji T, Muratsubaki T, Sugiura M, Fukudo S, Kawabata M, Sunada M, Noda T, Tose K, Isobe M, Kodama N, Kakeda S, Takahashi M, Takakura S, Gondo M, Yoshihara K, Moriguchi Y, Shimizu E, Sekiguchi A, Hirano Y. Comprehensive elucidation of resting-state functional connectivity in anorexia nervosa by a multicenter cross-sectional study. Psychol Med 2024; 54:2347-2360. [PMID: 38500410 DOI: 10.1017/s0033291724000485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
BACKGROUND Previous research on the changes in resting-state functional connectivity (rsFC) in anorexia nervosa (AN) has been limited by an insufficient sample size, which reduced the reliability of the results and made it difficult to set the whole brain as regions of interest (ROIs). METHODS We analyzed functional magnetic resonance imaging data from 114 female AN patients and 135 healthy controls (HC) and obtained self-reported psychological scales, including eating disorder examination questionnaire 6.0. One hundred sixty-four cortical, subcortical, cerebellar, and network parcellation regions were considered as ROIs. We calculated the ROI-to-ROI rsFCs and performed group comparisons. RESULTS Compared to HC, AN patients showed 12 stronger rsFCs mainly in regions containing dorsolateral prefrontal cortex (DLPFC), and 33 weaker rsFCs primarily in regions containing cerebellum, within temporal lobe, between posterior fusiform cortex and lateral part of visual network, and between anterior cingulate cortex (ACC) and thalamus (p < 0.01, false discovery rate [FDR] correction). Comparisons between AN subtypes showed that there were stronger rsFCs between right lingual gyrus and right supracalcarine cortex and between left temporal occipital fusiform cortex and medial part of visual network in the restricting type compared to the binge/purging type (p < 0.01, FDR correction). CONCLUSION Stronger rsFCs in regions containing mainly DLPFC, and weaker rsFCs in regions containing primarily cerebellum, within temporal lobe, between posterior fusiform cortex and lateral part of visual network, and between ACC and thalamus, may represent categorical diagnostic markers discriminating AN patients from HC.
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Affiliation(s)
- Yusuke Sudo
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- Department of Cognitive Behavioral Physiology, Chiba University, Chiba, Japan
- Department of Psychiatry, Chiba University Hospital, Chiba, Japan
| | - Junko Ota
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- Applied MRI Research, Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - Tsunehiko Takamura
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Rio Kamashita
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - Sayo Hamatani
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
- Research Center for Child Mental Development, Fukui University, Eiheizi, Japan
| | - Noriko Numata
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - Ritu Bhusal Chhatkuli
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- Applied MRI Research, Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - Tokiko Yoshida
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Jumpei Takahashi
- Department of Psychiatry, Chiba Aoba Municipal Hospital, Chiba, Japan
| | - Hitomi Kitagawa
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Koji Matsumoto
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Yoshitada Masuda
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Michiko Nakazato
- Department of Psychiatry, School of Medicine, International University of Health and Welfare, Narita, Japan
| | - Yasuhiro Sato
- Department of Psychosomatic Medicine, Tohoku University Hospital, Sendai, Japan
| | - Yumi Hamamoto
- Department of Psychology, Northumbria University, Newcastle-upon-Tyne, UK
- Department of Human Brain Science, Institute of Development, Aging, and Cancer, Tohoku University, Sendai, Japan
| | - Tomotaka Shoji
- Department of Psychosomatic Medicine, Tohoku University Hospital, Sendai, Japan
- Department of Internal Medicine, Nagamachi Hospital, Sendai, Japan
- Department of Psychosomatic Medicine, Tohoku University School of Medicine, Sendai, Japan
| | - Tomohiko Muratsubaki
- Department of Psychosomatic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Motoaki Sugiura
- Department of Human Brain Science, Institute of Development, Aging, and Cancer, Tohoku University, Sendai, Japan
- Cognitive Sciences Lab, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Shin Fukudo
- Department of Psychosomatic Medicine, Tohoku University Hospital, Sendai, Japan
- Department of Psychosomatic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Michiko Kawabata
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Momo Sunada
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tomomi Noda
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Keima Tose
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masanori Isobe
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Naoki Kodama
- Division of Psychosomatic Medicine, Department of Neurology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shingo Kakeda
- Department of Radiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Masatoshi Takahashi
- Division of Psychosomatic Medicine, Department of Neurology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shu Takakura
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Motoharu Gondo
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Kazufumi Yoshihara
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Yoshiya Moriguchi
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
- Department of Sleep-Wake Disorders, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- Department of Cognitive Behavioral Physiology, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - Atsushi Sekiguchi
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
- Center for Eating Disorder Research and Information, National Center of Neurology and Psychiatry, Kodaira, Japan
- Department of Advanced Neuroimaging, Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- Applied MRI Research, Department of Molecular Imaging and Theranostics, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
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Muratore AF, Foerde K, Lloyd EC, Touzeau C, Uniacke B, Aw N, Semanek D, Wang Y, Walsh BT, Attia E, Posner J, Steinglass JE. Reduced dorsal fronto-striatal connectivity at rest in anorexia nervosa. Psychol Med 2024; 54:2200-2209. [PMID: 38497102 DOI: 10.1017/s003329172400031x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
BACKGROUND Anorexia nervosa (AN) is a serious psychiatric illness that remains difficult to treat. Elucidating the neural mechanisms of AN is necessary to identify novel treatment targets and improve outcomes. A growing body of literature points to a role for dorsal fronto-striatal circuitry in the pathophysiology of AN, with increasing evidence of abnormal task-based fMRI activation within this network among patients with AN. Whether these abnormalities are present at rest and reflect fundamental differences in brain organization is unclear. METHODS The current study combined resting-state fMRI data from patients with AN (n = 89) and healthy controls (HC; n = 92) across four studies, removing site effects using ComBat harmonization. First, the a priori hypothesis that dorsal fronto-striatal connectivity strength - specifically between the anterior caudate and dlPFC - differed between patients and HC was tested using seed-based functional connectivity analysis with small-volume correction. To assess specificity of effects, exploratory analyses examined anterior caudate whole-brain connectivity, amplitude of low-frequency fluctuations (ALFF), and node centrality. RESULTS Compared to HC, patients showed significantly reduced right, but not left, anterior caudate-dlPFC connectivity (p = 0.002) in small-volume corrected analyses. Whole-brain analyses also identified reduced connectivity between the right anterior caudate and left superior frontal and middle frontal gyri (p = 0.028) and increased connectivity between the right anterior caudate and right occipital cortex (p = 0.038). No group differences were found in analyses of anterior caudate ALFF and node centrality. CONCLUSIONS Decreased coupling of dorsal fronto-striatal regions indicates that circuit-based abnormalities persist at rest and suggests this network may be a potential treatment target.
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Affiliation(s)
- Alexandra F Muratore
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Karin Foerde
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - E Caitlin Lloyd
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Caroline Touzeau
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Blair Uniacke
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Natalie Aw
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - David Semanek
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Yun Wang
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - B Timothy Walsh
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Evelyn Attia
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Jonathan Posner
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Duke University, Durham, NC, USA
| | - Joanna E Steinglass
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
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Berchio C, Kumar SS, Micali N. EEG Spatial-temporal Dynamics of Resting-state Activity in Young Women with Anorexia Nervosa: Preliminary Evidence. Brain Topogr 2024; 37:447-460. [PMID: 37615798 DOI: 10.1007/s10548-023-01001-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/14/2023] [Indexed: 08/25/2023]
Abstract
The aim of this study was to provide preliminary evidence on temporal dynamics of resting-state brain networks in youth with anorexia nervosa (AN) using electroencephalography (EEG). Resting-state EEG data were collected in 18 young women with AN and 18 healthy controls (HC). Between-group differences in brain networks were assessed using microstates analyses. Five microstates were identified across all subjects (A, B, C, D, E). Using a single set of maps representative of the whole dataset, group differences were identified for microstates A, C, and E. A common-for-all template revealed a relatively high degree of consistency in results for reduced time coverage of microstate C, but also an increased presence of microstate class E. AN and HC had different microstate transition probabilities, largely involving microstate A. Using LORETA, for microstate D, we found that those with AN had augmented activations in the left frontal inferior operculum, left insula, and bilateral paracentral lobule, compared with HC. For microstate E, AN had augmented activations in the para-hippocampal gyrus, caudate, pallidum, cerebellum, and cerebellar vermis. Our findings suggest altered microstates in young women with AN associated with integration of sensory and bodily signals, monitoring of internal/external mental states, and self-referential processes. Future research should examine how EEG-derived microstates could be applied to develop diagnostic and prognostic models of AN.
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Affiliation(s)
- Cristina Berchio
- Group of Psychiatric Neuroscience, Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Piazza Giulio Cesare, 11, 70121, Bari, Italy.
| | - Samika S Kumar
- Department of Psychology, University of Cambridge, Cambridge, UK
- Section on Functional Imaging Methods, Laboratory of Brain and Cognition, National Institute of Mental Health, Bethesda, MD, USA
| | - Nadia Micali
- Great Ormond Street Institute of Child Health, University College London, London, UK
- Mental Health Services in the Capital Region of Denmark, Eating Disorders Research Unit, Psychiatric Centre Ballerup, Ballerup, Denmark
- Institute of biological Psychiatry, Psykiatrisk Center Sct. Hans, Region Hovedstaden, Denmark
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7
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Thomas SA, Ryan SK, Gilman J. Resting state network connectivity is associated with cognitive flexibility performance in youth in the Adolescent Brain Cognitive Development Study. Neuropsychologia 2023; 191:108708. [PMID: 37898357 PMCID: PMC10842068 DOI: 10.1016/j.neuropsychologia.2023.108708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 10/13/2023] [Accepted: 10/25/2023] [Indexed: 10/30/2023]
Abstract
Cognitive flexibility is an executive functioning skill that develops in childhood, and when impaired, has transdiagnostic implications for psychiatric disorders. To identify how intrinsic neural architecture at rest is linked to cognitive flexibility performance, we used the data-driven method of independent component analysis (ICA) to investigate resting state networks (RSNs) and their whole-brain connectivity associated with levels of cognitive flexibility performance in children. We hypothesized differences by cognitive flexibility performance in RSN connectivity strength in cortico-striatal circuitry, which would manifest via the executive control network, right and left frontoparietal networks (FPN), salience network, default mode network (DMN), and basal ganglia network. We selected participants from the Adolescent Brain Cognitive Development (ABCD) Study who scored at the 25th, ("CF-Low"), 50th ("CF-Average"), or 75th percentiles ("CF-High") on a cognitive flexibility task, were early to middle puberty, and did not exhibit significant psychopathology (n = 967, 47.9% female; ages 9-10). We conducted whole-brain ICA, identifying 14 well-characterized RSNs. Groups differed in connectivity strength in the right FPN, anterior DMN, and posterior DMN. Planned comparisons indicated CF-High had stronger connectivity between right FPN and supplementary motor/anterior cingulate than CF-Low. CF-High had more anti-correlated connectivity between anterior DMN and precuneus than CF-Average. CF-Low had stronger connectivity between posterior DMN and supplementary motor/anterior cingulate than CF-Average. Post-hoc correlations with reaction time by trial type demonstrated significant associations with connectivity. In sum, our results suggest childhood cognitive flexibility performance is associated with DMN and FPN connectivity strength at rest, and that there may be optimal levels of connectivity associated with task performance that vary by network.
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Affiliation(s)
- Sarah A Thomas
- Bradley Hasbro Children's Research Center, 25 Hoppin St., Box #36, Providence, RI, 02903, USA; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Carney Institute for Brain Science, Brown University, Box 1901, 164 Angell St., 4th Floor, Providence, RI, 02912, USA.
| | - Sarah K Ryan
- Bradley Hasbro Children's Research Center, 25 Hoppin St., Box #36, Providence, RI, 02903, USA.
| | - Jodi Gilman
- Massachusetts General Hospital (MGH) Department of Psychiatry, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
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8
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Wang J, Wu G, Wang M, Li W, Wang Y, Ren X, Wei X, Yang Z, Li Z, Wang Z, Chen Q, Zhang P, Tang L. Exploring the thalamus: a crucial hub for brain function and communication in patients with bulimia nervosa. J Eat Disord 2023; 11:207. [PMID: 37986127 PMCID: PMC10662785 DOI: 10.1186/s40337-023-00933-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/15/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Bulimia nervosa (BN) is an eating disorder characterized by recurrent binge eating and compensatory behaviors. The thalamus plays a crucial role in the neural circuitry related to eating behavior and needs to be further explored in BN. METHODS In this study, 49 BN patients and 44 healthy controls (HCs) were recruited. We applied the fractional amplitude of low-frequency fluctuation to investigate regional brain activity in the thalamus and functional connectivity (FC) to examine the synchronization of activity between thalamic subregions and other brain regions in both groups. All results underwent false discovery rate (p < 0.05, FDR correction) correction. Pearson correlation analysis was performed to assess the relationship between the patients' abnormal clinical performance and the thalamic alterations (p < 0.05, FDR correction). RESULTS We found no significant differences in neural activity between BN patients and HCs in the sixteen thalamic subregions. However, compared to the HCs, the individuals with BN showed decreased FC between the thalamic subregions and several regions, including the bilateral prefrontal cortex, right inferior parietal lobule, right supplementary motor area, right insula, cingulate gyrus and vermis. Additionally, BN patients showed increased FC between the thalamic subregions and visual association regions, primary sensorimotor cortex, and left cerebellum. These altered FC patterns in the thalamus were found to be correlated with clinical variables (the frequency of binge eating/purging per week and external eating behavior scale scores) in the BN group. All results have passed FDR correction. CONCLUSIONS Our study provides evidence that there is disrupted FC between thalamic subregions and other brain regions in BN patients during resting state. These regions are primarily located within the frontoparietal network, default mode network, somatosensory, and visual network. These findings elucidate the neural activity characteristics underlying BN and suggest that thalamic subregions have potential as targets for future neuromodulation interventions.
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Affiliation(s)
- Jiani Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, China
| | - Guowei Wu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Miao Wang
- Chinese Institute for Brain Research, Beijing, China
| | - Weihua Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, China
| | - Yiling Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, China
| | - Xiaodan Ren
- Beijing Anding Hospital, Capital Medical University, No. 5 Ankang Hutong, Xicheng District, Beijing, China
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Xuan Wei
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, China
| | - Zhanjiang Li
- Beijing Anding Hospital, Capital Medical University, No. 5 Ankang Hutong, Xicheng District, Beijing, China
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, China
| | - Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, China.
| | - Peng Zhang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Xicheng District, Beijing, China.
| | - Lirong Tang
- Beijing Anding Hospital, Capital Medical University, No. 5 Ankang Hutong, Xicheng District, Beijing, China.
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing, China.
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9
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Brizzi G, Sansoni M, Di Lernia D, Frisone F, Tuena C, Riva G. The multisensory mind: a systematic review of multisensory integration processing in Anorexia and Bulimia Nervosa. J Eat Disord 2023; 11:204. [PMID: 37974266 PMCID: PMC10655389 DOI: 10.1186/s40337-023-00930-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 11/12/2023] [Indexed: 11/19/2023] Open
Abstract
Individuals with Anorexia Nervosa and Bulimia Nervosa present alterations in the way they experience their bodies. Body experience results from a multisensory integration process in which information from different sensory domains and spatial reference frames is combined into a coherent percept. Given the critical role of the body in the onset and maintenance of both Anorexia Nervosa and Bulimia Nervosa, we conducted a systematic review to examine multisensory integration abilities of individuals affected by these two conditions and investigate whether they exhibit impairments in crossmodal integration. We searched for studies evaluating crossmodal integration in individuals with a current diagnosis of Anorexia Nervosa and Bulimia Nervosa as compared to healthy individuals from both behavioral and neurobiological perspectives. A search of PubMed, PsycINFO, and Web of Sciences databases was performed to extract relevant articles. Of the 2348 studies retrieved, 911 were unique articles. After the screening, 13 articles were included. Studies revealed multisensory integration abnormalities in patients affected by Anorexia Nervosa; only one included individuals with Bulimia Nervosa and observed less severe impairments compared to healthy controls. Overall, results seemed to support the presence of multisensory deficits in Anorexia Nervosa, especially when integrating interoceptive and exteroceptive information. We proposed the Predictive Coding framework for understanding our findings and suggested future lines of investigation.
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Affiliation(s)
- Giulia Brizzi
- Applied Technology for Neuro- Psychology Laboratory, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149, Milan, Italy.
| | - Maria Sansoni
- Humane Technology Laboratory, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121, Milan, Italy
| | - Daniele Di Lernia
- Applied Technology for Neuro- Psychology Laboratory, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149, Milan, Italy
| | - Fabio Frisone
- Humane Technology Laboratory, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121, Milan, Italy
| | - Cosimo Tuena
- Applied Technology for Neuro- Psychology Laboratory, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro- Psychology Laboratory, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149, Milan, Italy
- Humane Technology Laboratory, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121, Milan, Italy
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10
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Meneguzzo P, Dal Brun D, Collantoni E, Meregalli V, Todisco P, Favaro A, Tenconi E. Linguistic embodiment in typical and atypical anorexia nervosa: Evidence from an image-word matching task. EUROPEAN EATING DISORDERS REVIEW 2023; 31:837-849. [PMID: 37415396 DOI: 10.1002/erv.3008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 06/13/2023] [Accepted: 06/22/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVE The integration of sensory, motor, and cognitive systems is embodied cognition, according to which mind and body are not separate and distinct, and our body (and our brain, as part of the body) contributes to determining our mental and cognitive processes. In spite of limited data available, Anorexia nervosa (AN) appears as a condition in which embodied cognition is altered, in particular, if we consider bodily sensations and visuospatial information processing. We aimed to evaluate the ability to correctly identify body parts and actions in both full (AN) and atypical AN (AAN), looking at the role of the underweight status. METHOD A group of 143 females (AN = 45, AAN = 43, unaffected women = 55) was enrolled. All participants performed a linguistic embodied task to evaluate the association between a picture-showing a bodily action-and a written verb. Additionally, a subsample of 24 AN participants performed a retest after stable weight recovery. RESULTS Both AN and AAN demonstrated an abnormal ability to evaluate the picture-written verb associations, especially if the involved bodily effectors were the same in both stimuli (i.e., pictorial and verbal) and needed a longer response time. CONCLUSIONS Specific embodied cognition linked to body schema seems to be impaired in persons with AN. The longitudinal analysis showed a difference between AN and AAN only in the underweight condition, suggesting the presence of an abnormal linguistic embodiment. More attention should be devoted to embodiment during AN treatment to improve bodily cognition, which might, in turn, diminish body misperception.
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Affiliation(s)
- Paolo Meneguzzo
- Department of Neuroscience, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
| | - David Dal Brun
- Department of Linguistic and Literary Studies, University of Padova, Padova, Italy
| | - Enrico Collantoni
- Department of Neuroscience, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Valentina Meregalli
- Department of Neuroscience, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Patrizia Todisco
- Eating Disorders Unit, Casa di Cura "Villa Margherita, Vicenza, Italy
| | - Angela Favaro
- Department of Neuroscience, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Elena Tenconi
- Department of Neuroscience, University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
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11
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Choquette EM, Flux MC, Moseman SE, Chappelle S, Naegele J, Upshaw V, Morton A, Paulus MP, Feinstein JS, Khalsa SS. The impact of floatation therapy on body image and anxiety in anorexia nervosa: a randomised clinical efficacy trial. EClinicalMedicine 2023; 64:102173. [PMID: 37936658 PMCID: PMC10626164 DOI: 10.1016/j.eclinm.2023.102173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/05/2023] [Accepted: 08/08/2023] [Indexed: 11/09/2023] Open
Abstract
Background Body image disturbance and anxiety are core features of anorexia nervosa (AN), a psychiatric disorder with one of the highest mortality rates. This study examined the efficacy of a novel non-pharmacological treatment, floatation-REST (Reduced Environmental Stimulation Therapy) on body image disturbance and anxiety in inpatients with AN. Methods This parallel group randomised controlled trial compared floatation-REST vs. care as usual in women and girls hospitalised for treatment of AN in Tulsa, Oklahoma, USA. Participants were randomised on a 2:1 ratio to receive eight, twice-weekly, 60-min floatation-REST sessions for 4 weeks, in addition to care as usual, or to receive care as usual. The primary outcome was the average change in body dissatisfaction from pre- to post-float as measured by the Photographic Figure Rating Scale. The secondary outcome was the average change in anxiety from pre- to post-float as measured by the state version of the State Trait Anxiety Inventory. Longitudinal effects of floatation-REST on body dissatisfaction were also examined. All analyses were conducted using the intention-to-treat principle. Planned linear mixed models tested the effect of floatation-REST vs. care as usual. The trial was preregistered (clinicaltrials.govNCT03610451). Findings Between March 16, 2018 and February 25, 2021, 133 participants were screened for eligibility, and 86 were consented. Eighteen were excluded after consent, for a final randomisation sample of 68 participants (45 floatation-REST; 23 care as usual). There were two session by condition interactions on body dissatisfaction (p = 0.00026) and state anxiety (p < 0.0001), such that the floatation-REST group exhibited acute (i.e., pre- to post-session) reductions in body dissatisfaction (floatation-REST group mean change (Δm) = -0.43; 95% CI -0.56 to -0.30, p < 0.0001, Cohen's d = 0.23), and acute reductions in anxiety (floatation-REST group Δm = -15.75; 95% CI -17.95 to -13.56, p < 0.0001, Cohen's d = 1.52); however, the care as usual group exhibited no significant changes. With regard to longitudinal results, there was a significant time by treatment interaction between baseline and immediately post intervention (p = 0.012) and baseline and six-month follow up (p = 0.0019). At immediately post intervention, there was a trending reduction in body dissatisfaction for the floatation-REST group (Δm = -0.41, 95% CI -0.86 to 0.03, p = 0.068) and care as usual group (Δm = 0.61; 95% CI -0.04 to 1.27, p = 0.070). At six-months post-intervention, the floatation-REST group exhibited lower body dissatisfaction (Δm = -0.91; 95% CI -1.37 to -0.45, p = 0.0020, Cohen's d = 0.53) whereas the care as usual group reported no change in body dissatisfaction (Δm = 0.35; 95% CI -0.28 to 0.98, p = 0.96) relative to baseline. There were no adverse events related to the trial during the study. Interpretation Our findings suggest that Floatation-REST decreased body dissatisfaction compared to care as usual acutely after each float session and at six-month follow-up. Floatation-REST has potential utility for the treatment of body image disturbance and anxiety in AN. These results may be limited by some generalisability concerns given the recruitment of a modest sample receiving inpatient treatment at a single site. Funding The William K. Warren Foundation.
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Affiliation(s)
| | | | - Scott E. Moseman
- Laureate Eating Disorders Program, Saint Francis Health System, Tulsa, Oklahoma, USA
| | | | | | - Valerie Upshaw
- Laureate Institute for Brain Research, Tulsa, Oklahoma, USA
| | - Alexa Morton
- Laureate Institute for Brain Research, Tulsa, Oklahoma, USA
| | - Martin P. Paulus
- Laureate Institute for Brain Research, Tulsa, Oklahoma, USA
- Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma, USA
| | - Justin S. Feinstein
- Laureate Institute for Brain Research, Tulsa, Oklahoma, USA
- Float Research Collective, Kihei, Hawaii, USA
| | - Sahib S. Khalsa
- Laureate Institute for Brain Research, Tulsa, Oklahoma, USA
- Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma, USA
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12
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Wronski ML, Geisler D, Bernardoni F, Seidel M, Bahnsen K, Doose A, Steinhäuser JL, Gronow F, Böldt LV, Plessow F, Lawson EA, King JA, Roessner V, Ehrlich S. Differential alterations of amygdala nuclei volumes in acutely ill patients with anorexia nervosa and their associations with leptin levels. Psychol Med 2023; 53:6288-6303. [PMID: 36464660 PMCID: PMC10358440 DOI: 10.1017/s0033291722003609] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/24/2022] [Accepted: 11/02/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND The amygdala is a subcortical limbic structure consisting of histologically and functionally distinct subregions. New automated structural magnetic resonance imaging (MRI) segmentation tools facilitate the in vivo study of individual amygdala nuclei in clinical populations such as patients with anorexia nervosa (AN) who show symptoms indicative of limbic dysregulation. This study is the first to investigate amygdala nuclei volumes in AN, their relationships with leptin, a key indicator of AN-related neuroendocrine alterations, and further clinical measures. METHODS T1-weighted MRI scans were subsegmented and multi-stage quality controlled using FreeSurfer. Left/right hemispheric amygdala nuclei volumes were cross-sectionally compared between females with AN (n = 168, 12-29 years) and age-matched healthy females (n = 168) applying general linear models. Associations with plasma leptin, body mass index (BMI), illness duration, and psychiatric symptoms were analyzed via robust linear regression. RESULTS Globally, most amygdala nuclei volumes in both hemispheres were reduced in AN v. healthy control participants. Importantly, four specific nuclei (accessory basal, cortical, medial nuclei, corticoamygdaloid transition in the rostral-medial amygdala) showed greater volumetric reduction even relative to reductions of whole amygdala and total subcortical gray matter volumes, whereas basal, lateral, and paralaminar nuclei were less reduced. All rostral-medially clustered nuclei were positively associated with leptin in AN independent of BMI. Amygdala nuclei volumes were not associated with illness duration or psychiatric symptom severity in AN. CONCLUSIONS In AN, amygdala nuclei are altered to different degrees. Severe volume loss in rostral-medially clustered nuclei, collectively involved in olfactory/food-related reward processing, may represent a structural correlate of AN-related symptoms. Hypoleptinemia might be linked to rostral-medial amygdala alterations.
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Affiliation(s)
- Marie-Louis Wronski
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Daniel Geisler
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Fabio Bernardoni
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Maria Seidel
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Klaas Bahnsen
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Arne Doose
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Jonas L. Steinhäuser
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Franziska Gronow
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
- Institute of Medical Psychology, Charité University Medicine Berlin, Berlin, Germany
| | - Luisa V. Böldt
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
- Charité University Medicine Berlin, Berlin, Germany
| | - Franziska Plessow
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Elizabeth A. Lawson
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Joseph A. King
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Stefan Ehrlich
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
- Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
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13
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Chen X, Dong D, Zhou F, Gao X, Liu Y, Wang J, Qin J, Tian Y, Xiao M, Xu X, Li W, Qiu J, Feng T, He Q, Lei X, Chen H. Connectome-based prediction of eating disorder-associated symptomatology. Psychol Med 2023; 53:5786-5799. [PMID: 36177890 DOI: 10.1017/s0033291722003026] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Despite increasing knowledge on the neuroimaging patterns of eating disorder (ED) symptoms in non-clinical populations, studies using whole-brain machine learning to identify connectome-based neuromarkers of ED symptomatology are absent. This study examined the association of connectivity within and between large-scale functional networks with specific symptomatic behaviors and cognitions using connectome-based predictive modeling (CPM). METHODS CPM with ten-fold cross-validation was carried out to probe functional networks that were predictive of ED-associated symptomatology, including body image concerns, binge eating, and compensatory behaviors, within the discovery sample of 660 participants. The predictive ability of the identified networks was validated using an independent sample of 821 participants. RESULTS The connectivity predictive of body image concerns was identified within and between networks implicated in cognitive control (frontoparietal and medial frontal), reward sensitivity (subcortical), and visual perception (visual). Crucially, the set of connections in the positive network related to body image concerns identified in one sample was generalized to predict body image concerns in an independent sample, suggesting the replicability of this effect. CONCLUSIONS These findings point to the feasibility of using the functional connectome to predict ED symptomatology in the general population and provide the first evidence that functional interplay among distributed networks predicts body shape/weight concerns.
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Affiliation(s)
- Ximei Chen
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Debo Dong
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Feng Zhou
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Xiao Gao
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Yong Liu
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Junjie Wang
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Jingmin Qin
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Yun Tian
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Mingyue Xiao
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Xiaofei Xu
- School of Computing Technologies, RMIT University, Melbourne, Australia
| | - Wei Li
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Jiang Qiu
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
- Southwest University Branch, Collaborative Innovation Center of Assessment Toward Basic Education Quality at Beijing Normal University, Chongqing, China
| | - Tingyong Feng
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
- Research Center of Psychology and Social Development, Faculty of Psychology, Southwest University, Chongqing, China
| | - Qinghua He
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
- Southwest University Branch, Collaborative Innovation Center of Assessment Toward Basic Education Quality at Beijing Normal University, Chongqing, China
| | - Xu Lei
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
- Sleep and NeuroImaging Center, Faculty of Psychology, Southwest University, Chongqing, China
| | - Hong Chen
- Key Laboratory of Cognition and Personality, Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
- Research Center of Psychology and Social Development, Faculty of Psychology, Southwest University, Chongqing, China
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14
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De la Cruz F, Teed AR, Lapidus RC, Upshaw V, Schumann A, Paulus MP, Bär KJ, Khalsa SS. Central Autonomic Network Alterations in Anorexia Nervosa Following Peripheral Adrenergic Stimulation. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:720-730. [PMID: 37055325 PMCID: PMC10285030 DOI: 10.1016/j.bpsc.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Anorexia nervosa (AN) is characterized by low body weight, disturbed eating, body image disturbance, anxiety, and interoceptive dysfunction. However, the neural processes underlying these dysfunctions in AN are unclear. This investigation combined an interoceptive pharmacological probe, the peripheral β-adrenergic agonist isoproterenol, with resting-state functional magnetic resonance imaging to examine whether individuals with AN relative to healthy comparison participants show dysregulated neural coupling in central autonomic network brain regions. METHODS Resting-state functional magnetic resonance imaging was performed in 23 weight-restored female participants with AN and 23 age- and body mass index-matched healthy comparison participants before and after receiving isoproterenol infusions. Whole-brain functional connectivity (FC) changes were examined using central autonomic network seeds in the amygdala, anterior insular cortex, posterior cingulate cortex, and ventromedial prefrontal cortex after performing physiological noise correction procedures. RESULTS Relative to healthy comparison participants, adrenergic stimulation caused widespread FC reductions in the AN group between central autonomic network regions and motor, premotor, frontal, parietal, and visual brain regions. Across both groups, these FC changes were inversely associated with trait anxiety (State-Trait Anxiety Inventory-Trait), trait depression (9-item Patient Health Questionnaire), and negative body image perception (Body Shape Questionnaire) measures, but not with changes in resting heart rate. These results were not accounted for by baseline group FC differences. CONCLUSIONS Weight-restored females with AN show a widespread state-dependent disruption of signaling between central autonomic, frontoparietal, and sensorimotor brain networks that facilitate interoceptive representation and visceromotor regulation. Additionally, trait associations between central autonomic network regions and these other brain networks suggest that dysfunctional processing of interoceptive signaling may contribute to affective and body image disturbance in AN.
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Affiliation(s)
- Feliberto De la Cruz
- Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Adam R Teed
- Laureate Institute for Brain Research, Tulsa, Oklahoma
| | - Rachel C Lapidus
- Laureate Institute for Brain Research, Tulsa, Oklahoma; Eating Disorders Center for Treatment and Research, University of California San Diego, San Diego, California
| | | | - Andy Schumann
- Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Martin P Paulus
- Laureate Institute for Brain Research, Tulsa, Oklahoma; Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma
| | - Karl-Jürgen Bär
- Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Sahib S Khalsa
- Laureate Institute for Brain Research, Tulsa, Oklahoma; Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma.
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15
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Kaufmann LK, Hänggi J, Jäncke L, Baur V, Piccirelli M, Kollias S, Schnyder U, Martin-Soelch C, Milos G. Disrupted longitudinal restoration of brain connectivity during weight normalization in severe anorexia nervosa. Transl Psychiatry 2023; 13:136. [PMID: 37117179 PMCID: PMC10147636 DOI: 10.1038/s41398-023-02428-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/03/2023] [Accepted: 04/06/2023] [Indexed: 04/30/2023] Open
Abstract
Altered intrinsic brain connectivity of patients with anorexia nervosa has been observed in the acute phase of the disorder, but it remains unclear to what extent these alterations recover during weight normalization. In this study, we used functional imaging data from three time points to probe longitudinal changes in intrinsic connectivity patterns in patients with severe anorexia nervosa (BMI ≤ 15.5 kg/m2) over the course of weight normalization. At three distinct stages of inpatient treatment, we examined resting-state functional connectivity in 27 women with severe anorexia nervosa and 40 closely matched healthy controls. Using network-based statistics and graph-theoretic measures, we examined differences in global network strength, subnetworks with altered intrinsic connectivity, and global network topology. Patients with severe anorexia nervosa showed weakened intrinsic connectivity and altered network topology which did not recover during treatment. The persistent disruption of brain networks suggests sustained alterations of information processing in weight-recovered severe anorexia nervosa.
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Affiliation(s)
- Lisa-Katrin Kaufmann
- Department of Consultation-Liaison Psychiatry and Psychosomatics, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland.
| | - Jürgen Hänggi
- Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Lutz Jäncke
- Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program (URPP) "Dynamic of Healthy Aging", University of Zurich, Zurich, Switzerland
| | - Volker Baur
- Department of Consultation-Liaison Psychiatry and Psychosomatics, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Marco Piccirelli
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Spyros Kollias
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | | | - Chantal Martin-Soelch
- Unit of Clinical and Health Psychology, Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Gabriella Milos
- Department of Consultation-Liaison Psychiatry and Psychosomatics, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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16
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Meregalli V, Tenconi E, Madan CR, Somà E, Meneguzzo P, Ceccato E, Zuanon S, Sala A, Favaro A, Collantoni E. Beyond body image: what body schema and motor imagery can tell us about the way patients with anorexia nervosa experience their body. Psychiatry Clin Neurosci 2023; 77:94-101. [PMID: 36330847 DOI: 10.1111/pcn.13501] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/04/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Abstract
AIM Recent evidence suggests that the body image disturbance often observed in patients with anorexia nervosa also extends to the body schema. According to the embodiment approach, the body schema is not only involved in motor execution, but also in tasks that only require a mental simulation of a movement such as motor imagery, mental rotation of bodies, and visuospatial perspective-taking. The aim of the present study was to assess the ability of patients with anorexia to mentally simulate movements. METHODS The sample included 52 patients with acute anorexia and 62 healthy controls. All participants completed three tests of explicit motor imagery, a mental rotation test and a test of visuospatial perspective-taking. RESULTS Patients with anorexia nervosa, with respect to controls, reported greater difficulties in imagining movements according to a first-person perspective, lower accuracy in motor imagery, selective impairment in the mental rotation of human figures, and reduced ability in assuming a different egocentric visuospatial perspective. CONCLUSION These results are indicative of a specific alteration in motor imagery in patients with anorexia nervosa. Interestingly, patients' difficulties appear to be limited to those tasks which specifically rely on the body schema, while patients and controls performed similarly in the 3D objects mental rotation task.
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Affiliation(s)
- Valentina Meregalli
- Department of Neurosciences, University of Padua, Padova, Italy.,Padua Neuroscience Center, University of Padua, Padova, Italy
| | - Elena Tenconi
- Department of Neurosciences, University of Padua, Padova, Italy.,Padua Neuroscience Center, University of Padua, Padova, Italy
| | | | - Enrica Somà
- Department of Neurosciences, University of Padua, Padova, Italy
| | - Paolo Meneguzzo
- Department of Neurosciences, University of Padua, Padova, Italy.,Padua Neuroscience Center, University of Padua, Padova, Italy
| | - Enrico Ceccato
- Eating Disorders Unit, Ospedale San Bortolo, Vicenza, Italy
| | - Sophia Zuanon
- Eating Disorders Unit, Ospedale San Bortolo, Vicenza, Italy
| | | | - Angela Favaro
- Department of Neurosciences, University of Padua, Padova, Italy.,Padua Neuroscience Center, University of Padua, Padova, Italy
| | - Enrico Collantoni
- Department of Neurosciences, University of Padua, Padova, Italy.,Padua Neuroscience Center, University of Padua, Padova, Italy
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17
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Pappaianni E, Barona M, Doucet GE, Clark C, Frangou S, Micali N. Neurocognitive Endophenotypes for Eating Disorders: A Preliminary High-Risk Family Study. Brain Sci 2023; 13:brainsci13010099. [PMID: 36672080 PMCID: PMC9856317 DOI: 10.3390/brainsci13010099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/26/2022] [Accepted: 12/29/2022] [Indexed: 01/06/2023] Open
Abstract
Eating disorders (EDs) are psychiatric disorders with a neurobiological basis. ED-specific neuropsychological and brain characteristics have been identified, but often in individuals in the acute phase or recovered from EDs, precluding an understanding of whether they are correlates and scars of EDs vs. predisposing factors. Although familial high-risk (FHR) studies are available across other disorders, this study design has not been used in EDs. We carried out the first FMH study in EDs, investigating healthy offspring of women with EDs and controls. We preliminarily aimed to investigate ED-related neurocognitive and brain markers that could point to predisposing factors for ED. Sixteen girls at FHR for EDs and twenty control girls (age range: 8−15), completed neuropsychological tests assessing executive functions. Girls also underwent a resting-state fMRI scan to quantify functional connectivity (FC) within resting-state networks. Girls at FHR for EDs performed worse on a cognitive flexibility task compared with controls (F = 5.53, p = 0.02). Moreover, they showed different FC compared with controls in several resting-state networks (p < 0.05 FDR-corrected). Differences identified in cognitive flexibility and in FC are in line with those identified in individuals with EDs, strongly pointing to a role as potential endophenotypes of EDs.
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Affiliation(s)
- Edoardo Pappaianni
- Mental Health Services in the Capital Region of Denmark, Eating Disorders Research Unit, Psychiatric Center Ballerup, 2750 Ballerup, Denmark
| | - Manuela Barona
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Gaelle E. Doucet
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE 68010, USA
| | - Christopher Clark
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
| | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Psychiatry, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Nadia Micali
- Mental Health Services in the Capital Region of Denmark, Eating Disorders Research Unit, Psychiatric Center Ballerup, 2750 Ballerup, Denmark
- Great Ormond Street Institute of Child Health, University College London, London WC1N 1EH, UK
- Correspondence:
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18
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Lucherini Angeletti L, Innocenti M, Felciai F, Ruggeri E, Cassioli E, Rossi E, Rotella F, Castellini G, Stanghellini G, Ricca V, Northoff G. Anorexia nervosa as a disorder of the subcortical-cortical interoceptive-self. Eat Weight Disord 2022; 27:3063-3081. [PMID: 36355249 PMCID: PMC9803759 DOI: 10.1007/s40519-022-01510-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 11/03/2022] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Anorexia nervosa (AN) is characterized by a diminished capacity in perceiving the physiological correlates of interoceptive sensations, namely bodily self-consciousness. Given the neural division of self-processing into interoceptive-, exteroceptive- and mental-self, we hypothesize neural deficits in the interoceptive-processing regions in AN. METHODS To prove this, we reviewed resting state (rs), task and rest-task studies in AN literature. RESULTS Neuronal data demonstrate the following in AN: (i) decreased rs-functional connectivity (rsFC) of subcortical-cortical midline structures (SCMS); (ii) reduced rsFC between medial (default-mode network/DMN and salience network/SN) and lateral (executive-control network/ECN) cortical regions; (iii) decreased rsFC in mainly the regions of the interoceptive-self; (iv) altered activity with overall increased activity in response to sensory/body image stimuli, especially in the regions of the interoceptive-self; (v) lack of a clear task-related distinction between own's and others' body image. CONCLUSION These data may indicate that rs-hypoconnectivity between SCMS, as neural correlate of a reduced intero-exteroceptive integration resulting in self-objectification, might be linked to overall increased activity in interoceptive regions during sensory/body image stimuli in AN, engendering an "anxious bodily self." LEVEL OF EVIDENCE I: Systematic review.
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Affiliation(s)
- Lorenzo Lucherini Angeletti
- Department of Health Sciences, Psychiatry Unit, University of Florence, Largo G. Alessandro Brambilla 3, 50134, Florence, Italy.
| | - Matteo Innocenti
- Department of Health Sciences, Psychiatry Unit, University of Florence, Largo G. Alessandro Brambilla 3, 50134, Florence, Italy
| | - Federica Felciai
- Department of Health Sciences, Psychiatry Unit, University of Florence, Largo G. Alessandro Brambilla 3, 50134, Florence, Italy
| | - Emanuele Ruggeri
- Department of Health Sciences, Psychiatry Unit, University of Florence, Largo G. Alessandro Brambilla 3, 50134, Florence, Italy
| | - Emanuele Cassioli
- Department of Health Sciences, Psychiatry Unit, University of Florence, Largo G. Alessandro Brambilla 3, 50134, Florence, Italy
| | - Eleonora Rossi
- Department of Health Sciences, Psychiatry Unit, University of Florence, Largo G. Alessandro Brambilla 3, 50134, Florence, Italy
| | | | - Giovanni Castellini
- Department of Health Sciences, Psychiatry Unit, University of Florence, Largo G. Alessandro Brambilla 3, 50134, Florence, Italy
| | - Giovanni Stanghellini
- Department of Health Sciences, Psychology Unit, University of Florence, Florence, Italy
| | - Valdo Ricca
- Department of Health Sciences, Psychiatry Unit, University of Florence, Largo G. Alessandro Brambilla 3, 50134, Florence, Italy
| | - Georg Northoff
- Mental Health Centre, Zhejiang University School of Medicine, Hangzhou, China
- Centre for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China
- The Royal's Institute of Mental Health Research & University of Ottawa, Ottawa, ON, Canada
- Centre for Neural Dynamics, Faculty of Medicine, Brain and Mind Research Institute, University of Ottawa, Ottawa, ON, Canada
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19
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Di Lodovico L, Hanachi M, Duriez P, Gorwood P. The Fitter I Am, the Larger I Feel-The Vicious Circle of Physical Exercise in Anorexia Nervosa. Nutrients 2022; 14:4507. [PMID: 36364769 PMCID: PMC9657677 DOI: 10.3390/nu14214507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/21/2022] [Accepted: 10/21/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction: Body image distortion is a core symptom of anorexia nervosa (AN), embodying dissatisfaction and overvaluation of body appearance and weight. Body image distortion is an important factor in the maintenance of weight loss behaviours such as compulsive physical exercise. Conversely, physical exercise seems to have an aggravating effect on body image in patients with AN, but the evidence is still poor. The aim of this study was to examine the relationship between body image distortion and physical exercise in AN in order to understand whether physical exercise may play a specific role in body image distortion beyond psychopathological severity. Methods: Forty patients with AN and 21 healthy controls were tested for body image distortion and different proxies of physical exercise. Univariate correlations tested the relationship between body image distortion and physical exercise in AN and control groups. Then, to experimentally assess the effect of exercise on body image distortion, participants were invited to rate their body image before and after a standardised effort test. Results: In the AN group, a correlation was found between physical activity and body image distortion (p < 0.01), which was still significant after controlling for psychopathological severity. No correlation was found in healthy controls. After a standardised effort, patients with AN had higher increases in body image distortion than healthy controls (almost 4 kg/m2 vs. 0.8 kg/m2) (p < 0.01). Discussion: Physical exercise may contribute to the distortion of body image in anorexia nervosa and explain the paradoxical augmentation of unhealthy exercise despite ongoing weight loss.
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Affiliation(s)
- Laura Di Lodovico
- Clinique des Maladies Mentales et de l’Encéphale (CMME), Hôpital Sainte-Anne, GHU Paris Psychiatrie et Neurosciences, 75014 Paris, France
- Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Université Paris Cité, 75006 Paris, France
| | - Mouna Hanachi
- Nutrition Unit, Paul Brousse University Hospital, Assistance Publique–Hôpitaux de Paris, 94800 Villejuif, France
- Micalis Institute, INRA, AgroParisTech, Université Paris-Saclay, 78350 Jouy-en-Josas, France
| | - Philibert Duriez
- Clinique des Maladies Mentales et de l’Encéphale (CMME), Hôpital Sainte-Anne, GHU Paris Psychiatrie et Neurosciences, 75014 Paris, France
- Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Université Paris Cité, 75006 Paris, France
| | - Philip Gorwood
- Clinique des Maladies Mentales et de l’Encéphale (CMME), Hôpital Sainte-Anne, GHU Paris Psychiatrie et Neurosciences, 75014 Paris, France
- Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Université Paris Cité, 75006 Paris, France
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20
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Time evaluation and its accuracy in eating disorders: differences in relation to interoceptive awareness. Eat Weight Disord 2022; 27:2551-2560. [PMID: 35410413 PMCID: PMC9556400 DOI: 10.1007/s40519-022-01394-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/14/2022] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Time evaluation has been poorly studied in eating disorder (ED) patients despite its relationship with body awareness, which is a core psychopathological feature in EDs and is influenced by impulsivity, interoception, and working memory. This study aims to evaluate time estimation and its accuracy across the ED spectrum in connection with specific and general psychopathology. METHODS A group of 215 women was enrolled in a computerized task involving the estimation of 1-min intervals. Impulsivity and body awareness constructs (self-monitoring, depersonalization, interoceptive deficit) were evaluated and examined for significant correlations with time estimation and the accuracy of the measure. RESULTS Patients with EDs showed an impaired ability to estimate time, with an accuracy that positively correlated with compulsive self-monitoring (p = 0.03). Differences between diagnostic subgroups showed an overestimation of time in anorexia nervosa patients and an underestimation of time in binge eating disorder patients, whose time estimation was also less accurate. CONCLUSION The relationship between time estimation and compulsive self- monitoring might corroborate the presence of an imbalanced integration of information in patients with EDs that was not present in the community women included in the study. Time perception should be further evaluated in the ED field, and longitudinal changes due to psychopathological recovery or BMI changes should be examined. LEVEL OF EVIDENCE Level III: Evidence obtained from a well-designed cohort or case-control analytic study.
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21
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Casper RC. Restlessness and an Increased Urge to Move (Drive for Activity) in Anorexia Nervosa May Strengthen Personal Motivation to Maintain Caloric Restriction and May Augment Body Awareness and Proprioception: A Lesson From Leptin Administration in Anorexia Nervosa. Front Psychol 2022; 13:885274. [PMID: 35959022 PMCID: PMC9359127 DOI: 10.3389/fpsyg.2022.885274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 06/20/2022] [Indexed: 12/02/2022] Open
Abstract
Anorexia nervosa (AN), a disorder of voluntary food restriction leading to severe weight loss in female adolescents, remains an enigma. In particular, the appropriation of the starved thin body into the self-concept in AN is a process insufficiently researched and still poorly understood. Healthy humans undergoing starvation experience a slowing of movements and avoid voluntary exercise. By contrast, AN tends to be not infrequently associated with voluntary, sometimes excessive and/or compulsive exercise. Such deliberate exercise, not reported in starvation, seems to be facilitated by an increased urge for movement and physical restlessness, particular to AN. The increased urge to move would reflect spontaneous daily activity, the energy expended for everything that is not sleeping, eating, or voluntary exercise. Our hypothesis is that the starvation-induced increased urge to move and restlessness may promote the development of AN. Reversal of the fasting state, by either high caloric food or by leptin administration, would be expected to reduce restlessness and the increased urge to move along with improvement in other symptoms in AN. This review explores the idea that such restless activation in AN, in itself and through accelerating body weight loss, might foster the integration of the starving body into the self-concept by (1) enhancing the person’s sense of self-control and sense of achievement and (2) through invigorating proprioception and through intensifying the perception of the changing body shape. (3) Tentative evidence from studies piloting leptin administration in chronic AN patients which support this hypothesis is reviewed. The findings show that short term administration of high doses of leptin indeed mitigated depressive feelings, inner tension, intrusive thoughts of food, and the increased urge to be physically active, easing the way to recovery, yet had little influence on the patients’ personal commitment to remain at a low weight. Full recovery then requires resolution of the individuals’ personal unresolved psychological conflicts through psychotherapy and frequently needs specialized treatment approaches to address psychiatric co-morbidities. AN might be conceptualized as a hereditary form of starvation resistance, facilitated by the effects of starvation on fitness allowing for an exceptionally intense personal commitment to perpetuate food restriction.
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22
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Wang JN, Tang LR, Li WH, Zhang XY, Shao X, Wu PP, Yang ZM, Wu GW, Chen Q, Wang Z, Zhang P, Li ZJ, Wang Z. Regional Neural Activity Abnormalities and Whole-Brain Functional Connectivity Reorganization in Bulimia Nervosa: Evidence From Resting-State fMRI. Front Neurosci 2022; 16:858717. [PMID: 35573287 PMCID: PMC9100949 DOI: 10.3389/fnins.2022.858717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 04/04/2022] [Indexed: 11/13/2022] Open
Abstract
The management of eating behavior in bulimia nervosa (BN) patients is a complex process, and BN involves activity in multiple brain regions that integrate internal and external functional information. This functional information integration occurs in brain regions involved in reward, cognition, attention, memory, emotion, smell, taste, vision and so on. Although it has been reported that resting-state brain activity in BN patients is different from that of healthy controls, the neural mechanisms remain unclear and need to be further explored. The fractional amplitude of low-frequency fluctuation (fALFF) analyses are an important data-driven method that can measure the relative contribution of low-frequency fluctuations within a specific frequency band to the whole detectable frequency range. The fALFF is well suited to reveal the strength of interregional cooperation at the single-voxel level to investigate local neuronal activity power. FC is a brain network analysis method based on the level of correlated dynamics between time series, which establishes the connection between two spatial regions of interest (ROIs) with the assistance of linear temporal correlation. Based on the psychological characteristics of patients with BN and the abnormal brain functional activities revealed by previous neuroimaging studies, in this study, we investigated alterations in regional neural activity by applying fALFF analysis and whole-brain functional connectivity (FC) in patients with BN in the resting state and to explore correlations between brain activities and eating behavior. We found that the left insula and bilateral inferior parietal lobule (IPL), as key nodes in the reorganized resting-state neural network, had altered FC with other brain regions associated with reward, emotion, cognition, memory, smell/taste, and vision-related functional processing, which may have influenced restrained eating behavior. These results could provide a further theoretical basis and potential effective targets for neuropsychological treatment in patients with BN.
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Affiliation(s)
- Jia-ni Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Li-rong Tang
- Beijing Anding Hospital, Capital Medical University, Beijing, China
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Wei-hua Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xin-yu Zhang
- Beijing Anding Hospital, Capital Medical University, Beijing, China
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Xiao Shao
- Beijing Anding Hospital, Capital Medical University, Beijing, China
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Ping-ping Wu
- Beijing Anding Hospital, Capital Medical University, Beijing, China
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Ze-mei Yang
- Beijing Anding Hospital, Capital Medical University, Beijing, China
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing, China
| | - Guo-wei Wu
- Chinese Institute for Brain Research, Beijing, China
| | - Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zheng Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Peng Zhang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- *Correspondence: Zhenchang Wang,
| | - Zhan-jiang Li
- Beijing Anding Hospital, Capital Medical University, Beijing, China
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing, China
- *Correspondence: Zhenchang Wang,
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- *Correspondence: Zhenchang Wang,
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23
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Gupta A, Bhatt RR, Rivera-Cancel A, Makkar R, Kragel PA, Rodriguez T, Graner JL, Alaverdyan A, Hamadani K, Vora P, Naliboff B, Labus JS, LaBar KS, Mayer EA, Zucker N. Complex functional brain network properties in anorexia nervosa. J Eat Disord 2022; 10:13. [PMID: 35123579 PMCID: PMC8817538 DOI: 10.1186/s40337-022-00534-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anorexia nervosa (AN) is a disorder characterized by an incapacitating fear of weight gain and by a disturbance in the way the body is experienced, facets that motivate dangerous weight loss behaviors. Multimodal neuroimaging studies highlight atypical neural activity in brain networks involved in interoceptive awareness and reward processing. METHODS The current study used resting-state neuroimaging to model the architecture of large-scale functional brain networks and characterize network properties of individual brain regions to clinical measures. Resting-state neuroimaging was conducted in 62 adolescents, 22 (21 female) with a history of AN and 40 (39 female) healthy controls (HCs). Sensorimotor and basal ganglia regions, as part of a 165-region whole-brain network, were investigated. Subject-specific functional brain networks were computed to index centrality. A contrast analysis within the general linear model covarying for age was performed. Correlations between network properties and behavioral measures were conducted (significance q < .05). RESULTS Compared to HCs, AN had lower connectivity from sensorimotor regions, and greater connectivity from the left caudate nucleus to the right postcentral gyrus. AN demonstrated lower sensorimotor centrality, but higher basal ganglia centrality. Sensorimotor connectivity dyads and centrality exhibited negative correlations with body dissatisfaction and drive for thinness, two essential features of AN. CONCLUSIONS These findings suggest that AN is associated with greater communication from the basal ganglia, and lower information propagation in sensorimotor cortices. This is consistent with the clinical presentation of AN, where individuals exhibit patterns of rigid habitual behavior that is not responsive to bodily needs, and seem "disconnected" from their bodies.
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Affiliation(s)
- Arpana Gupta
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA. .,David Geffen School of Medicine, UCLA, Los Angeles, CA, 90095, USA. .,Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA, Los Angeles, CA, 90095, USA.
| | - Ravi R Bhatt
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA.,Imaging Genetics Center, Mark and Mary Stevens Institute for Neuroimaging and Informatics, Keck School of Medicine at USC, University of Southern California, Los Angeles, USA
| | | | - Rishi Makkar
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA
| | | | - Thomas Rodriguez
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA
| | - John L Graner
- Department of Psychology and Neuroscience, Duke University, Durham, USA
| | - Anita Alaverdyan
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA
| | - Kareem Hamadani
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA
| | - Priten Vora
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA
| | - Bruce Naliboff
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA.,David Geffen School of Medicine, UCLA, Los Angeles, CA, 90095, USA.,Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA, Los Angeles, CA, 90095, USA
| | - Jennifer S Labus
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA.,David Geffen School of Medicine, UCLA, Los Angeles, CA, 90095, USA.,Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA, Los Angeles, CA, 90095, USA
| | - Kevin S LaBar
- Department of Psychology and Neuroscience, Duke University, Durham, USA
| | - Emeran A Mayer
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA, Los Angeles, CA, 90095, USA.,David Geffen School of Medicine, UCLA, Los Angeles, CA, 90095, USA.,Vatche and Tamar Manoukian Division of Digestive Diseases, UCLA, Los Angeles, CA, 90095, USA.,Ahmanson-Lovelace Brain Mapping Center, UCLA, Los Angeles, CA, 90095, USA
| | - Nancy Zucker
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, USA.,Department of Psychology and Neuroscience, Duke University, Durham, USA
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24
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Lee H, Kwon J, Lee JE, Park BY, Park H. Disrupted stepwise functional brain organization in overweight individuals. Commun Biol 2022; 5:11. [PMID: 35013513 PMCID: PMC8748821 DOI: 10.1038/s42003-021-02957-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 12/09/2021] [Indexed: 11/29/2022] Open
Abstract
Functional hierarchy establishes core axes of the brain, and overweight individuals show alterations in the networks anchored on these axes, particularly in those involved in sensory and cognitive control systems. However, quantitative assessments of hierarchical brain organization in overweight individuals are lacking. Capitalizing stepwise functional connectivity analysis, we assess altered functional connectivity in overweight individuals relative to healthy weight controls along the brain hierarchy. Seeding from the brain regions associated with obesity phenotypes, we conduct stepwise connectivity analysis at different step distances and compare functional degrees between the groups. We find strong functional connectivity in the somatomotor and prefrontal cortices in both groups, and both converge to transmodal systems, including frontoparietal and default-mode networks, as the number of steps increased. Conversely, compared with the healthy weight group, overweight individuals show a marked decrease in functional degree in somatosensory and attention networks across the steps, whereas visual and limbic networks show an increasing trend. Associating functional degree with eating behaviors, we observe negative associations between functional degrees in sensory networks and hunger and disinhibition-related behaviors. Our findings suggest that overweight individuals show disrupted functional network organization along the hierarchical axis of the brain and these results provide insights for behavioral associations.
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Affiliation(s)
- Hyebin Lee
- Department of Electrical and Computer Engineering, Sungkyunkwan University, Suwon, Korea
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Korea
| | - Junmo Kwon
- Department of Electrical and Computer Engineering, Sungkyunkwan University, Suwon, Korea
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Korea
| | - Jong-Eun Lee
- Department of Electrical and Computer Engineering, Sungkyunkwan University, Suwon, Korea
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Korea
| | - Bo-Yong Park
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Korea.
- Department of Data Science, Inha University, Incheon, Korea.
| | - Hyunjin Park
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Korea.
- School of Electronic and Electrical Engineering, Sungkyunkwan University, Suwon, Korea.
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25
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Vidal L, Ortega MA, Alvarez-Mon MA, Álvarez-Mon M, Lahera G. Volumetric Alterations of the Cerebral Cortex in Eating Disorders. J Clin Med 2021; 10:jcm10235480. [PMID: 34884181 PMCID: PMC8658332 DOI: 10.3390/jcm10235480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/10/2021] [Accepted: 11/18/2021] [Indexed: 11/16/2022] Open
Abstract
Eating disorders are relatively frequent psychiatric disorders that can produce serious consequences at the brain level. In an effort to clarify the neurobiological mechanisms of their pathogenesis, some studies have suggested the existence of modifications of the cortical architecture in eating disorders, but it is unknown whether the alterations described are a cause or consequence of eating disorders. The main objective of this systematic review is to collect the evidence available about the volumetric alterations of the cerebral cortex in eating disorders in adults and their apparent relationship with the pathogenesis of the disease. Initially, 91 articles were found by a search that included the terms anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder, gray matter, cortical thickness (CT), and brain volume. To pare down the articles, the following inclusion criteria were applied: (1) cortical thickness and/or gray matter volume (GMV) in patients with anorexia, bulimia nervosa, or binge-eating disorder was the main measure of the study; and (2) the sample was adult patients aged 18–65. The exclusion criteria were as follows: (1) articles that did not analyze cortical thickness or gray matter volume; (2) studies with patients with comorbidities; and (3) studies in patients who did not meet the DSM-IV/DSM-V criteria. In the first phase of selection, we proceeded to read the titles and abstracts as a first screen, thereby excluding 62 studies, followed by a complete critical reading of the 29 remaining articles. In this last phase, nine studies were excluded because they did not specify the eating disorder subtype, they included adolescents, or they did not measure GMV or CT. Finally, after the above systematic selection process, 20 articles were included in this review. Despite the methodological heterogeneity of the studies, there was some agreement between them. They showed an overall reduction in GMV in eating disorders, as well as alterations in certain regions of the cerebral cortex. Some of the most often mentioned cortical areas were the frontal, cingulate, and right orbitofrontal cortices, the precuneus, the right insula, and some temporoparietal gyri in cases of AN, with greater cortical involvement in frontotemporal and medial orbitofrontal regions in BN and binge eating disorder. Likewise, certain cortical regions, such as the left inferior frontal gyrus, the precuneus, the right superior motor area, the cingulate cortex, the insula, and the medial orbitofrontal sulcus, often remained altered after recovery from AN, making them potential cortical areas involved in the etiopathogenesis of AN. A reduction in GMV in specific areas of the CNS can inform us about the neurobiological mechanisms that underlie eating disorders as well as give us a better understanding of their possible consequences at the brain level.
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Affiliation(s)
- Laura Vidal
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcalá de Henares, Spain; (L.V.); (M.A.A.-M.); (M.Á.-M.); (G.L.)
| | - Miguel A Ortega
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcalá de Henares, Spain; (L.V.); (M.A.A.-M.); (M.Á.-M.); (G.L.)
- Ramón y Cajal Institute of Sanitary Researcsh, 28034 Madrid, Spain
- Cancer Registry and Pathology Department, Hospital Universitario Principe de Asturias, 28806 Alcalá de Henares, Spain
- Correspondence:
| | - Miguel Angel Alvarez-Mon
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcalá de Henares, Spain; (L.V.); (M.A.A.-M.); (M.Á.-M.); (G.L.)
- Ramón y Cajal Institute of Sanitary Researcsh, 28034 Madrid, Spain
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
| | - Melchor Álvarez-Mon
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcalá de Henares, Spain; (L.V.); (M.A.A.-M.); (M.Á.-M.); (G.L.)
- Ramón y Cajal Institute of Sanitary Researcsh, 28034 Madrid, Spain
- Immune System Diseases-Rheumatology, Oncology Service an Internal Medicine, University Hospital Príncipe de Asturias, 28806 Alcalá de Henares, Spain
| | - Guillermo Lahera
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcalá de Henares, Spain; (L.V.); (M.A.A.-M.); (M.Á.-M.); (G.L.)
- Ramón y Cajal Institute of Sanitary Researcsh, 28034 Madrid, Spain
- Psychiatry Service, Center for Biomedical Research in the Mental Health Network, University Hospital Príncipe de Asturias, 28806 Alcalá de Henares, Spain
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Myrvang AD, Vangberg TR, Linnman C, Stedal K, Rø Ø, Endestad T, Rosenvinge JH, Aslaksen PM. Altered functional connectivity in adolescent anorexia nervosa is related to age and cortical thickness. BMC Psychiatry 2021; 21:490. [PMID: 34615497 PMCID: PMC8496064 DOI: 10.1186/s12888-021-03497-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 09/22/2021] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Functional networks develop throughout adolescence when anorexia nervosa (AN) normally debuts. In AN, cerebral structural alterations are found in most brain regions and may be related to the observed functional brain changes. Few studies have investigated the functional networks of the brain in adolescent AN patients.. The aim of this explorative study was to investigate multiple functional networks in adolescent AN patients compared to healthy age-matched controls (HC) and the relationship with age, eating disorder symptoms and structural alterations. METHODS Included were 29 female inpatients with restrictive AN, and 27 HC. All participants were between the ages of 12 to 18 years. Independent component analysis (ICA) identified 21 functional networks that were analyzed with multivariate and univariate analyses of components and group affiliation (AN vs HC). Age, age × group interaction and AN symptoms were included as covariates. Follow-up correlational analyses of selected components and structural measures (cortical thickness and subcortical volume) were carried out. RESULTS Decreased functional connectivity (FC) in AN patients was found in one cortical network, involving mainly the precuneus, and identified as a default mode network (DMN). Cortical thickness in the precuneus was significantly correlated with functional connectivity in this network. Significant group differences were also found in two subcortical networks involving mainly the hippocampus and the amygdala respectively, and a significant interaction effect of age and group was found in both these networks. There were no significant associations between FC and the clinical measures used in the study. CONCLUSION The findings from the present study may imply that functional alterations are related to structural alterations in selected regions and that the restricted food intake in AN patients disrupt normal age-related development of functional networks involving the amygdala and hippocampus.
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Affiliation(s)
- Anna D. Myrvang
- grid.10919.300000000122595234Department of Psychology, Faculty of Health Sciences, UiT The Artic University of Norway, Huginbakken 32, N-9037 Tromsø, Norway
| | - Torgil R. Vangberg
- grid.10919.300000000122595234Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway ,grid.412244.50000 0004 4689 5540PET Center, University Hospital of North Norway, Tromsø, Norway
| | - Clas Linnman
- grid.416228.b0000 0004 0451 8771Spaulding Rehabilitation Hospital, Boston, USA
| | - Kristin Stedal
- grid.55325.340000 0004 0389 8485Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Øyvind Rø
- grid.55325.340000 0004 0389 8485Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway ,grid.5510.10000 0004 1936 8921Institute of clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway
| | - Tor Endestad
- grid.5510.10000 0004 1936 8921Department of psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway ,Helgelandssykehuset, Mosjøen, Norway
| | - Jan H. Rosenvinge
- grid.10919.300000000122595234Department of Psychology, Faculty of Health Sciences, UiT The Artic University of Norway, Huginbakken 32, N-9037 Tromsø, Norway
| | - Per M. Aslaksen
- grid.10919.300000000122595234Department of Psychology, Faculty of Health Sciences, UiT The Artic University of Norway, Huginbakken 32, N-9037 Tromsø, Norway ,grid.412244.50000 0004 4689 5540Regional Center for Eating Disorders, University Hospital of North Norway, Tromsø, Norway
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27
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Leslie M, Halls D, Leppanen J, Sedgewick F, Lang K, Fonville L, Simic M, Mandy W, Nicholls D, Williams S, Tchanturia K. The neural correlates of a central coherence task in young women with anorexia nervosa. EUROPEAN EATING DISORDERS REVIEW 2021; 29:744-755. [PMID: 34278640 DOI: 10.1002/erv.2852] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 06/22/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Heightened detail-processing and low levels of central coherence are common in individuals with anorexia nervosa (AN) and predict poorer prognosis. However, it is unclear whether these processing styles predate the disorder or, rather, emerge during later stages of AN. The current study aimed to address this question by investigating central coherence, and the neural correlates of central coherence, in a sample of young women with AN with shorter duration of illness than previous studies recruiting adult samples. METHODS We recruited 186 participants, including: 73 young women with AN, 45 young women weight-recovered from AN, and 68 age-matched controls. Participants completed the Embedded Figures Task during an fMRI scan. RESULTS There were no significant differences between the participant groups in performance accuracy or reaction time. There were no other between-groups differences in neural response to the Embedded Figures Task. CONCLUSIONS These findings contrast with evidence from older adults demonstrating differences in the neural underpinning of central coherence amongst participants with AN versus control participants. The current study adds to an increasing literature base demonstrating the resilience of neuropsychological traits and associated brain systems in the early stages of AN.
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Affiliation(s)
- Monica Leslie
- Department of Psychological Medicine - London, King's College London (KCL), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), UK
- Department of Psychology, University of Chester, Chester, UK
| | - Daniel Halls
- Department of Psychological Medicine - London, King's College London (KCL), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), UK
| | - Jenni Leppanen
- Department of Psychological Medicine - London, King's College London (KCL), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), UK
| | - Felicity Sedgewick
- Department of Psychological Medicine - London, King's College London (KCL), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), UK
- School of Education, University of Bristol, Bristol, UK
| | - Katie Lang
- Department of Psychology - London, King's College London (KCL), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), UK
| | - Leon Fonville
- Division of Brain Sciences, Imperial College London, UK
| | - Mima Simic
- South London and Maudsley NHS Foundation Trust, UK
| | - William Mandy
- Research Department of Clinical, Health and Educational Psychology, UCL, London, UK
| | | | - Steven Williams
- Department of Neuroimaging - London, King's College London (KCL), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), UK
| | - Kate Tchanturia
- Department of Psychological Medicine - London, King's College London (KCL), Institute of Psychiatry, Psychology and Neuroscience (IoPPN), UK
- Psychology Department, Illia State University, Tbilisi, Georgia
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28
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Lang K, Kerr-Gaffney J, Hodsoll J, Jassi A, Tchanturia K, Krebs G. Is poor global processing a transdiagnostic feature of Body Dysmorphic Disorder and Anorexia Nervosa? A meta-analysis. Body Image 2021; 37:94-105. [PMID: 33582531 DOI: 10.1016/j.bodyim.2021.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 01/26/2021] [Accepted: 01/26/2021] [Indexed: 11/27/2022]
Abstract
Body dysmorphic disorder (BDD) and anorexia nervosa (AN) are characterised by body image disturbance. It has been suggested that poor global integration in visual processing may underlie distorted body image, but empirical studies have yielded mixed results. The current study involved two meta-analyses aimed at examining the extent to which poor global processing is evident in BDD and AN. Studies were identified through a systematic literature search up to October 2020. The BDD search yielded 16 studies and the AN search yielded 18 studies. Random-effect models demonstrated a small pooled effect size for BDD (g = -0.44, 95 % CI -0.70, -0.17, p < 0.001) and a moderate pooled effect size for AN (g = -0.63, 95 % CI -0.77, -0.49, p < .001), with no evidence of significant publication bias for either. The results provide evidence that poor global processing is a transdiagnostic feature of both BDD and AN, although effects may be more pronounced in AN. Our findings highlight the possibility that interventions aimed at promoting global visual processing could prove beneficial in disorders characterised by distorted body image.
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Affiliation(s)
- Katie Lang
- King's College London (KCL), Psychology Department, Institute of Psychiatry, UK; National & Specialist OCD, BDD and Related Disorder Clinic, South London & Maudsley NHS Trust, UK.
| | - Jess Kerr-Gaffney
- King's College London (KCL), Psychological Medicine, Institute of Psychiatry, UK
| | - John Hodsoll
- King's College London (KCL), Department of Biostatistics, Institute of Psychiatry, UK
| | - Amita Jassi
- National & Specialist OCD, BDD and Related Disorder Clinic, South London & Maudsley NHS Trust, UK
| | - Kate Tchanturia
- King's College London (KCL), Psychological Medicine, Institute of Psychiatry, UK; National Eating Disorder Unit, South London & Maudsley NHS Trust, UK
| | - Georgina Krebs
- National & Specialist OCD, BDD and Related Disorder Clinic, South London & Maudsley NHS Trust, UK; King's College London (KCL), Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, UK
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29
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Collantoni E, Meneguzzo P, Tenconi E, Meregalli V, Manara R, Favaro A. Shift Toward Randomness in Brain Networks of Patients With Anorexia Nervosa: The Role of Malnutrition. Front Neurosci 2021; 15:645139. [PMID: 33841085 PMCID: PMC8024518 DOI: 10.3389/fnins.2021.645139] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 02/15/2021] [Indexed: 01/12/2023] Open
Abstract
No study to date investigated structural white matter (WM) connectome characteristics in patients with anorexia nervosa (AN). Previous research in AN found evidence of imbalances in global and regional connectomic brain architecture and highlighted a role of malnutrition in determining structural brain changes. The aim of our study was to explore the characteristics of the WM network architecture in a sample of patients with AN. Thirty-six patients with AN and 36 healthy women underwent magnetic resonance imaging to obtain a high-resolution three-dimensional T1-weighted anatomical image and a diffusion tensor imaging scan. Probabilistic tractography data were extracted and analyzed in their network properties through graph theory tools. In comparison to healthy women, patients with AN showed lower global network segregation (normalized clustering: p = 0.029), an imbalance between global network integration and segregation (i.e., lower small-worldness: p = 0.031), and the loss of some of the most integrative and influential hubs. Both clustering and small-worldness correlated with the lowest lifetime body mass index. A significant relationship was found between the average regional loss of cortical volume and changes in network properties of brain nodes: the more the difference in the cortical volume of brain areas, the more the increase in the centrality of corresponding nodes in the whole brain, and the decrease in clustering and efficiency of the nodes of parietal cortex. Our findings showed an unbalanced connectome wiring in AN patients, which seems to be influenced by malnutrition and loss of cortical volume. The role of this rearrangement in the maintenance and prognosis of AN and its reversibility with clinical improvement needs to be established by future studies.
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Affiliation(s)
| | - Paolo Meneguzzo
- Department of Neurosciences, University of Padua, Padua, Italy
| | - Elena Tenconi
- Department of Neurosciences, University of Padua, Padua, Italy.,Padova Neuroscience Center, University of Padua, Padua, Italy
| | | | - Renzo Manara
- Department of Neurosciences, University of Padua, Padua, Italy
| | - Angela Favaro
- Department of Neurosciences, University of Padua, Padua, Italy.,Padova Neuroscience Center, University of Padua, Padua, Italy
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Recovery-Associated Resting-State Activity and Connectivity Alterations in Anorexia Nervosa. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 6:1023-1033. [PMID: 33766777 DOI: 10.1016/j.bpsc.2021.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 02/16/2021] [Accepted: 03/04/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Previous studies provided controversial insight on the impact of starvation, disease status, and underlying gray matter volume (GMV) changes on resting-state functional magnetic resonance imaging alterations in anorexia nervosa (AN). Here, we adapt a combined longitudinal and cross-sectional approach to disentangle the effects of these factors on resting-state alterations in AN. METHODS Overall, 87 female subjects were included in the study: adolescent patients with acute AN scanned at inpatient admission (n = 22, mean age 15.3 years) and at discharge (n = 21), patients who recovered from AN (n = 21, mean age 22.3 years), and two groups of healthy age-matched control subjects (both n = 22, mean age 16.0 and 22.5 years, respectively). Whole-brain measures of resting-state activity and functional connectivity were computed (network-based statistics, global correlation, integrated local correlation, and fractional amplitude of low-frequency fluctuations) to assess resting-state functional magnetic resonance imaging alterations over the course of AN treatment before and after controlling for underlying GMV. RESULTS Patients with acute AN displayed strong and widespread prefrontal, sensorimotor, parietal, temporal, precuneal, and insular reductions of resting-state connectivity and activity. All alterations were independent of GMV and were largely normalized in short-term recovered AN and absent in long-term recovered patients. CONCLUSIONS Resting-state functional magnetic resonance imaging alterations in AN constitute acute and GMV-independent, presumably starvation-related, phenomena. The majority of alterations found here normalized over the course of recovery without evidence for possible preexisting trait- or remaining "scar" effects.
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31
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Keegan E, Tchanturia K, Wade TD. Central coherence and set-shifting between nonunderweight eating disorders and anorexia nervosa: A systematic review and meta-analysis. Int J Eat Disord 2021; 54:229-243. [PMID: 33305366 DOI: 10.1002/eat.23430] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/20/2020] [Accepted: 11/22/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This systematic review and meta-analysis compared previously documented inefficiencies in central coherence and set-shifting between people with nonunderweight eating disorders (bulimia nervosa and binge-eating disorder) and people with anorexia nervosa. METHOD We performed random-effects meta-analyses on 16 studies (1,112 participants) for central coherence and 38 studies (3,505 participants) for set-shifting. Random effects meta-regressions were used to test whether the effect sizes for people with nonunderweight eating disorders were significantly different from the effect sizes for people with anorexia nervosa. RESULTS People with anorexia nervosa (Hedge's g = -0.53, 95% CIs: -0.80, -0.27, p < .001) and bulimia nervosa (Hedge's g = -0.70, 95% CIs: -1.14, -0.25, p = .002), but not binge-eating disorder, had significantly poorer central coherence than healthy controls. Similarly, people with anorexia nervosa (Hedge's g = -0.38, 95% CIs: -0.50, -0.26, p < .001) and bulimia nervosa (Hedge's g = -0.55, 95% CIs: -0.81, -0.29, p < .001), but not binge-eating disorder, had significantly poorer set-shifting than healthy controls. The effect sizes for people with nonunderweight eating disorders did not significantly differ from those for people with anorexia nervosa. DISCUSSION Our meta-analysis was underpowered to make definitive judgments about people with binge-eating disorder. However, we found that people with bulimia nervosa clearly have central coherence and set-shifting inefficiencies which do not significantly differ from those observed in people with anorexia nervosa. Clinically, this suggests that people with bulimia nervosa might benefit from adjunctive approaches to address these inefficiencies, such as cognitive remediation therapy.
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Affiliation(s)
- Ella Keegan
- Blackbird Initiative, Órama Research Institute, Flinders University, Adelaide, Australia
| | | | - Tracey D Wade
- Blackbird Initiative, Órama Research Institute, Flinders University, Adelaide, Australia
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32
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de la Cruz F, Schumann A, Suttkus S, Helbing N, Zopf R, Bär KJ. Cortical thinning and associated connectivity changes in patients with anorexia nervosa. Transl Psychiatry 2021; 11:95. [PMID: 33542197 PMCID: PMC7862305 DOI: 10.1038/s41398-021-01237-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 12/12/2020] [Accepted: 12/15/2020] [Indexed: 01/30/2023] Open
Abstract
Structural brain abnormalities are a consistent finding in anorexia nervosa (AN) and proposed as a state biomarker of the disorder. Yet little is known about how regional structural changes affect intrinsic resting-state functional brain connectivity (rsFC). Using a cross-sectional, multimodal imaging approach, we investigated the association between regional cortical thickness abnormalities and rsFC in AN. Twenty-two acute AN patients and twenty-six age- and gender-matched healthy controls underwent a resting-state functional magnetic resonance imaging scan and cognitive tests. We performed group comparisons of whole-brain cortical thickness, seed-based rsFC, and network-based statistical (NBS) analyses. AN patients showed cortical thinning in the precuneus and inferior parietal lobules, regions involved in visuospatial memory and imagery. Cortical thickness in the precuneus correlated with nutritional state and cognitive functions in AN, strengthening the evidence for a critical role of this region in the disorder. Cortical thinning was accompanied by functional connectivity reductions in major brain networks, namely default mode, sensorimotor and visual networks. Similar to the seed-based approach, the NBS analysis revealed a single network of reduced functional connectivity in patients, comprising mainly sensorimotor- occipital regions. Our findings provide evidence that structural and functional brain abnormalities in AN are confined to specific regions and networks involved in visuospatial and somatosensory processing. We show that structural changes of the precuneus are linked to nutritional and functional states in AN, and future longitudinal research should assess how precuneus changes might be related to the evolution of the disorder.
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Affiliation(s)
- Feliberto de la Cruz
- Lab for Autonomic Neuroscience, Imaging and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Andy Schumann
- Lab for Autonomic Neuroscience, Imaging and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Stefanie Suttkus
- Lab for Autonomic Neuroscience, Imaging and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Nadin Helbing
- Lab for Autonomic Neuroscience, Imaging and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Regine Zopf
- Department of Cognitive Science, Perception in Action Research Centre, Faculty of Medical, Health & Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Karl-Jürgen Bär
- Lab for Autonomic Neuroscience, Imaging and Cognition (LANIC), Department of Psychosomatic Medicine and Psychotherapy, Jena University Hospital, Jena, Germany.
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33
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Postmortem Dissections of the Papez Circuit and Nonmotor Targets for Functional Neurosurgery. World Neurosurg 2020; 144:e866-e875. [DOI: 10.1016/j.wneu.2020.09.088] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/16/2020] [Accepted: 09/16/2020] [Indexed: 12/11/2022]
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34
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Seidel M, Geisler D, Borchardt V, King JA, Bernardoni F, Jaite C, Roessner V, Calhoun V, Walter M, Ehrlich S. Evaluation of spontaneous regional brain activity in weight-recovered anorexia nervosa. Transl Psychiatry 2020; 10:395. [PMID: 33177499 PMCID: PMC7658198 DOI: 10.1038/s41398-020-01081-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 09/14/2020] [Accepted: 10/21/2020] [Indexed: 02/08/2023] Open
Abstract
Whereas research using structural magnetic resonance imaging (sMRI) reports sizable grey matter reductions in patients suffering from acute anorexia nervosa (AN) to be largely reversible already after short-term weight gain, many task-based and resting-state functional connectivity (RSFC) studies suggest persistent brain alterations even after long-term weight rehabilitation. First investigations into spontaneous regional brain activity using voxel-wise resting-state measures found widespread abnormalities in acute AN, but no studies have compared intrinsic brain activity properties in weight-recovered individuals with a history of AN (recAN) with healthy controls (HCs). SMRI and RSFC data were analysed from a sample of 130 female volunteers: 65 recAN and 65 pairwise age-matched HC. Cortical grey matter thickness was assessed using FreeSurfer software. Fractional amplitude of low-frequency fluctuations (fALFFs), mean-square successive difference (MSSD), regional homogeneity (ReHo), voxel-mirrored homotopic connectivity (VHMC), and degree centrality (DC) were calculated. SMRI and RSFC data were analysed from a sample of 130 female volunteers: 65 recAN and 65 pairwise age-matched HCs. Cortical grey matter thickness was assessed using FreeSurfer software. Fractional amplitude of low-frequency fluctuations (fALFF), mean-square successive difference (MSSD), regional homogeneity (ReHo), voxel-mirrored homotopic connectivity (VHMC), and degree centrality (DC) were calculated. Abnormal regional homogeneity found in acute AN seems to normalize in recAN, supporting assumptions of a state rather than a trait marker. Aberrant fALFF values in the cerebellum and the infertior temporal gyrus could possibly hint towards trait factors or a scar (the latter, e.g., from prolonged periods of undernutrition), warranting further longitudinal research.
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Affiliation(s)
- Maria Seidel
- grid.4488.00000 0001 2111 7257Faculty of Medicine, Division of Psychological and Social Medicine, and Developmental Neuroscience, Technische Universität Dresden, Dresden, Germany
| | - Daniel Geisler
- grid.4488.00000 0001 2111 7257Faculty of Medicine, Division of Psychological and Social Medicine, and Developmental Neuroscience, Technische Universität Dresden, Dresden, Germany
| | - Viola Borchardt
- grid.5807.a0000 0001 1018 4307Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany ,grid.418723.b0000 0001 2109 6265Department of Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Joseph A. King
- grid.4488.00000 0001 2111 7257Faculty of Medicine, Division of Psychological and Social Medicine, and Developmental Neuroscience, Technische Universität Dresden, Dresden, Germany
| | - Fabio Bernardoni
- grid.4488.00000 0001 2111 7257Faculty of Medicine, Division of Psychological and Social Medicine, and Developmental Neuroscience, Technische Universität Dresden, Dresden, Germany
| | - Charlotte Jaite
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité–Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Veit Roessner
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, University Hospital C. G. Carus, Technische Universität Dresden, Dresden, Germany
| | - Vince Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA USA
| | - Martin Walter
- grid.5807.a0000 0001 1018 4307Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany ,grid.418723.b0000 0001 2109 6265Department of Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany ,grid.275559.90000 0000 8517 6224Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Stefan Ehrlich
- Faculty of Medicine, Division of Psychological and Social Medicine, and Developmental Neuroscience, Technische Universität Dresden, Dresden, Germany. .,Faculty of Medicine, Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Department of Child and Adolescent Psychiatry, Technische Universität Dresden, Dresden, Germany.
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35
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Alfano V, Mele G, Cotugno A, Longarzo M. Multimodal neuroimaging in anorexia nervosa. J Neurosci Res 2020; 98:2178-2207. [PMID: 32770570 DOI: 10.1002/jnr.24674] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 02/26/2020] [Accepted: 05/25/2020] [Indexed: 12/13/2022]
Abstract
Anorexia nervosa (AN) is a severe and complex psychiatric disorder characterized by intense fear about weight gain and finalized to food-related control behaviors. Growing interest has been demonstrated about neurobiological processes subtend to AN physiopathology. The present review aimed to collect neurostructural and neurofunctional available data from 2010 to 2019. Results have been organized according to the neuroimaging technique employed, also including a specific section on electroencephalographic results, mostly neglected in previous reviews. Diffuse cerebral vulnerability has been demonstrated and the contribution of several structures has been identified. Insula, cingulate cortex, parietal and frontal areas are primarily involved both by structural and functional perspectives. Moreover, consistent alterations in white matter integrity and brain electrical activity have been reported. Neuroimaging findings give a substantial contribution to AN pathophysiological description, also in order to understand altered but reversible processes in the passage from acute illness phase to disorder's remission, useful also for defining therapy.
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36
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Cheng B, Qi X, Liang C, Zhang L, Ma M, Li P, Liu L, Cheng S, Yao Y, Chu X, Ye J, Wen Y, Jia Y, Zhang F. Integrative Genomic Enrichment Analysis Identified the Brain Regions and Development Stages Related to Anorexia Nervosa and Obsessive-Compulsive Disorder. Cereb Cortex 2020; 30:6481-6489. [PMID: 32770201 DOI: 10.1093/cercor/bhaa214] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/29/2020] [Accepted: 07/14/2020] [Indexed: 12/31/2022] Open
Abstract
Our aim is to explore the spatial and temporal features of anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) considering different brain regions and development stages. The gene sets related to 16 brain regions and nine development stages were obtained from a brain spatial and temporal transcriptomic dataset. Using the genome-wide association study data, transcriptome-wide association study (TWAS) was conducted to identify the genes whose imputed expressions were associated with AN and OCD, respectively. The mRNA expression profiles were analyzed by GEO2R to obtain differentially expressed genes. Gene set enrichment analysis was conducted to detect the spatial and temporal features related to AN and OCD using the TWAS and mRNA expression analysis results. We observed multiple common association signals shared by TWAS and mRNA expression analysis of AN, such as the primary auditory cortex vs. cerebellar cortex in fetal development and earlier vs. later fetal development in the somatosensory cortex. For OCD, we also detected multiple common association signals, such as medial prefrontal cortex vs. amygdala in adulthood and fetal development vs. infancy in mediodorsal nucleus of thalamus. Our study provides novel clues for describing the spatial and temporal features of brain development in the pathogenesis of AN and OCD.
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Affiliation(s)
- Bolun Cheng
- Key Laboratory of Trace Elements and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an 710061, P.R. China
| | - Xin Qi
- Key Laboratory of Trace Elements and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an 710061, P.R. China
| | - Chujun Liang
- Key Laboratory of Trace Elements and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an 710061, P.R. China
| | - Lu Zhang
- Key Laboratory of Trace Elements and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an 710061, P.R. China
| | - Mei Ma
- Key Laboratory of Trace Elements and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an 710061, P.R. China
| | - Ping Li
- Key Laboratory of Trace Elements and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an 710061, P.R. China
| | - Li Liu
- Key Laboratory of Trace Elements and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an 710061, P.R. China
| | - Shiqiang Cheng
- Key Laboratory of Trace Elements and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an 710061, P.R. China
| | - Yao Yao
- Key Laboratory of Trace Elements and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an 710061, P.R. China
| | - Xiaomeng Chu
- Key Laboratory of Trace Elements and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an 710061, P.R. China
| | - Jing Ye
- Key Laboratory of Trace Elements and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an 710061, P.R. China
| | - Yan Wen
- Key Laboratory of Trace Elements and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an 710061, P.R. China
| | - Yumeng Jia
- Key Laboratory of Trace Elements and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an 710061, P.R. China
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases, Collaborative Innovation Center of Endemic Disease and Health Promotion for Silk Road Region, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an 710061, P.R. China
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Saure E, Laasonen M, Lepistö-Paisley T, Mikkola K, Ålgars M, Raevuori A. Characteristics of autism spectrum disorders are associated with longer duration of anorexia nervosa: A systematic review and meta-analysis. Int J Eat Disord 2020; 53:1056-1079. [PMID: 32181530 DOI: 10.1002/eat.23259] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 02/14/2020] [Accepted: 02/14/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Anorexia nervosa (AN) is associated with neuropsychological characteristics such as impairments in central coherence, cognitive flexibility, and emotion recognition. The same features also manifest in autism spectrum disorders (ASD) and have been suggested to be associated with illness prolongation in AN. The purpose of this meta-analysis was to examine whether pronounced neuropsychological characteristics related to ASD are associated with illness duration in AN. METHOD Four databases (Medline, PsycINFO, Scopus, PubMed) were searched for eligible studies. Search terms were (a) "anorexia nervosa" and (b) "cognitive flexibility" or "set-shifting" or "central coherence" or "emotion recognition" or "theory of mind". The final sample consisted of 53 studies. Duration of AN was divided into three categories in order to investigate differences between the groups with varying illness duration. The meta-analysis was performed with Review Manager using a random-effects model. RESULTS Deficits in central coherence, cognitive flexibility, and emotion recognition were pronounced among individuals with prolonged AN compared to those with shorter illness duration. DISCUSSION A prolonged course of AN appears to be associated with underlying neuropsychological characteristics that are also distinctive to ASD. Neuropsychological impairments may lead to prolonged AN, and prolonged illness may contribute to the subsequent "neurological scar effect," further strengthening these impairments.
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Affiliation(s)
- Emma Saure
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Marja Laasonen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland.,Department of Otorhinolaryngology and Phoniatrics, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | - Katri Mikkola
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Monica Ålgars
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Åbo Akademi University, Department of Psychology, Åbo Akademi Fakulteten för humaniora psykologi och teologi, Turku, Finland
| | - Anu Raevuori
- Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland.,Department of Adolescent Psychiatry, Helsinki University Hospital, Helsinki, Finland
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Cortical Complexity in Anorexia Nervosa: A Fractal Dimension Analysis. J Clin Med 2020; 9:jcm9030833. [PMID: 32204343 PMCID: PMC7141241 DOI: 10.3390/jcm9030833] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/16/2020] [Accepted: 03/17/2020] [Indexed: 11/17/2022] Open
Abstract
Fractal Dimension (FD) has shown to be a promising means to describe the morphology of cortical structures across different neurologic and psychiatric conditions, displaying a good sensitivity in capturing atrophy processes. In this study, we aimed at exploring the morphology of cortical areas by means of FD in 58 female patients with Anorexia Nervosa (AN) (38 currently underweight and 20 fully recovered) and 38 healthy controls (HC). All participants underwent high-resolution MRI. Surface extraction was completed using FreeSurfer, FD was computed using the calcFD toolbox. The whole cortex mean FD value was lower in acute AN patients compared to HC (p < 0.001). Recovered AN patients did not show differences in the global FD when compared to HC. However, some brain areas showed higher FD in patients than controls, while others showed the opposite pattern. Parietal regions showed lower FD in both AN groups. In acute AN patients, the FD correlated with age (p < 0.001), body mass index (p = 0.019) and duration of illness (p = 0.011). FD seems to represent a feasible method to explore cortical complexity in patients with AN since it demonstrated to be sensitive to the effects of both severity and duration of malnutrition.
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Miyoshi T, Tanioka K, Yamamoto S, Yadohisa H, Hiroyasu T, Hiwa S. Revealing Changes in Brain Functional Networks Caused by Focused-Attention Meditation Using Tucker3 Clustering. Front Hum Neurosci 2020; 13:473. [PMID: 32038204 PMCID: PMC6990115 DOI: 10.3389/fnhum.2019.00473] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 12/30/2019] [Indexed: 01/10/2023] Open
Abstract
This study examines the effects of focused-attention meditation on functional brain states in novice meditators. There are a number of feature metrics for functional brain states, such as functional connectivity, graph theoretical metrics, and amplitude of low frequency fluctuation (ALFF). It is necessary to choose appropriate metrics and also to specify the region of interests (ROIs) from a number of brain regions. Here, we use a Tucker3 clustering method, which simultaneously selects the feature vectors (graph theoretical metrics and fractional ALFF) and the ROIs that can discriminate between resting and meditative states based on the characteristics of the given data. In this study, breath-counting meditation, one of the most popular forms of focused-attention meditation, was used and brain activities during resting and meditation states were measured by functional magnetic resonance imaging. The results indicated that the clustering coefficients of the eight brain regions, Frontal Inf Oper L, Occipital Inf R, ParaHippocampal R, Cerebellum 10 R, Cingulum Mid R, Cerebellum Crus1 L, Occipital Inf L, and Paracentral Lobule R increased through the meditation. Our study also provided the framework of data-driven brain functional analysis and confirmed its effectiveness on analyzing neural basis of focused-attention meditation.
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Affiliation(s)
- Takuma Miyoshi
- Graduate School of Life and Medical Sciences, Doshisha University, Kyoto, Japan
| | - Kensuke Tanioka
- Clinical Study Support Center, Wakayama Medical University Hospital, Wakayama, Japan
| | - Shoko Yamamoto
- Graduate School of Life and Medical Sciences, Doshisha University, Kyoto, Japan
| | - Hiroshi Yadohisa
- Department of Culture and Information Science, Doshisha University, Kyoto, Japan
| | - Tomoyuki Hiroyasu
- Department of Biomedical Sciences and Informatics, Doshisha University, Kyoto, Japan
| | - Satoru Hiwa
- Department of Biomedical Sciences and Informatics, Doshisha University, Kyoto, Japan
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40
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Geisler D, Borchardt V, Boehm I, King JA, Tam FI, Marxen M, Biemann R, Roessner V, Walter M, Ehrlich S. Altered global brain network topology as a trait marker in patients with anorexia nervosa. Psychol Med 2020; 50:107-115. [PMID: 30621808 DOI: 10.1017/s0033291718004002] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Resting state functional magnetic resonance imaging studies have identified functional connectivity patterns associated with acute undernutrition in anorexia nervosa (AN), but few have investigated recovered patients. Thus, a trait connectivity profile characteristic of the disorder remains elusive. Using state-of-the-art graph-theoretic methods in acute AN, the authors previously found abnormal global brain network architecture, possibly driven by local network alterations. To disentangle trait from starvation effects, the present study examines network organization in recovered patients. METHODS Graph-theoretic metrics were used to assess resting-state network properties in a large sample of female patients recovered from AN (recAN, n = 55) compared with pairwise age-matched healthy controls (HC, n = 55). RESULTS Indicative of an altered global network structure, recAN showed increased assortativity and reduced global clustering as well as small-worldness compared with HC, while no group differences at an intermediate or local network level were evident. However, using support-vector classifier on local metrics, recAN and HC could be separated with an accuracy of 70.4%. CONCLUSIONS This pattern of results suggests that long-term recovered patients have an aberrant global brain network configuration, similar to acutely underweight patients. While the finding of increased assortativity may represent a trait marker of AN, the remaining findings could be seen as a scar following prolonged undernutrition.
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Affiliation(s)
- Daniel Geisler
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Viola Borchardt
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
- Department of Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Ilka Boehm
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Joseph A King
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Friederike I Tam
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Department of Child and Adolescent Psychiatry, Eating Disorder Treatment and Research Center, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Michael Marxen
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Ronald Biemann
- Institute of Clinical Chemistry and Pathobiochemistry, Otto-von-Guericke University, Magdeburg, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Eating Disorder Treatment and Research Center, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Martin Walter
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany
- Department of Behavioral Neurology, Leibniz Institute for Neurobiology, Magdeburg, Germany
- Clinic for Psychiatry and Psychotherapy, Eberhard-Karls University, Tuebingen, Germany
- Center for Behavioral Brain Sciences (CBBS), Magdeburg, Germany
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Department of Child and Adolescent Psychiatry, Eating Disorder Treatment and Research Center, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
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Seidel M, Borchardt V, Geisler D, King JA, Boehm I, Pauligk S, Bernardoni F, Biemann R, Roessner V, Walter M, Ehrlich S. Abnormal Spontaneous Regional Brain Activity in Young Patients With Anorexia Nervosa. J Am Acad Child Adolesc Psychiatry 2019; 58:1104-1114. [PMID: 30768380 DOI: 10.1016/j.jaac.2019.01.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 01/18/2019] [Accepted: 02/11/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Functional magnetic resonance imaging (fMRI) studies have repeatedly shown alterations in patients with anorexia nervosa (AN). These alterations might be driven by baseline signal characteristics such as the (fractional) amplitude of low frequency fluctuations (fALFF/ALFF), as well as regional signal consistency (ie, regional homogeneity [ReHo]) within circumscribed brain regions. Previous studies have also demonstrated gray matter (pseudo-) atrophy in underweight individuals with AN. Here we study fALFF/ALFF and ReHo in predominantly adolescent patients with AN, while taking gray matter changes into consideration. METHOD Resting state fMRI data were acquired from a sample of 148 female volunteers: 74 underweight patients with AN and 74 age-matched female healthy controls (HC). RESULTS Group differences for fALFF and ReHo measures were found in several AN-relevant brain regions, including networks related to cognitive control, habit formation, and the ventral visual stream. Furthermore, the magnitude of correlation between gray matter volume/thickness and fALFF and ReHo were reduced in AN compared to HC. CONCLUSION Abnormal local resting state characteristics in AN-related brain-networks as well as reduced structure-function relationships may help to explain previously reported task-related and classical resting state neural alterations in underweight AN. Patients with AN may serve as a valuable population for investigating dynamic changes in the relationships between brain structure and function.
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Affiliation(s)
- Maria Seidel
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Viola Borchardt
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany, and the Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Daniel Geisler
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Joseph A King
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Ilka Boehm
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Sophie Pauligk
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Fabio Bernardoni
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Ronald Biemann
- Institute of Clinical Chemistry and Pathobiochemistry, Otto-von-Guericke University, Magdeburg, Germany
| | - Veit Roessner
- Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Martin Walter
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany, and the Leibniz Institute for Neurobiology, Magdeburg, Germany; Clinic for Psychiatry and Psychotherapy, Eberhard-Karls University, Tuebingen, Germany
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neuroscience, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany; Translational Developmental Neuroscience Section, Eating Disorder Research and Treatment Center, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
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Meneguzzo P, Collantoni E, Solmi M, Tenconi E, Favaro A. Anorexia nervosa and diffusion weighted imaging: An open methodological question raised by a systematic review and a fractional anisotropy anatomical likelihood estimation meta-analysis. Int J Eat Disord 2019; 52:1237-1250. [PMID: 31518016 DOI: 10.1002/eat.23160] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 08/14/2019] [Accepted: 08/15/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Anorexia nervosa (AN) is characterized by white matter abnormalities in neuroimaging studies. Fractional anisotropy (FA) is a diffusion tensor imaging (DTI) index that is considered an instrument for the evaluation of white matter alterations. However, the literature has recently pointed out the role of the partial volume effect (PVE) as a confounding factor for the identification of juxtaposed tissues. Our goal was to review the DTI literature in AN and evaluate possible confounding factors linked to the reported results. METHOD A systematic review of the literature was conducted to identify Diffusion Tensor Imaging studies of individuals with AN and, subsequently, an anatomical likelihood estimation (ALE) meta-analysis was performed on studies published before March 18, 2019. RESULTS Twenty-four studies (AN = 517, controls = 542) were included in the qualitative systematic review of the literature. Ten published studies underwent the ALE-analysis (AN = 210, controls = 229), plus data from an unpublished cohort (AN = 38, controls = 38). Two clusters of decreased FA were identified, namely in the left corona radiata, and in the left thalamus. Only one article took the PVE correction analysis into account. CONCLUSIONS The alterations identified must be considered within the limits of a possible methodological bias regarding PVE and free water and re-analysis of the data may be recommended. The preliminary data showed that the alteration of white matter pathways between the limbic structures and brain cortex may be linked to the processing of somatosensory information that could play a key role in the psychopathology of the disorder.
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Affiliation(s)
- Paolo Meneguzzo
- Department of Neurosciences, University of Padova, Padova, Italy
| | | | - Marco Solmi
- Department of Neurosciences, University of Padova, Padova, Italy.,Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Elena Tenconi
- Department of Neurosciences, University of Padova, Padova, Italy.,Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Angela Favaro
- Department of Neurosciences, University of Padova, Padova, Italy.,Padova Neuroscience Center, University of Padova, Padova, Italy
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Abstract
PURPOSE OF REVIEW This article reviews new research in the context of existing literature to identify approaches that will advance understanding of the persistence of anorexia nervosa. RECENT FINDINGS Neuroscience research in anorexia nervosa has yielded disparate findings: no definitive neural mechanism underlying illness vulnerability or persistence has been identified and no clear neural target for intervention has emerged. Recent advances using structural and functional neuroimaging research, as well as new techniques for applying and combining these approaches, have led to a refined understanding of changes in neural architecture among individuals who are acutely ill, have undergone renourishment, or are in recovery/remission. In particular, advances have come from the incorporation of computational and translational approaches, as well as efforts to link experimental paradigms with illness-relevant behavior. Recent findings converge to suggest abnormalities in systems involved in reward learning and processing among individuals with anorexia nervosa. SUMMARY Anorexia nervosa is associated with neurobiological abnormalities. Aberrant learning and reward processing may contribute to the persistence of illness. To better utilize new techniques to understand the neural mechanisms of persistent anorexia nervosa, it may help to distinguish stages of illness and to link neurobiology with maladaptive behavior.
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Collantoni E, Meneguzzo P, Solmi M, Tenconi E, Manara R, Favaro A. Functional Connectivity Patterns and the Role of 5-HTTLPR Polymorphism on Network Architecture in Female Patients With Anorexia Nervosa. Front Neurosci 2019; 13:1056. [PMID: 31680805 PMCID: PMC6802575 DOI: 10.3389/fnins.2019.01056] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 09/19/2019] [Indexed: 12/21/2022] Open
Abstract
Introduction Recent neuroimaging studies suggest that anorexia nervosa (AN) symptoms emerge from failures in the relationships between spatially distributed networks that support different cognitive, emotional, and somatosensory functions. The 5-HTTLPR genotype has been shown to modulate all these abilities in AN, as well as the connectivity patterns between brain regions that support their functioning. This study aims at exploring the presence of any difference in functional connectome properties between AN patients and healthy controls (HC) by means of graph theory tools. The effect of 5-HTTLPR genotype on regional and global network characteristics in AN and HC was also explored. Methods A sample of 74 subjects (38 HC, 36 AN) underwent a resting state functional magnetic resonance imaging and was genotyped for 5-HTTLPR polymorphism. Comparisons of network properties were made between the AN and HC groups and, within each group, between 5-HTTLPR carriers of low-functioning alleles and carriers of the long–long genotype. Results Patients with AN displayed lower network clustering than HC (p = 0.04 at Mann–Whitney U test). Based on both degree and betweenness, a different distribution of network hubs emerged in the two groups. In particular, the anterior part of the anterior cingulate cortex was a hub only in the patient group. A correlation emerged between differences in brain volumes between patients and HC and differences in degree values of basal ganglia, nodes in the insula, and those in the parietal cortex. Carriers of the short allele of the 5-HTTLPR polymorphism were characterized by lower small-world properties (p = 0.027) and modularity (p = 0.031) in the patient group, and a trend toward higher modularity (p = 0.033) and small-world values (p = 0.123) in the HC group. Discussion Patients with AN showed differences in hubs distribution, providing evidence of the presence of a different functional architectural backbone in this group. Since some correlation emerged between different degree values of nodes and differences in volumes, further longitudinal studies are warranted to better understand the role of malnutrition on brain network architecture. The opposite effects of 5-HTTLPR polymorphism on global network characteristics in the two groups suggest an interaction of the short allele and malnutrition in modulating brain network properties.
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Affiliation(s)
| | - Paolo Meneguzzo
- Department of Neurosciences, University of Padua, Padua, Italy
| | - Marco Solmi
- Department of Neurosciences, University of Padua, Padua, Italy.,Padova Neuroscience Center, University of Padua, Padua, Italy
| | - Elena Tenconi
- Department of Neurosciences, University of Padua, Padua, Italy.,Padova Neuroscience Center, University of Padua, Padua, Italy
| | - Renzo Manara
- Radiology Unit, Department of Medicine and Surgery, Neuroscience Section, University of Salerno, Salerno, Italy
| | - Angela Favaro
- Department of Neurosciences, University of Padua, Padua, Italy.,Padova Neuroscience Center, University of Padua, Padua, Italy
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Yokokura M, Terada T, Bunai T, Nakaizumi K, Kato Y, Yoshikawa E, Futatsubashi M, Suzuki K, Yamasue H, Ouchi Y. Alterations in serotonin transporter and body image-related cognition in anorexia nervosa. NEUROIMAGE-CLINICAL 2019; 23:101928. [PMID: 31491815 PMCID: PMC6627582 DOI: 10.1016/j.nicl.2019.101928] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 06/17/2019] [Accepted: 07/01/2019] [Indexed: 01/09/2023]
Abstract
The serotonin system has been implicated in the pathophysiology of anorexia nervosa (AN). A recent report proposed that body image distortion (BID), a core symptom of AN, may relate to abnormalities of the serotonin system, especially the serotonin transporter (5HTT). Positron emission tomography (PET) studies of underweight patients with active AN reported alterations in serotonin receptors, but not 5HTT. Here, we aimed to disclose the clinicopathophysiology of AN by focusing on 5HTT and cognitive functions, including BID, in groups with active AN. Twenty-two underweight female patients with AN (12 restricting-type AN (ANR); 10 binge-eating/purging-type AN (ANBP)) and 20 age-matched healthy female subjects underwent PET with a 5HTT radioligand [11C]DASB. The binding potential (BPND) of [11C]DASB was estimated semiquantitatively, and clinical data from Raven's colored progressive matrices for general intelligence, the Stroop test for focused attention, the Iowa gambling task for decision making and a dot-probe task designed for BID were compared with the levels of BPND in different groups. [11C]DASB BPND was significantly decreased in the medial parietal cortex in patients with AN and in the dorsal raphe in patients with ANR compared with healthy subjects (p < .05 corrected). Patients with ANR showed a significantly negative correlation between [11C]DASB BPND in the dorsal raphe and performance on the dot-probe task (p < .05 corrected). While reduced 5HTT in the medial parietal cortex (the somatosensory association area) is pathophysiologically important in AN in general, additional 5HTT reduction in the dorsal raphe as seen in ANR is implicated for the clinicopathophysiological relevance. 5HTT decreased in the parietal cortex in patients with AN. 5HTT decreased in the parietal cortex in patients with ANBP. 5HTT decreased in the parietal cortex and the dorsal raphe in patients with ANR. Patients with AN were poor at responding to the test for body image distortion (BID). 5HTT in the dorsal raphe was associated with cognitive performance of BID.
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Affiliation(s)
- Masamichi Yokokura
- Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tatsuhiro Terada
- Department of Biofunctional Imaging, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Tomoyasu Bunai
- Department of Biofunctional Imaging, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kyoko Nakaizumi
- Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yasuhiko Kato
- Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Etsuji Yoshikawa
- Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Japan
| | - Masami Futatsubashi
- Hamamatsu PET Imaging Center, Hamamatsu Medical Photonics Foundation, Hamamatsu, Japan
| | - Katsuaki Suzuki
- Department of Biofunctional Imaging, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hidenori Yamasue
- Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yasuomi Ouchi
- Department of Biofunctional Imaging, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, Hamamatsu, Japan.
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Collantoni E, Meneguzzo P, Tenconi E, Manara R, Favaro A. Small-world properties of brain morphological characteristics in Anorexia Nervosa. PLoS One 2019; 14:e0216154. [PMID: 31071118 PMCID: PMC6508864 DOI: 10.1371/journal.pone.0216154] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 04/15/2019] [Indexed: 12/21/2022] Open
Abstract
Cortical thickness and gyrification abnormalities in anorexia nervosa (AN) have been recently described, but no attempt has been made to explore their organizational patterns to characterize the neurobiology of the disorder in the different stages of its course. The aim of this study was to explore cortical thickness and gyrification patterns by means of graph theory tools in 38 patients with AN, 20 fully recovered patients, and 38 healthy women (HC). All participants underwent high-resolution magnetic resonance imaging. Connectome properties were compared between: 1) AN patients and HC, 2) fully recovered patients and HC, 3) patients with a full remission at a 3-year follow-up assessment and patients who had not recovered. Small-worldness was greater in patients with acute AN in comparison to HC in both cortical thickness and gyrification networks. In the cortical thickness network, patients with AN also showed increased Local Efficiency, Modularity and Clustering coefficients, whereas integration measures were lower in the same group. Patients with a poor outcome showed higher segregation measures and lower small-worldness in the gyrification network, but no differences emerged for the cortical thickness network. For both cortical thickness and gyrification patterns, regional analyses revealed differences between patients with different outcomes. Different patterns between cortical thickness and gyrification networks are probably due to their peculiar developmental trajectories and sensitivity to environmental influences. The role of gyrification network alterations in predicting the outcome suggests a role of early maturational processes in the prognosis of AN.
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Affiliation(s)
- Enrico Collantoni
- Department of Neurosciences, University of Padua, Padova, Italy
- * E-mail:
| | - Paolo Meneguzzo
- Department of Neurosciences, University of Padua, Padova, Italy
| | - Elena Tenconi
- Department of Neurosciences, University of Padua, Padova, Italy
- Padua Neuroscience Center, University of Padua, Padova, Italy
| | - Renzo Manara
- Radiology Unit, Department of Medicine and Surgery, Neuroscience section, University of Salerno, Salerno, Italy
| | - Angela Favaro
- Department of Neurosciences, University of Padua, Padova, Italy
- Padua Neuroscience Center, University of Padua, Padova, Italy
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47
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Stanghellini G, Ballerini M, Mancini M. The Optical-Coenaesthetic Disproportion Hypothesis of Feeding and Eating Disorders in the Light of Neuroscience. Front Psychiatry 2019; 10:630. [PMID: 31607958 PMCID: PMC6755335 DOI: 10.3389/fpsyt.2019.00630] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 08/05/2019] [Indexed: 12/12/2022] Open
Abstract
This article builds on and extends the 'optical-coenaesthetic disproportion' (OCDisp) hypothesis of feeding and eating disorders (FEDs) matching data obtained through clinical research with laboratory evidence from neuroscience and neuropsychological studies. The OCDisp hypothesis, developed through the assessment in clinical setting of bodily experience using the IDentity and EAting (IDEA) disorder questionnaire, argues that in persons with FED the internal perception of one's embodied self (i.e., coenaesthesia) is deeply affected (their possibility to feel themselves is weakened or threatened by coenaesthopathic and emotional paroxysms; their bodily feelings are discontinuous over time), and as a compensation to it, these persons experience their own body as an object that is looked at by others. To FED persons, their body is principally given to them as an object 'to be seen.' The other's look serves as an optical prosthesis to cope with hypo- and dis-coenaesthesia and as a device through which persons with FED can define themselves and attenuate the anxiety produced by the conflicts between being-oneself and being-for-others. After describing the OCDisp hypothesis, we will gather evidence supporting it with neuroscience studies on FED. Our focus will be on data pointing to dampened multisensory integration of interoceptive and esteroceptive signals, demonstrating a predominance of the visual afferents toward signals arising within the body. In the final part of the article, we will show consistencies but also draw distinctions between our clinical hypothesis and neuroscience-based data and hypotheses and draft a potential agenda for translational research inspired by these.
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Affiliation(s)
- Giovanni Stanghellini
- Department of Psychological Sciences, Health, Territory, G. d'Annunzio University of Chieti and Pescara, Chieti, Italy.,Centro de estudios de fenomenología y psiquiatría - Diego Portales' University, Santiago, Chile
| | | | - Milena Mancini
- Department of Psychological Sciences, Health, Territory, G. d'Annunzio University of Chieti and Pescara, Chieti, Italy
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48
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Fuglset TS. Set-shifting, central coherence and decision-making in individuals recovered from anorexia nervosa: a systematic review. J Eat Disord 2019; 7:22. [PMID: 31249687 PMCID: PMC6585061 DOI: 10.1186/s40337-019-0251-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 05/22/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The aim of this study was to review the existing literature and evaluate whether deficits in set-shifting, central coherence and decision-making persist in individuals recovered from anorexia nervosa (AN-REC). METHOD A systematic review approach was used. Literature was identified via searches in PubMed, PsychInfo and Embase database. The main search resulted in 158 articles. After exclusion of 135 articles, 23 articles were included in the review. RESULTS The majority of studies on set-shifting showed that set-shifting difficulties persist after recovery. Central coherence might also be trait related, however findings are inconsistent. Few studies have investigated decision-making in AN-REC, however those studies that do exist suggest that decision-making is not impaired in AN-REC. CONCLUSIONS Novel treatment strategies based on neuroscience research are emerging, focusing on targeting the underlying mechanisms of the illness, including neuropsychological functioning. Whether these functions are trait or state related could have implications for how they are targeted in treatment.
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Affiliation(s)
- Tone Seim Fuglset
- Division of Mental Health and Addiction, Møre and Romsdal Hospital Trust, Parkvegen 84, 6412 Molde, Norway
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49
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Davidovic M, Karjalainen L, Starck G, Wentz E, Björnsdotter M, Olausson H. Abnormal brain processing of gentle touch in anorexia nervosa. Psychiatry Res Neuroimaging 2018; 281:53-60. [PMID: 30248526 DOI: 10.1016/j.pscychresns.2018.08.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 08/05/2018] [Accepted: 08/09/2018] [Indexed: 01/24/2023]
Abstract
Body image disturbance is a core symptom in anorexia nervosa (AN). Recent research suggests that abnormalities in touch perception may contribute to the disease mechanisms in AN. Here, we used functional magnetic resonance imaging (fMRI) to study possible abnormalities in cortical processing of affective touch in AN. Gentle skin strokes were applied to the right forearm during fMRI scanning in women diagnosed with AN (n = 25) and in matched healthy controls (HC; n = 25). Blocks of skin stroking were alternated with blocks of static skin indentation. Participants provided ratings of the pleasantness of skin stroking stimulation. AN participants perceived skin stroking as significantly less pleasant than HC. We observed no group differences for the contrast between skin stroking and skin indentation in primary tactile regions. We did find, however, significantly less activity in the AN group in areas including left caudate nucleus. Also, we found less activity in the AN group in bilateral lateral occipital cortex for the main effect of skin stroking. Our results suggest that abnormal functioning of the dorsal striatum could affect evaluation of pleasant tactile stimuli, and that abnormal functioning of the lateral occipital cortex might be related to disturbed body image perception.
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Affiliation(s)
- Monika Davidovic
- Institute of Neuroscience and Physiology, University of Gothenburg, Blå Stråket 7, 41345 Gothenburg, Sweden.
| | - Louise Karjalainen
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Göran Starck
- Department of Radiation Physics at the Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden; Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Elisabet Wentz
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Malin Björnsdotter
- Center for Social and Affective Neuroscience (CSAN), Linköping University, Linköping, Sweden; Centre for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Gothenburg, Sweden
| | - Håkan Olausson
- Institute of Neuroscience and Physiology, University of Gothenburg, Blå Stråket 7, 41345 Gothenburg, Sweden; Center for Social and Affective Neuroscience (CSAN), Linköping University, Linköping, Sweden
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50
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Irvine KR, McCarty K, McKenzie KJ, Pollet TV, Cornelissen KK, Tovée MJ, Cornelissen PL. Distorted body image influences body schema in individuals with negative bodily attitudes. Neuropsychologia 2018; 122:38-50. [PMID: 30500663 DOI: 10.1016/j.neuropsychologia.2018.11.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 10/10/2018] [Accepted: 11/26/2018] [Indexed: 10/27/2022]
Abstract
There is now a considerable body of evidence to suggest that internal representations of the body can be meaningfully separated into at least two general levels; body image as a perceptual construct and body schema as a motor metric. However, recent studies with eating disordered individuals have suggested that there may in fact be more interaction between these two representations than first thought. We aimed to investigate how body image might act to influence body schema within a typical, healthy population. 100 healthy adult women were asked to judge the smallest gap between a pair of sliding doors that they could just pass through. We then determined whether these estimates were sufficient to predict the size of the smallest gap that they could actually pass through, or whether perceptual and attitudinal body image information was required in order to make these predictions. It was found that perceptual body image did indeed mediate performance on the egocentric (but not allocentric) motor imagery affordance task, but only for those individuals with raised body image concerns and low self-esteem; body schema was influenced by both the perceptual and attitudinal components of body image in those with more negative bodily attitudes. Furthermore, disparities between perceived versus actual size were associated with body parts that had larger variations in adipose/muscle-dependent circumference. We therefore suggest that it may be the affective salience of a distorted body representation that mediates the degree to which it is incorporated into the current body state.
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Affiliation(s)
- Kamila R Irvine
- Department of Psychology, Northumbria University, Newcastle upon Tyne NE1 8ST, United Kingdom
| | - Kristofor McCarty
- Department of Psychology, Northumbria University, Newcastle upon Tyne NE1 8ST, United Kingdom
| | - Kirsten J McKenzie
- School of Psychology, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, United Kingdom
| | - Thomas V Pollet
- Department of Psychology, Northumbria University, Newcastle upon Tyne NE1 8ST, United Kingdom
| | - Katri K Cornelissen
- Department of Psychology, Northumbria University, Newcastle upon Tyne NE1 8ST, United Kingdom
| | - Martin J Tovée
- School of Psychology, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, United Kingdom
| | - Piers L Cornelissen
- Department of Psychology, Northumbria University, Newcastle upon Tyne NE1 8ST, United Kingdom.
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