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Mora L, Committeri G, L'Abbate T, Cocchini G. Unlocking the potential of 'passive' modulation: How sensory stimulation shapes hand and face size. J Neuropsychol 2024. [PMID: 38877675 DOI: 10.1111/jnp.12379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 05/30/2024] [Accepted: 06/03/2024] [Indexed: 06/16/2024]
Abstract
Knowledge of the body size is intricately tied to multisensory integration processes that rely on the dynamic interplay of top-down and bottom-up mechanisms. Recent years have seen the development of passive sensory stimulation protocols aimed at investigating the modulation of various cognitive functions, primarily inducing perceptual learning and behaviour change without the need for extensive training. Given that reductions in sensory input have been associated with alterations in body size perception, it is reasonable to hypothesize that increasing sensory information through passive sensory stimulation could similarly influence the perception of the size of body parts. The primary aim of this study was to investigate the potential modulatory effects of passive sensory stimulation on the perception of hand and face size in a group of young adults. Passive sensory stimulation effectively modulated the size representation of the stimulated hand, supporting the notion that access to somatosensory and proprioceptive information is prioritised for the hands but may not extend to the face. Increased somatosensory input resulted in a reduction of distortion, providing evidence for bottom-up modulation of size representation. Passive sensory stimulation can induce subjective changes in body size perception without the need for extensive training. This paradigm holds promise as a potential alternative for modulating distorted size representation in individuals with body representational deficits.
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Affiliation(s)
- Laura Mora
- Psychology Department, Goldsmiths University of London, London, UK
| | - Giorgia Committeri
- Institute of Advanced Biomedical Technologies, University "G. d'Annunzio", Chieti-Pescara, Italy
| | - Teresa L'Abbate
- Department of Psychology, International Telematic University Uninettuno, Rome, Italy
| | - Gianna Cocchini
- Psychology Department, Goldsmiths University of London, London, UK
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Hamamoto Y, Oba K, Ishibashi R, Ding Y, Nouchi R, Sugiura M. Reduced body-image disturbance by body-image interventions is associated with neural-response changes in visual and social processing regions: a preliminary study. Front Psychiatry 2024; 15:1337776. [PMID: 38510808 PMCID: PMC10951070 DOI: 10.3389/fpsyt.2024.1337776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/15/2024] [Indexed: 03/22/2024] Open
Abstract
Introduction Body-image disturbance is a major factor in the development of eating disorders, especially among young women. There are two main components: perceptual disturbance, characterized by a discrepancy between perceived and actual body size, and affective disturbance, characterized by a discrepancy between perceived and ideal body size. Interventions targeting body-image disturbance ask individuals to describe their own body without using negative expressions when either viewing it in a mirror or imagining it. Despite the importance of reducing body-image disturbance, its neural mechanisms remain unclear. Here we investigated the changes in neural responses before and after an intervention. We hypothesized that neural responses correlated with the degree of body-image disturbance would also be related to its reduction, i.e., a reduction in perceptual and affective disturbances would be related to changes in attentional and socio-cognitive processing, respectively. Methods Twenty-eight young adult women without known psychiatric disorders underwent a single 40-min intervention. Participants completed tasks before and after the intervention, in which they estimated their perceived and ideal body sizes using distorted silhouette images to measure body-image disturbance. We analyzed the behavioral and neural responses of participants during the tasks. Results The intervention did not significantly reduce body-image disturbance. Analysis of individual differences showed distinct changes in neural responses for each type of disturbance. A decrease in perceptual disturbance was associated with bodily visuospatial processing: increased activation in the left superior parietal lobule, bilateral occipital gyri, and right cuneus. Reduced affective disturbance was associated with socio-cognitive processing; decreased activation in the right temporoparietal junction, and increased functional connectivity between the left extrastriate body area and the right precuneus. Discussion We identified distinct neural mechanisms (bodily visuospatial and socio-cognitive processing) associated with the reduction in each component of body-image disturbance. Our results imply that different neural mechanisms are related to reduced perceptual disturbance and the expression thereof, whereas similar neural mechanisms are related to the reduction and expression of affective disturbance. Considering the small sample size of this study, our results should be regarded as preliminary.
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Affiliation(s)
- Yumi Hamamoto
- Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
- Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Kentaro Oba
- Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Ryo Ishibashi
- Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Yi Ding
- Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
- School of Medicine, Tohoku University, Sendai, Japan
| | - Rui Nouchi
- Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Motoaki Sugiura
- Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
- International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
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Karakuş Aydos Y, Dövencioğlu D, Karlı Oğuz K, Özdemir P, Pehlivantürk Kızılkan M, Kanbur N, Ünal D, Nalbant K, Çetin Çuhadaroğlu F, Akdemir D. Neural correlates of distorted body images in adolescent girls with anorexia nervosa: How is it different from major depressive disorder? J Neuropsychol 2024; 18:154-172. [PMID: 37431063 DOI: 10.1111/jnp.12340] [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: 11/22/2022] [Revised: 06/18/2023] [Accepted: 06/28/2023] [Indexed: 07/12/2023]
Abstract
Body image disturbance is closely linked to eating disorders including anorexia nervosa (AN). Distorted body image perception, dissatisfaction and preoccupation with weight and shape are often key factors in the development and maintenance of these disorders. Although the pathophysiological mechanism of body image disorder is not yet fully understood, aberrant biological processes may interfere with perceptive, cognitive and emotional aspects of body image. This study focuses on the neurobiological aspects of body image disturbance. The sample consisted of 12 adolescent girls diagnosed with AN, nine girls with major depressive disorder (MDD) and 10 without psychiatric diagnoses (HC, the healthy control group). We applied a block-design task in functional magnetic resonance imaging using participants' original and distorted overweight and underweight images. After imaging, the participants scored the images for resemblance, satisfaction and anxiety levels. The findings of this study demonstrate that overweight images elicited dissatisfaction and increased occipitotemporal activations across all participants. However, no difference was found between the groups. Furthermore, the MDD and HC groups showed increased activations in the prefrontal cortex and insula in response to underweight images compared to their original counterparts, whereas the AN group exhibited increased activations in the parietal cortex, cingulate gyrus and parahippocampal cortex in response to the same stimuli.
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Affiliation(s)
- Yağmur Karakuş Aydos
- Department of Child and Adolescent Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Dicle Dövencioğlu
- Department of Psychology, Middle East Technical University, Ankara, Turkey
| | - Kader Karlı Oğuz
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
- National MR Research Center (UMRAM), Bilkent University, Ankara, Turkey
| | - Pınar Özdemir
- Department of Bioistatistics, Hacettepe University, Ankara, Turkey
| | - Melis Pehlivantürk Kızılkan
- Section of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nuray Kanbur
- Section of Adolescent Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Dilek Ünal
- Department of Child and Adolescent Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Kevser Nalbant
- Department of Child and Adolescent Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Füsun Çetin Çuhadaroğlu
- Department of Child and Adolescent Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Devrim Akdemir
- Department of Child and Adolescent Psychiatry, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Plana MT, Flamarique I, Julià L, Tasa-Vinyals E, Citoler B, Díaz C, Moreno E, Andrés-Perpiñá S, Martínez E, Lázaro L, Castro-Fornieles J. Accuracy of estimating self and other body size among adolescent girls with anorexia nervosa. Eat Disord 2024; 32:29-42. [PMID: 37599453 DOI: 10.1080/10640266.2023.2243425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
This study aimed to analyze body size estimates of others by patients with anorexia nervosa (AN) and to identify any differences with the perception of their own body size. Adolescent females (age, 13-17 years) were enrolled into AN (n = 30) and control(n = 23) groups. The Subjective Body Dimensions Apparatus (SBDA) was used to evaluate body size estimates for oneself (self-estimation) and others (other-estimation). Participants also completed questionnaires assessing eating disorders and depressive symptoms. The AN and control groups scored significantly higher in self-estimation than in other-estimation. However, the AN group showed higher self-estimation scores than the control group for all the body parts and for the global silhouette (p < .001). Patients with more severe eating disorder symptomatology showed more distorted self-estimation (p < .05). No statistically significant differences were found in the other-estimation scores between the groups (p = .714), indicating that AN and control patients estimate the body sizes of others similarly. Eating disorder symptomatology correlates with self-estimation scores but not with other-estimation scores in adolescents with AN. No correlations existed between clinical symptomatology and other-estimation.
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Affiliation(s)
- Maria Teresa Plana
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Itziar Flamarique
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica En Red - Salud Mental (CIBERSAM), Spain
| | - Laia Julià
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Elisabet Tasa-Vinyals
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Bárbara Citoler
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Cristina Díaz
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Elena Moreno
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Susana Andrés-Perpiñá
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica En Red - Salud Mental (CIBERSAM), Spain
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Department of Psychology, University of Barcelona, Barcelona, Spain
| | - Esteban Martínez
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Luisa Lázaro
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica En Red - Salud Mental (CIBERSAM), Spain
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica En Red - Salud Mental (CIBERSAM), Spain
- Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
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Zhong S, Su T, Gong J, Huang L, Wang Y. Brain functional alterations in patients with anorexia nervosa: A meta-analysis of task-based functional MRI studies. Psychiatry Res 2023; 327:115358. [PMID: 37544086 DOI: 10.1016/j.psychres.2023.115358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 07/16/2023] [Accepted: 07/21/2023] [Indexed: 08/08/2023]
Abstract
The goal of this study was to discern the neural activation patterns associated with anorexia nervosa (AN) in response to tasks related to body-, food-, emotional-, cognitive-, and reward- processing. A meta-analysis was performed on task-based fMRI studies, revealing that patients with AN showed increased activity in the left superior temporal gyrus and bilaterally in the ACC during a reward-related task. During cognitive-related tasks, patients with AN also showed increased activity in the left superior parietal gyrus, right middle temporal gyrus, but decreased activity in the MCC. Additionally, patients with AN showed increased activity bilaterally in the cerebellum, MCC, and decreased activity bilaterally in the bilateral precuneus/PCC, right middle temporal gyrus, left ACC when they viewed food images. During emotion-related tasks, patients with AN showed increased activity in the left cerebellum, but decreased activity bilaterally in the striatum, right mPFC, and right superior parietal gyrus. Patients with AN also showed increased activity in the right striatum and decreased activity in the right inferior temporal gyrus and bilaterally in the mPFC during body-related tasks. The present meta-analysis provides a comprehensive overview of the patterns of brain activity evoked by task stimuli, thereby augmenting the current comprehension of the pathophysiology in AN.
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Affiliation(s)
- Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Ting Su
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Jiaying Gong
- Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China; Department of Radiology, Six Affiliated Hospital of Sun Yat-sen University, Guangzhou 510655, China
| | - Li Huang
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou 510630, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital, Jinan University, Guangzhou 510630, China; Institute of Molecular and Functional Imaging, Jinan University, Guangzhou 510630, China.
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6
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Hamamoto Y, Suzuki S, Motoki K, Oba K, Kawashima R, Sugiura M. Neural mechanisms of perceptual and affective body-image disturbance during own-body and ideal-body estimation. Behav Brain Res 2023; 444:114349. [PMID: 36801426 DOI: 10.1016/j.bbr.2023.114349] [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: 08/12/2022] [Revised: 01/04/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023]
Abstract
Body-image disturbance is a core feature of eating disorders and can predict their development in healthy individuals. There are two components of body-image disturbance: perceptual disturbance (associated with overestimation of body size) and affective disturbance (associated with body dissatisfaction). Previous behavioral studies have hypothesized that attention to particular body parts and negative body-related emotions resulting from social pressure are associated with the respective degrees of perceptual and affective disturbance; however, the neural representations that underlie this hypothesis have not been elucidated. Thus, this study investigated the brain regions and connectivity associated with the degree of body-image disturbance. Specifically, we examined the brain activations associated with participants' estimation of the width of their actual and ideal bodies; we sought to determine which brain regions and functional connectivity from body-related visual processing regions were correlated with the degree of each component of body-image disturbance. The degree of perceptual disturbance was positively correlated with excessive width-dependent brain activations in the left anterior cingulate cortex when estimating one's body size; it was positively correlated with the functional connectivity between the left extrastriate body area and left anterior insula. The degree of affective disturbance was positively correlated with excessive width-dependent brain activation in the right temporoparietal junction and negatively correlated with functional connectivity between the left extrastriate body area and right precuneus when estimating one's ideal body size. These results support the hypothesis that perceptual disturbance is associated with attentional processing, whereas affective disturbance is associated with social processing.
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Affiliation(s)
- Yumi Hamamoto
- School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; Japan Society for the Promotion of Science, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo 102-0083, Japan.
| | - Shinsuke Suzuki
- Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; Frontier Research Institute for Interdisciplinary Science, Tohoku University, 6-3 Aramaki aza Aoba, Aoba-ku, Sendai 980-8578, Japan; Centre for Brain, Minds and Markets, Department of Finance, Faculty of Business and Economics, The University of Melbourne, 198 Berkeley St, Carlton, VIC 3053, Australia; Center for the Promotion of Social Data Science Education and Research, Hitotsubashi University, 2-1 Naka, Kunitachi, Tokyo 186-8601, Japan
| | - Kosuke Motoki
- Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; Japan Society for the Promotion of Science, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo 102-0083, Japan; Department of Management, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Kentaro Oba
- Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan
| | - Ryuta Kawashima
- Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan
| | - Motoaki Sugiura
- Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan; International Research Institute of Disaster Science, Tohoku University, 468-1 Aoba, Aramaki, Aoba-ku, Sendai 980-8572, Japan
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Mora L, Gonzalez Alted C, Cocchini G. The flubbed body: Pathological body size representation in personal neglect. Neuropsychologia 2023; 183:108522. [PMID: 36863608 DOI: 10.1016/j.neuropsychologia.2023.108522] [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: 10/21/2022] [Revised: 01/21/2023] [Accepted: 02/20/2023] [Indexed: 03/04/2023]
Abstract
Personal Neglect (PN) is a disorder in which patients fail to attend or explore the contralateral side of their body. An increasing number of studies have considered PN as a form of body representation disorder frequently observed following damage to parietal areas. The extent and the direction of the body misrepresentation is still unclear with recent studies suggesting a general reduction of contralesional hand size. However, little is known about the specificity of this representation and whether the misrepresentation also generalises to other body parts. We explored the features of the representation of the hands and face in a group of 9 right brain damaged patients with (PN+) and without PN (PN-), when compared to a healthy control group. For this, we used a body size estimation task with pictures, in which patients were required to choose the one that most closely matched the perceived size of their body part. We found that PN + patients showed a labile body representation for both hands and face, having a larger distorted representational range. Interestingly, in comparison with PN + patients and healthy controls, PN- patients also showed misrepresentation of the left contralesional hand which could be related to impaired motor performance of their upper limb. Our findings are discussed within a theoretical framework suggesting a reliance on multisensory integration (body representation, ownership, and motor influences) for an ordered representation of the size of the body.
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Affiliation(s)
- Laura Mora
- Goldsmiths University of London, London, UK.
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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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McAdams CJ, Efseroff B, McCoy J, Ford L, Timko CA. Social Processing in Eating Disorders: Neuroimaging Paradigms and Research Domain Organizational Constructs. Curr Psychiatry Rep 2022; 24:777-788. [PMID: 36417153 PMCID: PMC10373941 DOI: 10.1007/s11920-022-01395-4] [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] [Accepted: 10/29/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE OF REVIEW Social and environmental factors have been related to both symptom expression of disordered eating in individuals and changes in the prevalence of eating disorders (EDs) in populations. Neural differences in processing social information may contribute to EDs. This review assesses the evidence for aberrant neural responses during social processing in EDs. RECENT FINDINGS This review examines how constructs within the social processing domain have been evaluated by neuroimaging paradigms in EDs, including communication, affiliation, and understanding of both oneself and others. Differences related to social processing in EDs include altered processing for self-relevant stimuli, in the context of identity, valence, expectations, and affiliative relationships. Future work is needed to integrate how differences in processing social stimuli relate to alterations in cognitive control and reward as well as specific disordered eating symptoms.
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Affiliation(s)
- Carrie J McAdams
- Department of Psychiatry, University of Texas at Southwestern Medical School, 6363 Forest Park Rd BL6.204, Dallas, TX, 75390, USA.
| | - Brayden Efseroff
- Department of Psychiatry, University of Texas at Southwestern Medical School, 6363 Forest Park Rd BL6.204, Dallas, TX, 75390, USA
| | - Jordan McCoy
- Department of Psychiatry, University of Texas at Southwestern Medical School, 6363 Forest Park Rd BL6.204, Dallas, TX, 75390, USA
| | - Lauren Ford
- Department of Psychiatry, University of Texas at Southwestern Medical School, 6363 Forest Park Rd BL6.204, Dallas, TX, 75390, USA
| | - C Alix Timko
- Department of Child and Adolescent Psychiatry and Behavioral Health, Children's Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania, 2716 South Street, Philadelphia, PA, 19146, USA
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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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11
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Malighetti C, Sansoni M, Gaudio S, Matamala-Gomez M, Di Lernia D, Serino S, Riva G. From Virtual Reality to Regenerative Virtual Therapy: Some Insights from a Systematic Review Exploring Inner Body Perception in Anorexia and Bulimia Nervosa. J Clin Med 2022; 11:jcm11237134. [PMID: 36498708 PMCID: PMC9737310 DOI: 10.3390/jcm11237134] [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: 09/09/2022] [Revised: 11/10/2022] [Accepted: 11/20/2022] [Indexed: 12/02/2022] Open
Abstract
Despite advances in our understanding of the behavioral and molecular factors that underlie the onset and maintenance of Eating Disorders (EDs), it is still necessary to optimize treatment strategies and establish their efficacy. In this context, over the past 25 years, Virtual Reality (VR) has provided creative treatments for a variety of ED symptoms, including body dissatisfaction, craving, and negative emotions. Recently, different researchers suggested that EDs may reflect a broader impairment in multisensory body integration, and a particular VR technique-VR body swapping-has been used to repair it, but with limited clinical results. In this paper, we use the results of a systematic review employing PRISMA guidelines that explore inner body perception in EDs (21 studies included), with the ultimate goal to analyze the features of multisensory impairment associated with this clinical condition and provide possible solutions. Deficits in interoception, proprioception, and vestibular signals were observed across Anorexia and Bulimia Nervosa, suggesting that: (a) alteration of inner body perception might be a crucial feature of EDs, even if further research is needed and; (b) VR, to be effective with these patients, has to simulate/modify both the external and the internal body. Following this outcome, we introduce a new therapeutic approach-Regenerative Virtual Therapy-that integrates VR with different technologies and clinical strategies to regenerate a faulty bodily experience by stimulating the multisensory brain mechanisms and promoting self-regenerative processes within the brain itself.
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Affiliation(s)
- Clelia Malighetti
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli 1, 20100 Milan, Italy
| | - Maria Sansoni
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli 1, 20100 Milan, Italy
- Correspondence: ; Tel.: +39-02-72-343-863
| | - Santino Gaudio
- Department of Neuroscience, Functional Pharmacology, Uppsala University, Husargatan 3, 75237 Uppsala, Sweden
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Montpellier 1, 00133 Rome, Italy
| | - Marta Matamala-Gomez
- Department of Psychology, Mind and Behavior Technological Center, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milan, Italy
| | - Daniele Di Lernia
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli 1, 20100 Milan, Italy
| | - Silvia Serino
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli 1, 20100 Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149 Milan, Italy
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Largo Gemelli 1, 20100 Milan, Italy
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12
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Coleman C, Gillmeister H. Body image and self-perception in women with navel piercings. PLoS One 2022; 17:e0274099. [PMID: 36083973 PMCID: PMC9462717 DOI: 10.1371/journal.pone.0274099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 08/23/2022] [Indexed: 11/19/2022] Open
Abstract
The present study investigated how women’s body image and body-perceptual processes are affected by navel piercings, an embellishment of the abdominal region women often feel negatively about. We probed perceptual (response times), cognitive (surveys), affective (aesthetic ratings) and neural (event-related potentials, ERPs) facets of (own) body perception. We found that navel piercings are primarily motivated by the desire to enhance one’s body image, and can significantly improve bodily self-perception relative to before and to imagined removal of the piercing. Hence, body image concerns in women with navel piercings were found to be comparable to those of a control group; and their aesthetic ratings of other women’s abdomens only differed, positively, for images depicting navel piercings. ERPs indicated that the sight of navel piercings enhances early structural encoding of bodies as well as late emotional-motivational processes, especially in women with navel piercings. We further found a strong self-advantage in both cortical and behavioural responses during recognition of own and others’ abdomens, especially for images displaying the piercing. Altogether, findings suggest that navel piercings become strongly, and beneficially, integrated into women’s bodily self image. Such piercings may thus be seen as expressions of body care that can protect against self-harming thoughts and behaviours.
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Affiliation(s)
- Christine Coleman
- Department of Psychology and Centre for Brain Science, University of Essex, Colchester, United Kingdom
| | - Helge Gillmeister
- Department of Psychology and Centre for Brain Science, University of Essex, Colchester, United Kingdom
- * E-mail:
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13
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Gizzi G, Cataldi S, Mazzeschi C, Delvecchio E, Ceccarini MR, Codini M, Albi E. Hypercholesterolemia in Cancer and in Anorexia Nervosa: A Hypothesis for a Crosstalk. Int J Mol Sci 2022; 23:ijms23137466. [PMID: 35806470 PMCID: PMC9267523 DOI: 10.3390/ijms23137466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/30/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022] Open
Abstract
The relationship between cholesterol and cancer has been widely demonstrated. Clinical studies have shown changes in blood cholesterol levels in cancer patients. In parallel, basic research studies have shown that cholesterol is involved in the mechanisms of onset and progression of the disease. On the other hand, anorexic patients have high cholesterol levels and a high susceptibility to cancer. In this review, we first present a brief background on the relations among nutrition, eating disorders and cancer. Using several notable examples, we then illustrate the changes in cholesterol in cancer and in anorexia nervosa, providing evidence for their important relationship. Finally, we show a new possible link between cholesterol disorder in cancer and in anorexia nervosa.
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Affiliation(s)
- Giulia Gizzi
- Department of Philosophy, Social Sciences and Education, University of Perugia, 06126 Perugia, Italy; (G.G.); (C.M.); (E.D.)
| | - Samuela Cataldi
- Department of Pharmaceutical Sciences, University of Perugia, 06126 Perugia, Italy; (S.C.); (M.R.C.); (M.C.)
| | - Claudia Mazzeschi
- Department of Philosophy, Social Sciences and Education, University of Perugia, 06126 Perugia, Italy; (G.G.); (C.M.); (E.D.)
| | - Elisa Delvecchio
- Department of Philosophy, Social Sciences and Education, University of Perugia, 06126 Perugia, Italy; (G.G.); (C.M.); (E.D.)
| | - Maria Rachele Ceccarini
- Department of Pharmaceutical Sciences, University of Perugia, 06126 Perugia, Italy; (S.C.); (M.R.C.); (M.C.)
| | - Michela Codini
- Department of Pharmaceutical Sciences, University of Perugia, 06126 Perugia, Italy; (S.C.); (M.R.C.); (M.C.)
| | - Elisabetta Albi
- Department of Pharmaceutical Sciences, University of Perugia, 06126 Perugia, Italy; (S.C.); (M.R.C.); (M.C.)
- Correspondence: ; Tel./Fax: +39-0755857940
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14
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Hamamoto Y, Suzuki S, Sugiura M. Two components of body-image disturbance are differentially associated with distinct eating disorder characteristics in healthy young women. PLoS One 2022; 17:e0262513. [PMID: 35020770 PMCID: PMC8754315 DOI: 10.1371/journal.pone.0262513] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 12/28/2021] [Indexed: 11/18/2022] Open
Abstract
Body-image disturbance comprises two components. The first is perceptual in nature, and is measured by a discrepancy between one’s actual body and perceived self-image (“perceived–actual discrepancy”). The other component is affective, and is measured by a discrepancy between one’s perceived self-image and ideal body image (“perceived–ideal discrepancy”). The present study evaluated the relationships between body-image disturbance and characteristics of eating disorders such as symptoms and related personality traits. In a psychophysiological experiment, female university students (mean ± SD age = 21.0 ± 1.38 years) were presented with silhouette images of their own bodies that were distorted in terms of width. The participants were asked whether each silhouette image was more overweight than their actual or ideal body images. Eating-disorder characteristics were assessed using six factors from the Japanese version of the Eating Disorder Inventory 2 (EDI2). We found that perceived–actual discrepancies correlated with negative self-evaluation (i.e., factor 3 of the EDI2), whereas perceived–ideal discrepancies correlated with dissatisfaction with one’s own body (i.e., factor 2 of EDI2). These results imply that distinct psychological mechanisms underlie the two components of body-image disturbance.
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Affiliation(s)
- Yumi Hamamoto
- School of Medicine, Tohoku University, Sendai-shi, Miyagi, Japan
- Institute of Development, Aging and Cancer, Tohoku University, Sendai-shi, Miyagi, Japan
- * E-mail: ,
| | - Shinsuke Suzuki
- Institute of Development, Aging and Cancer, Tohoku University, Sendai-shi, Miyagi, Japan
- Frontier Research Institute for Interdisciplinary Sciences, Tohoku University, Sendai-shi, Miyagi, Japan
- Brain, Minds and Markets Laboratory, Department of Finance, The University of Melbourne, Carlton Victoria, Australia
| | - Motoaki Sugiura
- Institute of Development, Aging and Cancer, Tohoku University, Sendai-shi, Miyagi, Japan
- International Research Institute of Disaster Science, Tohoku University, Sendai-shi, Miyagi, Japan
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15
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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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16
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Wayda-Zalewska M, Kostecka B, Kucharska K. Body Image in Borderline Personality Disorder: A Systematic Review of the Emerging Empirical Literature. J Clin Med 2021; 10:jcm10184264. [PMID: 34575375 PMCID: PMC8470847 DOI: 10.3390/jcm10184264] [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: 07/19/2021] [Revised: 09/17/2021] [Accepted: 09/17/2021] [Indexed: 12/02/2022] Open
Abstract
As an element of distorted self-image, body image disturbances may be relevant to borderline personality disorder (BPD). Therefore, this systematic review aims to critically discuss and summarize empirical findings in this matter. Based on the available theoretical models, three body image components were identified: (a) perception, (b) affect and cognition, and (c) general body dissatisfaction. We conducted a systematic search of the empirical literature published in English in the MEDLINE, PsycINFO, and Scopus databases until June 2021 using a priori eligibility criteria (BPD; BPD symptoms or features in nonclinical groups; quasipsychotic or psychotic symptoms were not considered). We included k = 10 records meeting the criteria. Compared with other analyzed groups, individuals diagnosed with BPD obtained higher scores in the three components of body image disturbances. The issue of body image in BPD is relatively understudied, although current research findings clearly indicate disturbances in all of the abovementioned body image components in individuals with BPD or significant relationships of these components with BPD traits or symptoms both in clinical and nonclinical samples. Eventually, possible practical implications and future research directions are also discussed.
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Affiliation(s)
- Magdalena Wayda-Zalewska
- Institute of Psychology, Cardinal Stefan Wyszynski University in Warsaw, 01-938 Warsaw, Poland; (M.W.-Z.); (K.K.)
| | - Barbara Kostecka
- II Department of Psychiatry, Medical University of Warsaw, 03-242 Warsaw, Poland
- Correspondence:
| | - Katarzyna Kucharska
- Institute of Psychology, Cardinal Stefan Wyszynski University in Warsaw, 01-938 Warsaw, Poland; (M.W.-Z.); (K.K.)
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17
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Regnaud A, Boto J, Klauser A, Lövblad KO, Vargas MI, Lazeyras F. Metabolic changes in the cingulate gyrus, precuneus, and white matter in anorexia nervosa using multivoxel MR spectroscopy. J Neuroimaging 2021; 31:1099-1110. [PMID: 34463008 PMCID: PMC9292420 DOI: 10.1111/jon.12922] [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: 09/18/2020] [Revised: 07/11/2021] [Accepted: 08/09/2021] [Indexed: 11/29/2022] Open
Abstract
Background and Purpose This study aimed to highlight anorexia nervosa‐related metabolic changes in different brain regions with different gray and white matter contents. Methods In a prospective study, 25 anorexic patients with mean body mass index (BMI) of 14.79 kg/m2 (range 10.04–20.58) were compared with 15 healthy controls with mean BMI of 21.08 kg/m2 (range 18.36–27.34). Two‐dimensional magnetic resonance spectroscopic imaging was acquired in the axial plane above the corpus callosum, including frontal, precentral, postcentral, cingular, and parietal regions, as well as the precuneus, each voxel containing gray and white matter. Results In the anorexic group, a significant increase of choline/creatine was observed in all brain regions except the precuneus: frontal (p = 0.009), cingulate (p = 0.001), precentral (p = 0.001), postcentral (p = 0.001), and parietal (p = 0.002); and in white and gray matter (p< 0.001). Macromolecules09/creatine was decreased in the following regions: frontal (p = 0.003), cingulate (p< 0.001), precentral (p = 0.004), and precuneus (p = 0.007), and in white and gray matter (p< 0.05). We observed significantly lower values of N‐acetyl aspartate/creatine in the frontal (p < 0.001) and precentral (p< 0.001) regions and in voxels containing more than 50% white matter (p = 0.001); and significantly lower values of myo‐inositol/creatine in the precentral (p = 0.006), postcentral (p< 0.001), and precuneus (p = 0.006) regions. Conclusions We observed an increase in choline/creatine in anorexics, possibly reflecting increased cell turnover; a decrease in macromolecules, which was particularly low in the cingulate and precuneus the former being known to be altered in eating disorders; and a decrease in N‐acetyl aspartate/creatine considered as a marker of neuronal density and function.
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Affiliation(s)
- Alice Regnaud
- Division of Neuroradiology, Faculty of Medicine of Geneva, Geneva University Hospital, Geneva, Switzerland
| | - José Boto
- Division of Neuroradiology, Faculty of Medicine of Geneva, Geneva University Hospital, Geneva, Switzerland
| | - Antoine Klauser
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland.,Center for Biomedical Imaging (CIBM), University of Geneva, Geneva, Switzerland
| | - Karl-Olof Lövblad
- Division of Neuroradiology, Faculty of Medicine of Geneva, Geneva University Hospital, Geneva, Switzerland
| | - Maria Isabel Vargas
- Division of Neuroradiology, Faculty of Medicine of Geneva, Geneva University Hospital, Geneva, Switzerland
| | - François Lazeyras
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland.,Center for Biomedical Imaging (CIBM), University of Geneva, Geneva, Switzerland
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18
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De Martino ML, De Bartolo M, Leemhuis E, Pazzaglia M. Rebuilding Body-Brain Interaction from the Vagal Network in Spinal Cord Injuries. Brain Sci 2021; 11:brainsci11081084. [PMID: 34439702 PMCID: PMC8391959 DOI: 10.3390/brainsci11081084] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/12/2021] [Accepted: 08/15/2021] [Indexed: 12/12/2022] Open
Abstract
Spinal cord injuries (SCIs) exert devastating effects on body awareness, leading to the disruption of the transmission of sensory and motor inputs. Researchers have attempted to improve perceived body awareness post-SCI by intervening at the multisensory level, with the integration of somatic sensory and motor signals. However, the contributions of interoceptive-visceral inputs, particularly the potential interaction of motor and interoceptive signals, remain largely unaddressed. The present perspective aims to shed light on the use of interoceptive signals as a significant resource for patients with SCI to experience a complete sense of body awareness. First, we describe interoceptive signals as a significant obstacle preventing such patients from experiencing body awareness. Second, we discuss the multi-level mechanisms associated with the homeostatic stability of the body, which creates a unified, coherent experience of one's self and one's body, including real-time updates. Body awareness can be enhanced by targeting the vagus nerve function by, for example, applying transcutaneous vagus nerve stimulation. This perspective offers a potentially useful insight for researchers and healthcare professionals, allowing them to be better equipped in SCI therapy. This will lead to improved sensory motor and interoceptive signals, a decreased likelihood of developing deafferentation pain, and the successful implementation of modern robotic technologies.
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Affiliation(s)
- Maria Luisa De Martino
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (M.L.D.M.); (M.D.B.); (E.L.)
- Body and Action Lab, IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy
| | - Mina De Bartolo
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (M.L.D.M.); (M.D.B.); (E.L.)
| | - Erik Leemhuis
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (M.L.D.M.); (M.D.B.); (E.L.)
- Body and Action Lab, IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy
| | - Mariella Pazzaglia
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (M.L.D.M.); (M.D.B.); (E.L.)
- Body and Action Lab, IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy
- Correspondence: ; Tel.: +39-6-49917633
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19
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Brain activation and connectivity in anorexia nervosa and body dysmorphic disorder when viewing bodies: relationships to clinical symptoms and perception of appearance. Brain Imaging Behav 2021; 15:1235-1252. [PMID: 32875486 DOI: 10.1007/s11682-020-00323-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Anorexia nervosa (AN) and body dysmorphic disorder (BDD) are characterized by distorted perception of appearance, yet no studies have directly compared the neurobiology associated with body perception. We compared AN and BDD in brain activation and connectivity in relevant networks when viewing images of others' bodies and tested their relationships with clinical symptoms and subjective appearance evaluations. We acquired fMRI data from 64 unmedicated females (20 weight-restored AN, 23 BDD, 21 controls) during a matching task using unaltered or spatial-frequency filtered photos of others' bodies. Using general linear model and independent components analyses we compared brain activation and connectivity in visual, striatal, and parietal networks and performed univariate and partial least squares multivariate analyses to investigate relationships with clinical symptoms and appearance evaluations. AN and BDD showed partially overlapping patterns of hyperconnectivity in the dorsal visual network and hypoconnectivity in parietal network compared with controls. BDD, but not AN, demonstrated hypoactivity in dorsal visual and parietal networks compared to controls. Further, there were significant activity and connectivity differences between AN and BDD in both networks. In both groups, activity and/or connectivity were associated with symptom severity and appearance ratings of others' bodies. Thus, AN and BDD demonstrate both distinct and partially-overlapping aberrant neural phenotypes involved in body processing and visually encoding global features. Nevertheless, in each disorder, aberrant activity and connectivity show relationships to clinically relevant symptoms and subjective perception. These results have implications for understanding distinct and shared pathophysiology underlying perceptual distortions of appearance and may inform future novel treatment strategies.
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20
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Clemens B, Votinov M, Puiu AA, Schüppen A, Hüpen P, Neulen J, Derntl B, Habel U. Replication of Previous Findings? Comparing Gray Matter Volumes in Transgender Individuals with Gender Incongruence and Cisgender Individuals. J Clin Med 2021; 10:1454. [PMID: 33916288 PMCID: PMC8037365 DOI: 10.3390/jcm10071454] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/23/2021] [Accepted: 03/29/2021] [Indexed: 01/30/2023] Open
Abstract
The brain structural changes related to gender incongruence (GI) are still poorly understood. Previous studies comparing gray matter volumes (GMV) between cisgender and transgender individuals with GI revealed conflicting results. Leveraging a comprehensive sample of transmen (n = 33), transwomen (n = 33), cismen (n = 24), and ciswomen (n = 25), we employ a region-of-interest (ROI) approach to examine the most frequently reported brain regions showing GMV differences between trans- and cisgender individuals. The primary aim is to replicate previous findings and identify anatomical regions which differ between transgender individuals with GI and cisgender individuals. On the basis of a comprehensive literature search, we selected a set of ROIs (thalamus, putamen, cerebellum, angular gyrus, precentral gyrus) for which differences between cis- and transgender groups have been previously observed. The putamen was the only region showing significant GMV differences between cis- and transgender, across previous studies and the present study. We observed increased GMV in the putamen for transwomen compared to both transmen and ciswomen and for all transgender participants compared to all cisgender participants. Such a pattern of neuroanatomical differences corroborates the large majority of previous studies. This potential replication of previous findings and the known involvement of the putamen in cognitive processes related to body representations and the creation of the own body image indicate the relevance of this region for GI and its potential as a structural biomarker for GI.
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Affiliation(s)
- Benjamin Clemens
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, 52062 Aachen, Germany; (M.V.); (A.A.P.); (P.H.); (U.H.)
- Institute of Neuroscience and Medicine 10, Research Centre Jülich, 52428 Jülich, Germany
| | - Mikhail Votinov
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, 52062 Aachen, Germany; (M.V.); (A.A.P.); (P.H.); (U.H.)
- Institute of Neuroscience and Medicine 10, Research Centre Jülich, 52428 Jülich, Germany
| | - Andrei Alexandru Puiu
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, 52062 Aachen, Germany; (M.V.); (A.A.P.); (P.H.); (U.H.)
- Institute of Neuroscience and Medicine 10, Research Centre Jülich, 52428 Jülich, Germany
| | - Andre Schüppen
- Interdisciplinary Center for Clinical Research (IZKF), Faculty of Medicine, RWTH Aachen University, 52062 Aachen, Germany;
- Division for Clinical and Cognitive Sciences, Department of Neurology, Faculty of Medicine, RWTH Aachen University, 52062 Aachen, Germany
| | - Philippa Hüpen
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, 52062 Aachen, Germany; (M.V.); (A.A.P.); (P.H.); (U.H.)
- Institute of Neuroscience and Medicine 10, Research Centre Jülich, 52428 Jülich, Germany
| | - Josef Neulen
- Department of Gynecological Endocrinology and Reproductive Medicine, Faculty of Medicine, RWTH Aachen University, 52062 Aachen, Germany;
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, University of Tübingen, 72074 Tübingen, Germany;
- LEAD Graduate School and Research Network, University of Tübingen, 72072 Tübingen, Germany
| | - Ute Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, 52062 Aachen, Germany; (M.V.); (A.A.P.); (P.H.); (U.H.)
- Institute of Neuroscience and Medicine 10, Research Centre Jülich, 52428 Jülich, Germany
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21
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Brown TA, Shott ME, Frank GKW. Body size overestimation in anorexia nervosa: Contributions of cognitive, affective, tactile and visual information. Psychiatry Res 2021; 297:113705. [PMID: 33472094 DOI: 10.1016/j.psychres.2021.113705] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 12/31/2020] [Indexed: 10/22/2022]
Abstract
Body image disturbance (BID) in anorexia nervosa (AN) is poorly understood and the individual contribution of perceptual, cognitive, and affective components remains unclear. This study compared females with AN and matched healthy controls (HC) on a perceptual size estimation task. Participants (AN n=19 M[SD] age=16.97[2.24], HC n=19, age=15.77[2.17]) were blindfolded and estimated the size of neutral objects, safe foods, unsafe foods, and parts of their bodies (hips, waist, knees, ankle) over three blocks using: 1) no sensory information (baseline), 2) tactile information, and 3) added visual information. There were no significant differences between AN and HC on neutral and safe or unsafe food objects. Participants with AN were significantly more likely to overestimate their body size across blocks compared to HC. Both groups made fewer errors on unsafe foods and body parts when using tactile or visual information compared to baseline. Exploratory analyses revealed significant correlations between body size overestimation and drive for thinness and body dissatisfaction in the AN group, with body dissatisfaction being the most robust. Results suggest that both deficits in tactile and visual perception and affective factors play a role in BID for young women with AN.
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Affiliation(s)
- Tiffany A Brown
- University of California, UCSD Eating Disorder Center for Treatment and Research, 4510 Executive Dr., Suite 315, San Diego, CA 92121, United States
| | - Megan E Shott
- University of California, UCSD Eating Disorder Center for Treatment and Research, 4510 Executive Dr., Suite 315, San Diego, CA 92121, United States
| | - Guido K W Frank
- University of California, UCSD Eating Disorder Center for Treatment and Research, 4510 Executive Dr., Suite 315, San Diego, CA 92121, United States.
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22
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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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23
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Hamamoto Y, Motoki K, Sugiura M. Assessing the Relationship Between Drive for Thinness and Taste-Shape Correspondences. Multisens Res 2020; 34:69-92. [PMID: 33706274 DOI: 10.1163/22134808-bja10030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 06/13/2020] [Indexed: 11/19/2022]
Abstract
Eating disorder tendencies are psychological characteristics that are prevalent in healthy young females and are known to be among the risk factors for eating disorders such as anorexia and bulimia nervosa. People with greater eating disorder tendencies strongly associate sweet and fatty foods with weight gain and strictly avoid consuming such foods. However, little is known about how eating disorder tendencies influence the association between taste and body shape impression. Research on crossmodal correspondences suggests that people preferentially associate sweet tastes with round shapes, and individual differences affect the degree of such associations. This study investigates how the degree of taste-shape matching is related to eating disorder tendencies with a preliminary investigation of what mediates this relationship. Two experiments were conducted: in Experiment 1, healthy participants rated the degree of association between basic taste words (sweet/sour/salty/bitter) and roundness of shape and subsequently completed questionnaires addressing eating disorder tendencies. In Experiment 2, participants answered additional questionnaires addressing obsessiveness, dichotomous thinking, and self-esteem. The results of Experiment 1 indicated a positive correlation between drive for thinness, which is one indicator of an eating disorder tendency, and the degree of matching sweetness to round shape. Experiment 2 replicated the results of Experiment 1 and revealed the mediating effect of obsessiveness. These findings suggest a relationship between individual differences in taste-shape matching and eating disorder tendency and the preliminary mediating role of obsessiveness. The present study provides new insight into the role of sweet-round matching in eating disorder tendencies and the associated psychological mechanisms.
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Affiliation(s)
- Yumi Hamamoto
- 1Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.,2Japan Society for the Promotion of Science, Tokyo, Japan
| | - Kosuke Motoki
- 1Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.,3Department of Food Management, School of Food, Agricultural and Environmental Sciences, Miyagi University, Sendai, Japan
| | - Motoaki Sugiura
- 1Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.,4International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
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24
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Looking at my body. Similarities and differences between anorexia nervosa patients and controls in body image visual processing. Eur Psychiatry 2020; 28:427-35. [DOI: 10.1016/j.eurpsy.2012.06.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 05/11/2012] [Accepted: 06/18/2012] [Indexed: 01/30/2023] Open
Abstract
AbstractBackgroundBody image distortion is a core symptom of eating disorders. Functional magnetic resonance imaging (fMRI) studies on body image processing, described different patterns of neural response, mainly involving the inferior and superior parietal lobules, and the dorsolateral prefrontal cortex (DLPFC), with conflicting results.MethodsThe neural response to the view of their own body pictures (normal size and distorted) was evaluated in 18 female anorexia nervosa (AN) restricting type patients, and in 19 healthy female subjects (HC) using fMRI. Clinical assessment was performed by means of the structured clinical interview for DSM-IV and self-reported questionnaires.ResultsIn response to the body image distortion, patients and controls showed an inverse pattern of activation, with the widest extent of activation in the oversize condition in AN, while in the undersize condition in HC. AN and HC showed a similar pattern of neural response to the view of their own body, with an increased activation in the extrastriate body area, superior and inferior parietal lobule and prefrontal areas, although the extent of activation in HC was more limited as compared with AN patients. Increased activity in AN patients, compared with HC, was observed in the DLPFC in response to the oversized body picture and a significant correlation was found in AN patients between DLPFC activation and eating disorder psychopathology.ConclusionsOur findings suggest the existence of a continuum from normalcy to pathology in neural response to body image, and confirm the clinical relevance of body image distortion in AN, reinforcing the key role of attentive, executive and self-evaluation networks in AN visual processing of own distorted body image.
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25
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Viceconti A, Camerone EM, Luzzi D, Pentassuglia D, Pardini M, Ristori D, Rossettini G, Gallace A, Longo MR, Testa M. Explicit and Implicit Own's Body and Space Perception in Painful Musculoskeletal Disorders and Rheumatic Diseases: A Systematic Scoping Review. Front Hum Neurosci 2020; 14:83. [PMID: 32327984 PMCID: PMC7161420 DOI: 10.3389/fnhum.2020.00083] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 02/24/2020] [Indexed: 12/21/2022] Open
Abstract
Background: Pain and body perception are essentially two subjective mutually influencing experiences. However, in the field of musculoskeletal disorders and rheumatic diseases we lack of a comprehensive knowledge about the relationship between body perception dysfunctions and pain or disability. We systematically mapped the literature published about the topics of: (a) somatoperception; (b) body ownership; and (c) perception of space, analysing the relationship with pain and disability. The results were organized around the two main topics of the assessment and treatment of perceptual dysfunctions. Methods: This scoping review followed the six-stage methodology suggested by Arksey and O'Malley. Ten electronic databases and grey literature were systematically searched. The PRISMA Extension for Scoping Reviews was used for reporting results. Two reviewers with different background, independently performed study screening and selection, and one author performed data extraction, that was checked by a second reviewer. Results: Thirty-seven studies fulfilled the eligibility criteria. The majority of studies (68%) concerned the assessment methodology, and the remaining 32% investigated the effects of therapeutic interventions. Research designs, methodologies adopted, and settings varied considerably across studies. Evidence of distorted body experience were found mainly for explicit somatoperception, especially in studies adopting self-administered questionnaire and subjective measures, highlighting in some cases the presence of sub-groups with different perceptual features. Almost half of the intervention studies (42%) provided therapeutic approaches combining more than one perceptual task, or sensory-motor tasks together with perceptual strategies, thus it was difficult to estimate the relative effectiveness of each single therapeutic component. Conclusions: To our knowledge, this is the first attempt to systematically map and summarize this research area in the field of musculoskeletal disorders and rheumatic diseases. Although methodological limitations limit the validity of the evidence obtained, some strategies of assessment tested and therapeutic strategies proposed represent useful starting points for future research. This review highlights preliminary evidence, strengths, and limitations of the literature published about the research questions, identifying key points that remain opened to be addressed, and make suggestions for future research studies. Body representation, as well as pain perception and treatment, can be better understood if an enlarged perspective including body and space perception is considered.
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Affiliation(s)
- Antonello Viceconti
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Savona, Italy
| | - Eleonora Maria Camerone
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Savona, Italy
| | - Deborah Luzzi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Savona, Italy
| | - Debora Pentassuglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Savona, Italy
| | - Matteo Pardini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genoa, Italy.,Policlinico S. Martino IRCCS, Genova, Italy
| | - Diego Ristori
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Savona, Italy
| | - Giacomo Rossettini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Savona, Italy
| | - Alberto Gallace
- Neuromi, Università di Milano-Bicocca, Milan, Italy.,Mind and Behavior Technological Center- Mibtec, Università di Milano-Bicocca, Milan, Italy
| | - Matthew R Longo
- Department of Psychological Sciences, Birkbeck, University of London, London, United Kingdom
| | - Marco Testa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Savona, Italy
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26
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Waist to hip ratio and breast size modulate the processing of female body silhouettes: An EEG study. EVOL HUM BEHAV 2020. [DOI: 10.1016/j.evolhumbehav.2020.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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27
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Horndasch S, Rösch J, Kratz O, Vogel A, Heinrich H, Graap H, Moll GH, Dörfler A, Forster C. Neural mechanisms of perceptive and affective processing of body stimuli in anorexia nervosa - are there developmental effects? Psychiatry Res 2020; 286:112853. [PMID: 32114206 DOI: 10.1016/j.psychres.2020.112853] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 02/04/2020] [Indexed: 10/25/2022]
Abstract
Different components of body image processing seem to be reflected by different neural mechanisms. A core symptom of Anorexia nervosa (AN) is a disturbance of body image with correlates found on a neural level. The present study focuses on the neural processing of visual body stimuli of different weight categories in adolescent and adult AN patients. Thirty-three adolescents aged 12-18 years (15 AN patients, 18 control participants) and 36 adult women (19 AN patients, 17 control participants) underwent functional magnetic resonance imaging (fMRI) while performing a perceptive and an affective body image task involving photographic stimuli of women belonging to different BMI categories. Differential effects on activation, depending on the BMI of the women shown in the pictures, were found in frontal brain regions, the thalamus, the caudate and the fusiform gyrus. Group effects differentiating between AN patients and control participants were seen mainly in the caudate and insula. No significant developmental effect was seen. During a perceptive task, diminished activation of regions involved in perceptive and evaluative functions as well as emotional reasoning was seen in AN. During an affective task there was a tendency towards activation differences reflecting reduced ability of size estimation and impaired integration of visual and body perception with emotions.
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Affiliation(s)
- Stefanie Horndasch
- Department of Child and Adolescent Mental Health, University of Erlangen, Nuremberg, Erlangen, Germany.
| | - Julie Rösch
- Department of Neuroradiology, University of Erlangen, Nuremberg, Erlangen, Germany.
| | - Oliver Kratz
- Department of Child and Adolescent Mental Health, University of Erlangen, Nuremberg, Erlangen, Germany
| | - Anne Vogel
- Department of Child and Adolescent Mental Health, University of Erlangen, Nuremberg, Erlangen, Germany
| | - Hartmut Heinrich
- Department of Child and Adolescent Mental Health, University of Erlangen, Nuremberg, Erlangen, Germany; Heckscher Klinikum, Munich, Germany
| | - Holmer Graap
- Department of Psychosomatic Medicine and Psychotherapy, University of Erlangen, Nuremberg, Erlangen, Germany
| | - Gunther H Moll
- Department of Child and Adolescent Mental Health, University of Erlangen, Nuremberg, Erlangen, Germany
| | - Arnd Dörfler
- Department of Neuroradiology, University of Erlangen, Nuremberg, Erlangen, Germany
| | - Clemens Forster
- Institute for Physiology and Pathophysiology, University of Erlangen, Nuremberg, Erlangen, Germany
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28
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Kot E, Kucharska K, Monteleone AM, Monteleone P. Structural and functional brain correlates of altered taste processing in anorexia nervosa: A systematic review. EUROPEAN EATING DISORDERS REVIEW 2019; 28:122-140. [DOI: 10.1002/erv.2713] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 08/30/2019] [Accepted: 11/05/2019] [Indexed: 11/06/2022]
Affiliation(s)
- Emilia Kot
- Faculty of PsychologyUniversity of Warsaw Warsaw Poland
| | | | | | - Palmiero Monteleone
- Department of PsychiatryUniversity of Campania “Luigi Vanvitelli” Naples Italy
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Section of NeurosciencesUniversity of Salerno Salerno Italy
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29
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Scharner S, Stengel A. Alterations of brain structure and functions in anorexia nervosa. CLINICAL NUTRITION EXPERIMENTAL 2019. [DOI: 10.1016/j.yclnex.2019.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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30
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Ralph-Nearman C, Achee M, Lapidus R, Stewart JL, Filik R. A systematic and methodological review of attentional biases in eating disorders: Food, body, and perfectionism. Brain Behav 2019; 9:e01458. [PMID: 31696674 PMCID: PMC6908865 DOI: 10.1002/brb3.1458] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 10/05/2019] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE The current systematic and methodological review aimed to critically review existing literature utilizing implicit processing, or automatic approach- and/or avoidance-related attentional biases between eating disorder (ED) and nonclinical samples, which (a) highlights how psychophysiological methods advance knowledge of ED implicit bias; (b) explains how findings fit into transdiagnostic versus disorder-specific ED frameworks; and (c) suggests how research can address perfectionism-related ED biases. METHOD Three databases were systematically searched to identify studies: PubMed, Scopus, and PsychInfo electronic databases. Peer-reviewed studies of 18- to 39-year-olds with both clinical ED and healthy samples assessing visual attentional biases using pictorial and/or linguistic stimuli related to food, body, and/or perfectionism were included. RESULTS Forty-six studies were included. While behavioral results were often similar across ED diagnoses, studies incorporating psychophysiological measures often revealed disease-specific attentional biases. Specifically, women with bulimia nervosa (BN) tend to approach food and other body types, whereas women with anorexia nervosa (AN) tend to avoid food as well as overweight bodies. CONCLUSIONS Further integration of psychophysiological and behavioral methods may identify subtle processing variations in ED, which may guide prevention strategies and interventions, and provide important clinical implications. Few implicit bias studies include male participants, investigate binge-eating disorder, or evaluate perfectionism-relevant stimuli, despite the fact that perfectionism is implicated in models of ED.
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Affiliation(s)
- Christina Ralph-Nearman
- Laureate Institute for Brain Research, Tulsa, OK, USA.,School of Psychology, University of Nottingham, Nottingham, UK
| | - Margaret Achee
- Department of Psychology, University of Tulsa, Tulsa, OK, USA
| | | | - Jennifer L Stewart
- Laureate Institute for Brain Research, Tulsa, OK, USA.,Department of Community Medicine, University of Tulsa, Tulsa, OK, USA
| | - Ruth Filik
- School of Psychology, University of Nottingham, Nottingham, UK
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31
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Ralph-Nearman C, Arevian AC, Puhl M, Kumar R, Villaroman D, Suthana N, Feusner JD, Khalsa SS. A Novel Mobile Tool (Somatomap) to Assess Body Image Perception Pilot Tested With Fashion Models and Nonmodels: Cross-Sectional Study. JMIR Ment Health 2019; 6:e14115. [PMID: 31469647 PMCID: PMC6915807 DOI: 10.2196/14115] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 08/11/2019] [Accepted: 08/25/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Distorted perception of one's body and appearance, in general, is a core feature of several psychiatric disorders including anorexia nervosa and body dysmorphic disorder and is operative to varying degrees in nonclinical populations. Yet, body image perception is challenging to assess, given its subjective nature and variety of manifestations. The currently available methods have several limitations including restricted ability to assess perceptions of specific body areas. To address these limitations, we created Somatomap, a mobile tool that enables individuals to visually represent their perception of body-part sizes and shapes as well as areas of body concerns and record the emotional valence of concerns. OBJECTIVE This study aimed to develop and pilot test the feasibility of a novel mobile tool for assessing 2D and 3D body image perception. METHODS We developed a mobile 2D tool consisting of a manikin figure on which participants outline areas of body concern and indicate the nature, intensity, and emotional valence of the concern. We also developed a mobile 3D tool consisting of an avatar on which participants select individual body parts and use sliders to manipulate their size and shape. The tool was pilot tested on 103 women: 65 professional fashion models, a group disproportionately exposed to their own visual appearance, and 38 nonmodels from the general population. Acceptability was assessed via a usability rating scale. To identify areas of body concern in 2D, topographical body maps were created by combining assessments across individuals. Statistical body maps of group differences in body concern were subsequently calculated using the formula for proportional z-score. To identify areas of body concern in 3D, participants' subjective estimates from the 3D avatar were compared to corresponding measurements of their actual body parts. Discrepancy scores were calculated based on the difference between the perceived and actual body parts and evaluated using multivariate analysis of covariance. RESULTS Statistical body maps revealed different areas of body concern between models (more frequently about thighs and buttocks) and nonmodels (more frequently about abdomen/waist). Models were more accurate at estimating their overall body size, whereas nonmodels tended to underestimate the size of individual body parts, showing greater discrepancy scores for bust, biceps, waist, hips, and calves but not shoulders and thighs. Models and nonmodels reported high ease-of-use scores (8.4/10 and 8.5/10, respectively), and the resulting 3D avatar closely resembled their actual body (72.7% and 75.2%, respectively). CONCLUSIONS These pilot results suggest that Somatomap is feasible to use and offers new opportunities for assessment of body image perception in mobile settings. Although further testing is needed to determine the applicability of this approach to other populations, Somatomap provides unique insight into how humans perceive and represent the visual characteristics of their body.
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Affiliation(s)
- Christina Ralph-Nearman
- Laureate Institute for Brain Research, Tulsa, OK, United States.,School of Psychology, University Park, University of Nottingham, Nottingham, United Kingdom
| | - Armen C Arevian
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, United States
| | - Maria Puhl
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Rajay Kumar
- International Technology Consulting, LLC, Los Angeles, CA, United States
| | - Diane Villaroman
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, United States.,Department of Neurosurgery, University of California Los Angeles, Los Angeles, CA, United States
| | - Nanthia Suthana
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, United States.,Department of Neurosurgery, University of California Los Angeles, Los Angeles, CA, United States
| | - Jamie D Feusner
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, United States
| | - Sahib S Khalsa
- Laureate Institute for Brain Research, Tulsa, OK, United States.,Oxley College of Heath Sciences, University of Tulsa, Tulsa, OK, United States
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32
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Steding J, Boehm I, King JA, Geisler D, Ritschel F, Seidel M, Doose A, Jaite C, Roessner V, Smolka MN, Ehrlich S. Goal-directed vs. habitual instrumental behavior during reward processing in anorexia nervosa: an fMRI study. Sci Rep 2019; 9:13529. [PMID: 31537862 PMCID: PMC6753148 DOI: 10.1038/s41598-019-49884-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 08/30/2019] [Indexed: 12/18/2022] Open
Abstract
Previous studies have proposed that altered reward processing and elevated cognitive control underlie the etiology of anorexia nervosa (AN). A newly debated notion suggests altered habit learning and an overreliance on habits may contribute to the persistence of AN. In weight-recovered AN patients, we previously found neuroimaging-based evidence for unaltered reward processing, but elevated cognitive control. In order to differentiate between state versus trait factors, we here contrast the aforementioned hypotheses in a sample of acutely underweight AN (acAN) patients. 37 acAN patients and 37 closely matched healthy controls (HC) underwent a functional MRI while performing an established instrumental motivation task. We found no group differences with respect to neural responses during the anticipation or receipt of reward. However, the behavioral response data showed a bimodal distribution, indicative for a goal-directed (gAN) and a habit-driven (hAN) patient subgroup. Additional analyses revealed decreased mOFC activation during reward anticipation in hAN, which would be in line with a habit-driven response. These findings provide a new perspective on the debate regarding the notion of increased goal-directed versus habitual behavior in AN. If replicable, the observed dissociation between gAN and hAN might help to tailor therapeutic approaches to individual patient characteristics.
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Affiliation(s)
- Julius Steding
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Ilka Boehm
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Joseph A King
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Daniel Geisler
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Franziska Ritschel
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Maria Seidel
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Arne Doose
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Charlotte Jaite
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Michael N Smolka
- Department of Psychiatry and Neuroimaging Center, TU Dresden, Dresden, Germany
| | - Stefan Ehrlich
- Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany. .,Translational Developmental Neuroscience Section, Department of Child and Adolescent Psychiatry, Eating Disorders Research and Treatment Center, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany.
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33
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Simon JJ, Stopyra MA, Friederich HC. Neural Processing of Disorder-Related Stimuli in Patients with Anorexia Nervosa: A Narrative Review of Brain Imaging Studies. J Clin Med 2019; 8:jcm8071047. [PMID: 31323803 PMCID: PMC6678397 DOI: 10.3390/jcm8071047] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/08/2019] [Accepted: 07/10/2019] [Indexed: 12/25/2022] Open
Abstract
Abnormalities and alterations in brain function are commonly associated with the etiology and maintenance of anorexia nervosa (AN). Different symptom categories of AN have been correlated with distinct neurobiological patterns in previous studies. The aim of this literature review is to provide a narrative overview of the investigations into neural correlates of disorder-specific stimuli in patients with AN. Although findings vary across studies, a summary of neuroimaging results according to stimulus category allows us to account for methodological differences in experimental paradigms. Based on the available evidence, the following conclusions can be made: (a) the neural processing of visual food cues is characterized by increased top-down control, which enables restrictive eating, (b) increased emotional and reward processing during gustatory stimulation triggers disorder-specific thought patterns, (c) hunger ceases to motivate food foraging but instead reinforces disorder-related behaviors, (d) body image processing is related to increased emotional and hedonic reactions, (e) emotional stimuli provoke increased saliency associated with decreased top-down control and (f) neural hypersensitivity during interoceptive processing reinforces avoidance behavior. Taken together, studies that investigated symptom-specific neural processing have contributed to a better understanding of the underlying mechanisms of AN.
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Affiliation(s)
- Joe J Simon
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany.
| | - Marion A Stopyra
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, Centre for Psychosocial Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany
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Todd J, Aspell JE, Barron D, Swami V. Multiple dimensions of interoceptive awareness are associated with facets of body image in British adults. Body Image 2019; 29:6-16. [PMID: 30771695 DOI: 10.1016/j.bodyim.2019.02.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 02/06/2019] [Accepted: 02/06/2019] [Indexed: 01/25/2023]
Abstract
Previous research has identified a relationship between interoception and body image, where lower interoceptive awareness (IA) is associated with negative body image. However, relationships between facets of interoception and positive body image remain unexplored, and men and older adults remain underrepresented. To overcome these limitations, we assessed relationships between multiple dimensions of interoceptive awareness (IA) and multiple facets of body image in community adults. An online sample of 646 British adults (447 women) aged 18-76 years completed the Multidimensional Assessment of Interoceptive Awareness (MAIA), the Body Appreciation Scale-2, the Functionality Appreciation Scale, the Authentic Pride subscale from the Body and Appearance Self-Conscious Emotions Scale, and the Appearance Orientation and Overweight Preoccupation subscales from the Multidimensional Body-Self Relations Questionnaire. Hierarchical regressions revealed significant predictive relationships between IA and all five facets of body image after controlling for sex, body mass index, and age. In the final models, the MAIA subscales emerged as significant predictors for at least one facet of body image, with the exception of the MAIA Body Listening subscale. These findings extend previous work by demonstrating significant relationships between IA and previously unexplored facets of body image, which may hold promise for practitioner-based interventions.
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Affiliation(s)
- Jennifer Todd
- School of Psychology and Sports Science, Anglia Ruskin University, Cambridge, UK.
| | - Jane E Aspell
- School of Psychology and Sports Science, Anglia Ruskin University, Cambridge, UK
| | - David Barron
- Centre for Psychological Medicine, Perdana University, Serdang, Malaysia
| | - Viren Swami
- School of Psychology and Sports Science, Anglia Ruskin University, Cambridge, UK; Centre for Psychological Medicine, Perdana University, Serdang, Malaysia
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35
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Beilharz F, Phillipou A, Castle D, Jenkins Z, Cistullo L, Rossell S. Dysmorphic concern in anorexia nervosa: Implications for recovery. Psychiatry Res 2019; 273:657-661. [PMID: 31207849 DOI: 10.1016/j.psychres.2019.01.102] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 01/28/2019] [Accepted: 01/30/2019] [Indexed: 10/27/2022]
Abstract
Body image disturbance ('dysmorphic concern') is a key diagnostic criterion for anorexia nervosa (AN). While dysmorphic concern has been described as a relapse predictor, relatively little is understood about the prevalence in AN, and the consequences upon wellbeing. The present study examined the rates of dysmorphic concern in a sample of treatment-seeking adults with AN (N = 39), and explored the associations with general mental health, disability and eating disorder symptoms. The majority of participants (61.5%) had clinically significant levels of dysmorphic concern. Furthermore, higher dysmorphic concern scores were associated with increased symptoms of anxiety, depression and eating disorder symptomatology. There was also a trend towards associations between dysmorphic concern and age of onset and stages of change (pre-contemplation, contemplation, preparation, action, maintenance), although replication is required. These findings suggest that strategies which specifically address body image distortions should be a key feature of treatment for anorexia nervosa to support long-term recovery and wellbeing.
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Affiliation(s)
- Francesca Beilharz
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia.
| | - Andrea Phillipou
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia; Department of Psychiatry, St Vincent's Hospital, Melbourne, VIC, Australia; Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia; Department of Mental Health, The Austin Hospital, Melbourne, VIC, Australia
| | - David Castle
- Department of Psychiatry, St Vincent's Hospital, Melbourne, VIC, Australia; Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - Zoe Jenkins
- Department of Psychiatry, St Vincent's Hospital, Melbourne, VIC, Australia; Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - Leonardo Cistullo
- Department of Psychiatry, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Susan Rossell
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia; Department of Psychiatry, St Vincent's Hospital, Melbourne, VIC, Australia
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36
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Murray SB, Strober M, Craske MG, Griffiths S, Levinson CA, Strigo IA. Fear as a translational mechanism in the psychopathology of anorexia nervosa. Neurosci Biobehav Rev 2018; 95:383-395. [DOI: 10.1016/j.neubiorev.2018.10.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 10/11/2018] [Accepted: 10/22/2018] [Indexed: 12/30/2022]
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37
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Statement of removal. Health Care Women Int 2018; 39:1316. [DOI: 10.1080/07399332.2018.1443108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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38
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Malecki J, Rhodes P, Ussher J. Childhood trauma and anorexia nervosa: from body image to embodiment. Health Care Women Int 2018; 39:936-951. [PMID: 30152723 DOI: 10.1080/07399332.2018.1492268] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Contemporary understandings of anorexia nervosa are framed by the body-image paradigm. The body-image framework considers that women's bodily experiences are reflected through distorted mental images of their bodies or disordered thinking and behavior around food and eating. Body image has come to symbolize all that can go wrong with women's relationships with their bodies, food, and eating. The problem with this approach is its failure to consider the experience of women who have survived childhood abuse. Women's bodily disturbances are not easily discernible through objective measures because they lie within the inner subjective realm of the embodied 'self' and embodied emotional experience. Consideration of the different ways that women inhabit their bodies informs this paper's examination of the conceptual framework of embodiment as an alternative to the body-image paradigm.
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Affiliation(s)
- Jennifer Malecki
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Paul Rhodes
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Jane Ussher
- School of Psychology, The University of Sydney, Sydney, NSW, Australia.,Centre for Health Research, School of Medicine, Western Sydney University, Sydney, Australia
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39
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Bischoff-Grethe A, Wierenga CE, Berner LA, Simmons AN, Bailer U, Paulus MP, Kaye WH. Neural hypersensitivity to pleasant touch in women remitted from anorexia nervosa. Transl Psychiatry 2018; 8:161. [PMID: 30115929 PMCID: PMC6095886 DOI: 10.1038/s41398-018-0218-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 06/27/2018] [Accepted: 07/14/2018] [Indexed: 02/06/2023] Open
Abstract
Interoception, or the sensing and integration of bodily state signals, has been implicated in anorexia nervosa (AN), given that the hallmark symptoms involve food restriction and body image disturbance. Here we focus on brain response to the anticipation and experience of affective interoceptive stimuli. Women remitted from AN (RAN; N = 18) and healthy comparison women (CW; N = 26) underwent a pleasant affective touch paradigm consisting of gentle strokes with a soft brush administered to the forearm or palm during functional neuroimaging. RAN had a lower brain response relative to CW during anticipation of touch, but a greater response when experiencing touch in the right ventral mid-insula. In RAN, this reduced anticipatory response was associated with higher levels of harm avoidance. Exploratory analyses in RAN also suggested that lower response during touch anticipation was associated with greater body dissatisfaction and higher perceived touch intensity ratings. This reduced responsivity to the anticipation of pleasant affective interoceptive stimuli in association with higher harm avoidance, along with an elevated response to the experience of touch, suggests an impaired ability in AN to predict and interpret incoming physiological stimuli. Impaired interoception may thus impact one's sense of self, thereby supporting observations of disturbed body image and avoidance of affective and social stimuli. Therapeutic approaches that help AN to better anticipate and interpret salient affective stimuli or improve tolerance of interoceptive experiences may be an important addition to current interventions.
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Affiliation(s)
- Amanda Bischoff-Grethe
- 0000 0001 2107 4242grid.266100.3Department of Psychiatry, University of California, San Diego, CA USA
| | - Christina E. Wierenga
- 0000 0001 2107 4242grid.266100.3Department of Psychiatry, University of California, San Diego, CA USA ,0000 0004 0419 2708grid.410371.0VA San Diego Healthcare System, San Diego, CA USA
| | - Laura A. Berner
- 0000 0001 2107 4242grid.266100.3Department of Psychiatry, University of California, San Diego, CA USA
| | - Alan N. Simmons
- 0000 0001 2107 4242grid.266100.3Department of Psychiatry, University of California, San Diego, CA USA ,0000 0004 0419 2708grid.410371.0VA San Diego Healthcare System, San Diego, CA USA
| | - Ursula Bailer
- 0000 0001 2107 4242grid.266100.3Department of Psychiatry, University of California, San Diego, CA USA ,0000 0000 9259 8492grid.22937.3dDivision of Biological Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Martin P. Paulus
- 0000 0001 2107 4242grid.266100.3Department of Psychiatry, University of California, San Diego, CA USA ,0000 0004 0512 8863grid.417423.7Laureate Institute for Brain Research, Tulsa, Oklahoma USA
| | - Walter H. Kaye
- 0000 0001 2107 4242grid.266100.3Department of Psychiatry, University of California, San Diego, CA USA
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40
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Costanzo F, Menghini D, Maritato A, Castiglioni MC, Mereu A, Varuzza C, Zanna V, Vicari S. New Treatment Perspectives in Adolescents With Anorexia Nervosa: The Efficacy of Non-invasive Brain-Directed Treatment. Front Behav Neurosci 2018; 12:133. [PMID: 30083095 PMCID: PMC6064943 DOI: 10.3389/fnbeh.2018.00133] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 06/13/2018] [Indexed: 01/29/2023] Open
Abstract
Poor treatment outcomes are available for anorexia nervosa (AN) and treatment innovations are urgently needed. Recently, non-invasive neuromodulation tools have suggested to have potential for reducing an symptomatology targeting brain alterations. The objective of the study was to verify whether left anodal/right cathodal prefrontal cortex transcranial direct current stimulation (tDCS), may aid in altering/resetting inter-hemispheric balance in patients with AN, re-establishing control over eating behaviors. Twenty-three adolescents with an underwent a treatment as usual (AU), including nutritional, pharmacological, and psychoeducational treatment, plus 18 sessions of tDCS (TDCS+AU = n11; mean age = 13.9, SD = 1.8 years) or a family based therapy (FBT+AU = n12, mean age = 15.1, SD = 1.5 years). Psychopathological scales and the body mass index (BMI) were assessed before and after treatment. After 6 weeks of treatment, the BMI values increased only in the tDCS group, even at 1-month follow-up. Independently of the treatment, all participants improved in several psychopathological measures, included AN psychopathology and mood and anxiety symptoms. Our results demonstrated for the first time a specific effect of the left anodal/right cathodal tDCS treatment protocol on stable weight gain and a superiority compared to an active control treatment for adolescents with AN. Results were interpreted as a possible direct/indirect effect of tDCS in into some pathophysiological mechanisms of AN, involving the mesocortical dopaminergic pathways and the promotion of food intake. This pilot study opens new perspectives in the treatment of an in adolescence, supporting the targeted and beneficial effects of a brain-based treatment.
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Affiliation(s)
- Floriana Costanzo
- Child Neuropsychiatric Unit, Department of Neuroscience, Bambino Gesù Children Hospital, Rome, Italy
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41
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Lantz EL, Gaspar ME, DiTore R, Piers AD, Schaumberg K. Conceptualizing body dissatisfaction in eating disorders within a self-discrepancy framework: a review of evidence. Eat Weight Disord 2018; 23:275-291. [PMID: 29423688 DOI: 10.1007/s40519-018-0483-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 01/17/2018] [Indexed: 11/30/2022] Open
Abstract
Body dissatisfaction, the negative subjective evaluation of one's body, is associated with many negative psychological and physical health consequences. One conceptualization of body dissatisfaction includes an experience of discrepancy between perceived actual and ideal body shapes. This paper reviews the literature on three facets of body dissatisfaction from the framework of self-discrepancy theory: perceptions of current weight, ideal body weight, and the relative importance of conforming to ideals. We review components of body dissatisfaction among healthy individuals and eating-disordered individuals. We also address the conceptualization's relationship among body dissatisfaction, weight history, and dieting to expand the impact of body dissatisfaction research and to provide more information on the nature and treatment of eating disorders.
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Affiliation(s)
- Elin L Lantz
- Department of Psychology, Drexel University, 3141 Chestnut St., Philadelphia, PA, 19104, USA.
| | - Monika E Gaspar
- Department of Psychology, Drexel University, 3141 Chestnut St., Philadelphia, PA, 19104, USA.,Department of Psychological Sciences, Texas Tech University, Box 42051, Lubbock, TX, 79409-2051, USA
| | - Rebecca DiTore
- Department of Psychology, Drexel University, 3141 Chestnut St., Philadelphia, PA, 19104, USA
| | - Amani D Piers
- Department of Psychology, Drexel University, 3141 Chestnut St., Philadelphia, PA, 19104, USA
| | - Katherine Schaumberg
- Department of Psychology, Drexel University, 3141 Chestnut St., Philadelphia, PA, 19104, USA.,Department of Psychiatry, University of North Carolina at Chapel Hill, 10618 Neurosciences Hospital CB #7160, Chapel Hill, NC, 27599, USA
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42
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Chubby hands or little fingers: sex differences in hand representation. PSYCHOLOGICAL RESEARCH 2018; 83:1375-1382. [PMID: 29616336 DOI: 10.1007/s00426-018-1003-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 03/30/2018] [Indexed: 12/24/2022]
Abstract
Disturbed body representation is a condition defined by the perception that one's body size is different from their anatomical size. While equal amounts of males and females suffer from disturbed body representation, there appear to be differences in the direction of this distortion. Females will typically overestimate, whereas males will typically underestimate body size. One part of the body that has been consistently misperceived is the hands. This misrepresentation consists of two distinct characteristics: an overestimation of hand width, and an underestimation of finger length. Many of these studies, however, have used predominately female participants, allowing for the possibility that women are driving this distortion. The aim of the present study was to examine possible sex differences in hand perception. To this end, participants estimated the location of ten landmarks on their hands when their hands were hidden from view. Our results indicate that females follow the characteristic distortion, whereas males only underestimate finger length (albeit more than females). These findings are surprising, because the hands are not an area of concern for weight gain/loss. We discuss these findings in relation to body dysmorphia literature.
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43
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Via E, Goldberg X, Sánchez I, Forcano L, Harrison BJ, Davey CG, Pujol J, Martínez-Zalacaín I, Fernández-Aranda F, Soriano-Mas C, Cardoner N, Menchón JM. Self and other body perception in anorexia nervosa: The role of posterior DMN nodes. World J Biol Psychiatry 2018; 19:210-224. [PMID: 27873550 DOI: 10.1080/15622975.2016.1249951] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Body image distortion is a core symptom of anorexia nervosa (AN), which involves alterations in self- (and other's) evaluative processes arising during body perception. At a neural level, self-related information is thought to rely on areas of the so-called default mode network (DMN), which, additionally, shows prominent synchronised activity at rest. METHODS Twenty female patients with AN and 20 matched healthy controls were scanned using magnetic resonance imaging when: (a) viewing video clips of their own body and another's body; (b) at rest. Between-group differences within the DMN during task performance were evaluated and further explored for task-related and resting-state-related functional connectivity alterations. RESULTS AN patients showed a hyperactivation of the dorsal posterior cingulate cortex during their own-body processing but a response failure to another's body processing at the precuneus and ventral PCC. Increased task-related connectivity was found between dPCC-dorsal anterior cingulate cortex and precuneus-mid-temporal cortex. Further, AN patients showed decreased resting-state connectivity between the dPCC and the angular gyrus. CONCLUSIONS The PCC and the precuneus are suggested as key components of a network supporting self-other-evaluative processes implicated in body distortion, while the existence of DMN alterations at rest might reflect a sustained, task-independent breakdown within this network in AN.
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Affiliation(s)
- Esther Via
- a Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) , Barcelona , Spain.,b Department of Clinical Sciences , School of Medicine, University of Barcelona , Barcelona , Spain.,c Melbourne Neuropsychiatry Centre, The Department of Psychiatry , The University of Melbourne , Melbourne , Australia.,d Depression and Anxiety Program, Mental Health Department , Parc Taulí Sabadell University Hospital , Barcelona , Spain
| | - Ximena Goldberg
- a Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) , Barcelona , Spain.,d Depression and Anxiety Program, Mental Health Department , Parc Taulí Sabadell University Hospital , Barcelona , Spain.,e CIBER Salud Mental (CIBERSAM) , Instituto de Salud Carlos III , Barcelona , Spain
| | - Isabel Sánchez
- a Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) , Barcelona , Spain
| | - Laura Forcano
- f Clinical research group in human pharmacology and neuroscience , IMIM Research Institute at the Hospital de Mar , Barcelona , Spain.,g CIBER Fisiopatología Obesidad y Nutrición (CIBERObn) , Instituto de Salud Carlos III , Barcelona , Spain
| | - Ben J Harrison
- c Melbourne Neuropsychiatry Centre, The Department of Psychiatry , The University of Melbourne , Melbourne , Australia
| | - Christopher G Davey
- c Melbourne Neuropsychiatry Centre, The Department of Psychiatry , The University of Melbourne , Melbourne , Australia.,h Orygen, The National Centre of Excellence in Youth Mental Health , Melbourne , Australia
| | - Jesús Pujol
- i MRI Research Unit , Hospital del Mar, CIBERSAM G21 , Barcelona , Spain
| | - Ignacio Martínez-Zalacaín
- a Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) , Barcelona , Spain
| | - Fernando Fernández-Aranda
- a Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) , Barcelona , Spain.,b Department of Clinical Sciences , School of Medicine, University of Barcelona , Barcelona , Spain.,g CIBER Fisiopatología Obesidad y Nutrición (CIBERObn) , Instituto de Salud Carlos III , Barcelona , Spain
| | - Carles Soriano-Mas
- a Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) , Barcelona , Spain.,e CIBER Salud Mental (CIBERSAM) , Instituto de Salud Carlos III , Barcelona , Spain.,j Department of Psychobiology and Methodology in Health Sciences , Universitat Autònoma de Barcelona , Spain
| | - Narcís Cardoner
- d Depression and Anxiety Program, Mental Health Department , Parc Taulí Sabadell University Hospital , Barcelona , Spain.,k Department of Psychiatry , Universitat Autònoma de Barcelona , Spain
| | - José M Menchón
- a Bellvitge University Hospital - Institut d'Investigació Biomèdica de Bellvitge (IDIBELL) , Barcelona , Spain.,b Department of Clinical Sciences , School of Medicine, University of Barcelona , Barcelona , Spain.,e CIBER Salud Mental (CIBERSAM) , Instituto de Salud Carlos III , Barcelona , Spain
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Mölbert SC, Thaler A, Mohler BJ, Streuber S, Romero J, Black MJ, Zipfel S, Karnath HO, Giel KE. Assessing body image in anorexia nervosa using biometric self-avatars in virtual reality: Attitudinal components rather than visual body size estimation are distorted. Psychol Med 2018; 48:642-653. [PMID: 28745268 PMCID: PMC5964466 DOI: 10.1017/s0033291717002008] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 06/20/2017] [Accepted: 06/21/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND Body image disturbance (BID) is a core symptom of anorexia nervosa (AN), but as yet distinctive features of BID are unknown. The present study aimed at disentangling perceptual and attitudinal components of BID in AN. METHODS We investigated n = 24 women with AN and n = 24 controls. Based on a three-dimensional (3D) body scan, we created realistic virtual 3D bodies (avatars) for each participant that were varied through a range of ±20% of the participants' weights. Avatars were presented in a virtual reality mirror scenario. Using different psychophysical tasks, participants identified and adjusted their actual and their desired body weight. To test for general perceptual biases in estimating body weight, a second experiment investigated perception of weight and shape matched avatars with another identity. RESULTS Women with AN and controls underestimated their weight, with a trend that women with AN underestimated more. The average desired body of controls had normal weight while the average desired weight of women with AN corresponded to extreme AN (DSM-5). Correlation analyses revealed that desired body weight, but not accuracy of weight estimation, was associated with eating disorder symptoms. In the second experiment, both groups estimated accurately while the most attractive body was similar to Experiment 1. CONCLUSIONS Our results contradict the widespread assumption that patients with AN overestimate their body weight due to visual distortions. Rather, they illustrate that BID might be driven by distorted attitudes with regard to the desired body. Clinical interventions should aim at helping patients with AN to change their desired weight.
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Affiliation(s)
- S. C. Mölbert
- Department of Psychosomatic Medicine and
Psychotherapy, Medical University Hospital
Tübingen, Tübingen, Germany
- Max Planck Institute for Biological
Cybernetics, Tübingen, Germany
- Graduate Training Centre of Neuroscience,
International Max Planck Research School, Universität Tübingen,
Tübingen, Germany
| | - A. Thaler
- Max Planck Institute for Biological
Cybernetics, Tübingen, Germany
- Graduate Training Centre of Neuroscience,
International Max Planck Research School, Universität Tübingen,
Tübingen, Germany
| | - B. J. Mohler
- Max Planck Institute for Biological
Cybernetics, Tübingen, Germany
| | - S. Streuber
- École Polytechnique Fédérale de Lausanne, Brain
Mind Institute, Lausanne,
Switzerland
| | - J. Romero
- Max Planck Institute for Intelligent
Systems, Tübingen, Germany
| | - M. J. Black
- Max Planck Institute for Intelligent
Systems, Tübingen, Germany
| | - S. Zipfel
- Department of Psychosomatic Medicine and
Psychotherapy, Medical University Hospital
Tübingen, Tübingen, Germany
| | - H.-O. Karnath
- Division of Neuropsychology,
Center of Neurology, Hertie-Institute for Clinical Brain Research, University
of Tübingen, Tübingen, Germany
| | - K. E. Giel
- Department of Psychosomatic Medicine and
Psychotherapy, Medical University Hospital
Tübingen, Tübingen, Germany
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45
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Monteleone AM, Castellini G, Volpe U, Ricca V, Lelli L, Monteleone P, Maj M. Neuroendocrinology and brain imaging of reward in eating disorders: A possible key to the treatment of anorexia nervosa and bulimia nervosa. Prog Neuropsychopharmacol Biol Psychiatry 2018; 80:132-142. [PMID: 28259721 DOI: 10.1016/j.pnpbp.2017.02.020] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 02/28/2017] [Indexed: 10/20/2022]
Abstract
Anorexia nervosa and bulimia nervosa are severe eating disorders whose etiopathogenesis is still unknown. Clinical features suggest that eating disorders may develop as reward-dependent syndromes, since eating less food is perceived as rewarding in anorexia nervosa while consumption of large amounts of food during binge episodes in bulimia nervosa aims at reducing the patient's negative emotional states. Therefore, brain reward mechanisms have been a major focus of research in the attempt to contribute to the comprehension of the pathophysiology of these disorders. Structural brain imaging data provided the evidence that brain reward circuits may be altered in patients with anorexia or bulimia nervosa. Similarly, functional brain imaging studies exploring the activation of brain reward circuits by food stimuli as well as by stimuli recognized to be potentially rewarding for eating disordered patients, such as body image cues or stimuli related to food deprivation and physical hyperactivity, showed several dysfunctions in ED patients. Moreover, very recently, it has been demonstrated that some of the biochemical homeostatic modulators of eating behavior are also implicated in the regulation of food-related and non-food-related reward, representing a possible link between the aberrant behaviors of ED subjects and their hypothesized deranged reward processes. In particular, changes in leptin and ghrelin occur in patients with anorexia or bulimia nervosa and have been suggested to represent not only homeostatic adaptations to an altered energy balance but to contribute also to the acquisition and/or maintenance of persistent starvation, binge eating and physical hyperactivity, which are potentially rewarding for ED patients. On the basis of such findings new pathogenetic models of EDs have been proposed, and these models may provide new theoretical basis for the development of innovative treatment strategies, either psychological and pharmacological, with the aim to improve the outcomes of so severe disabling disorders.
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Affiliation(s)
| | - Giovanni Castellini
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Umberto Volpe
- Department of Psychiatry, University of Naples SUN, Naples, Italy
| | - Valdo Ricca
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Lorenzo Lelli
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Palmiero Monteleone
- Department of Psychiatry, University of Naples SUN, Naples, Italy; Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Section of Neurosciences, University of Salerno, Salerno, Italy.
| | - Mario Maj
- Department of Psychiatry, University of Naples SUN, Naples, Italy
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Mölbert SC, Klein L, Thaler A, Mohler BJ, Brozzo C, Martus P, Karnath HO, Zipfel S, Giel KE. Depictive and metric body size estimation in anorexia nervosa and bulimia nervosa: A systematic review and meta-analysis. Clin Psychol Rev 2017; 57:21-31. [PMID: 28818670 DOI: 10.1016/j.cpr.2017.08.005] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 07/06/2017] [Accepted: 08/09/2017] [Indexed: 12/28/2022]
Abstract
A distorted representation of one's own body is a diagnostic criterion and core psychopathology of both anorexia nervosa (AN) and bulimia nervosa (BN). Despite recent technical advances in research, it is still unknown whether this body image disturbance is characterized by body dissatisfaction and a low ideal weight and/or includes a distorted perception or processing of body size. In this article, we provide an update and meta-analysis of 42 articles summarizing measures and results for body size estimation (BSE) from 926 individuals with AN, 536 individuals with BN and 1920 controls. We replicate findings that individuals with AN and BN overestimate their body size as compared to controls (ES=0.63). Our meta-regression shows that metric methods (BSE by direct or indirect spatial measures) yield larger effect sizes than depictive methods (BSE by evaluating distorted pictures), and that effect sizes are larger for patients with BN than for patients with AN. To interpret these results, we suggest a revised theoretical framework for BSE that accounts for differences between depictive and metric BSE methods regarding the underlying body representations (conceptual vs. perceptual, implicit vs. explicit). We also discuss clinical implications and argue for the importance of multimethod approaches to investigate body image disturbance.
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Affiliation(s)
- Simone Claire Mölbert
- Medical University Hospital Tübingen, Dpt. of Psychosomatic Medicine and Psychotherapy, Tübingen, Germany; Max Planck Institute for Biological Cybernetics, Tübingen, Germany; Center of Neurology, Division of Neuropsychology, University of Tübingen, Tübingen, Germany; Graduate Training Centre of Neuroscience, International Max Planck Research School, University of Tübingen, Tübingen, Germany.
| | - Lukas Klein
- Medical University Hospital Tübingen, Dpt. of Psychosomatic Medicine and Psychotherapy, Tübingen, Germany
| | - Anne Thaler
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany; Graduate Training Centre of Neuroscience, International Max Planck Research School, University of Tübingen, Tübingen, Germany
| | - Betty J Mohler
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Chiara Brozzo
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Peter Martus
- Institute for Epidemiology and Applied Biometry, University of Tübingen, Tübingen, Germany
| | - Hans-Otto Karnath
- Center of Neurology, Division of Neuropsychology, University of Tübingen, Tübingen, Germany
| | - Stephan Zipfel
- Medical University Hospital Tübingen, Dpt. of Psychosomatic Medicine and Psychotherapy, Tübingen, Germany
| | - Katrin Elisabeth Giel
- Medical University Hospital Tübingen, Dpt. of Psychosomatic Medicine and Psychotherapy, Tübingen, Germany
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From the body’s viscera to the body’s image: Is there a link between interoception and body image concerns? Neurosci Biobehav Rev 2017; 77:237-246. [DOI: 10.1016/j.neubiorev.2017.03.017] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 03/13/2017] [Accepted: 03/31/2017] [Indexed: 01/30/2023]
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Xu J, Harper JA, Van Enkevort EA, Latimer K, Kelley U, McAdams CJ. Neural activations are related to body-shape, anxiety, and outcomes in adolescent anorexia nervosa. J Psychiatr Res 2017; 87:1-7. [PMID: 27978457 PMCID: PMC5421407 DOI: 10.1016/j.jpsychires.2016.12.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 11/21/2016] [Accepted: 12/02/2016] [Indexed: 11/25/2022]
Abstract
Anorexia nervosa (AN) is an illness that frequently begins during adolescence and involves weight loss. Two groups of adolescent girls (AN-A, weight-recovered following AN) and (HC-A, healthy comparison) completed a functional magnetic resonance imaging task involving social evaluations, allowing comparison of neural activations during self-evaluations, friend-evaluations, and perspective-taking self-evaluations. Although the two groups were not different in their whole-brain activations, anxiety and body shape concerns were correlated with neural activity in a priori regions of interest. A cluster in medial prefrontal cortex and the dorsal anterior cingulate correlated with the body shape questionnaire; subjects with more body shape concerns used this area less during self than friend evaluations. A cluster in medial prefrontal cortex and the cingulate also correlated with anxiety such that more anxiety was associated with engagement when disagreeing rather than agreeing with social terms during self-evaluations. This data suggests that differences in the utilization of frontal brain regions during social evaluations may contribute to both anxiety and body shape concerns in adolescents with AN. Clinical follow-up was obtained, allowing exploration of whether brain function early in course of disease relates to illness trajectory. The adolescents successful in recovery used the posterior cingulate and precuneus more for friend than self evaluations than the adolescents that remained ill, suggesting that neural differences related to social evaluations may provide clinical predictive value. Utilization of both MPFC and the precuneus during social and self evaluations may be a key biological component for achieving sustained weight-recovery in adolescents with AN.
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Affiliation(s)
- Jie Xu
- Department of Psychiatry, University of Texas at Southwestern Medical School, Dallas, TX, 75390, USA
| | - Jessica A Harper
- Department of Psychiatry, University of Texas at Southwestern Medical School, Dallas, TX, 75390, USA
| | - Erin A Van Enkevort
- Department of Psychiatry, University of Texas at Southwestern Medical School, Dallas, TX, 75390, USA
| | - Kelsey Latimer
- Department of Psychiatry, University of Texas at Southwestern Medical School, Dallas, TX, 75390, USA; Psychiatry, Children's Medical Center, Dallas, TX, USA
| | - Urszula Kelley
- Department of Psychiatry, University of Texas at Southwestern Medical School, Dallas, TX, 75390, USA; Psychiatry, Children's Medical Center, Dallas, TX, USA
| | - Carrie J McAdams
- Department of Psychiatry, University of Texas at Southwestern Medical School, Dallas, TX, 75390, USA; Psychiatry, Children's Medical Center, Dallas, TX, USA; Psychiatry, Texas Health Presbyterian Hospital of Dallas, Dallas, TX, 75321, USA.
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Nakamura Y, Ikuta T. Caudate-Precuneus Functional Connectivity Is Associated with Obesity Preventive Eating Tendency. Brain Connect 2017; 7:211-217. [PMID: 28260392 DOI: 10.1089/brain.2016.0424] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
There exists diversity among individuals in difficulty controlling body weight. Body weight control, or obesity prevention, requires cognitive control over ingestive behavior, which may account for the diverse ability of body weight control. The caudate nuclei, especially the dorsal area, have been shown to play critical roles in ingestive behaviors, which significantly influences body weight control. However, the practice of body weight control is dependent on the body weight status, because the current obesity status determines the need for body weight control. To elucidate the underlying neural mechanism that accounts for individual differences in obesity prevention, we aimed to isolate functional caudate connectivity responsible for the underlying tendency of obesity prevention, independent of the current obesity status, using resting state fMRI data, body mass index (BMI), and assessment of ingestive behavior from 185 individuals from the NKI-Rockland sample. The underlying tendency of obesity prevention was estimated from BMI and behavioral and cognitive components of food intake. Functional connectivities between the caudate head and the whole brain were tested as a function of the estimated tendency in a voxel-wise manner. The bilateral precuneus showed inverse association between its connectivity to the caudate and the estimated tendency. Caudate-precuneus connectivity may have significant implications to understanding personal differences that accounts for the success in body weight control.
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Affiliation(s)
- Yuko Nakamura
- 1 Center for Evolutionary Cognitive Science, The University of Tokyo , Tokyo, Japan
| | - Toshikazu Ikuta
- 2 Department of Communication Sciences and Disorders, University of Mississippi , University, Mississippi
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The importance of the hypothalamo-pituitary-adrenal axis as a therapeutic target in anorexia nervosa. Physiol Behav 2016; 171:13-20. [PMID: 28043861 DOI: 10.1016/j.physbeh.2016.12.035] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 12/26/2016] [Accepted: 12/27/2016] [Indexed: 12/19/2022]
Abstract
Anorexia nervosa (AN) is an eating disorder, mainly affecting women, with a lifetime prevalence of about 1%, that can run a chronic course. While an effective pharmacotherapy is lacking, it is hypothesized that the progesterone and type II glucocorticoid receptor antagonist mifepristone (RU486) might be useful, as it is well known that the hypothalamo-pituitary-adrenal axis (HPA) is activated in AN. Even if secondary to the eating disorder, an active HPA axis may contribute to maintaining the neuroendocrine, emotional and behavioral effects observed in AN. More specifically, it is suggested that the HPA axis interacts with limbic structures, including the insular and prefrontal cortices, to uphold the changes in interoceptive and emotional awareness seen in AN. As such, it is proposed that mifepristone (RU486) reverses these effects by acting on these limbic regions. In conclusion, the theoretical efficacy of mifepristone (RU486) in improving symptoms of AN should be tested in randomized clinical trials.
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