Memory performance in acute and weight-restored anorexia nervosa patients

Nikendei, Christoph; Funiok, C.; Pfüller, Ute; Zastrow, Arne; Aschenbrenner, Steffen; Weisbrod, Matthias; Herzog, Wolfgang; Friederich, Hans Christoph

doi:10.1017/s0033291710001121

Cited by 59 publications

(64 citation statements)

References 61 publications

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“…The cognitive measures in this study were selected because of their known relationship to the thalamo-frontal circuits under study; however, they have limitations. Although we found that working memory, as measured by the LNS, was significantly impaired in patients with AN in our study, other studies have not found impairment in this cognitive domain (Lao-Kaim et al, 2014;Nikendei et al, 2011). Cognitive flexibility is often impaired in AN (Steinglass et al, 2006;Wu et al, 2014), but findings with the Stroop and TMT have been inconsistent, perhaps because these tasks are less cognitively demanding.…”

Section: Discussioncontrasting

confidence: 91%

Evidence for Thalamocortical Circuit Abnormalities and Associated Cognitive Dysfunctions in Underweight Individuals with Anorexia Nervosa

Biezonski

Cha

Steinglass

et al. 2015

Neuropsychopharmacol

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Anorexia nervosa (AN) is characterized by extremely low body weight resulting from pathological food restriction, and carries a mortality rate among the highest of any psychiatric illness. AN, particularly during the acute, underweight state of the illness, has been associated with abnormalities across a range of brain regions, including the frontal cortex and basal ganglia. Few studies of AN have investigated the thalamus, a key mediator of information flow through frontal-basal ganglia circuit loops. We examined both thalamic surface morphology using anatomical MRI and thalamo-frontal functional connectivity using resting-state functional MRI. Individuals with AN (n = 28) showed localized inward deformations of the thalamus relative to healthy controls (HC, n = 22), and abnormal functional connectivity between the thalamus and the dorsolateral and anterior prefrontal cortices. Alterations in thalamo-frontal connectivity were associated with deficits in performance on tasks probing cognitive control (Stroop task) and working memory (Letter-Number Sequencing (LNS) task). Our findings suggest that abnormalities in thalamo-frontal circuits may have a role in mediating aspects of cognitive dysfunction in underweight individuals with AN.

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Section: Discussioncontrasting

confidence: 91%

Evidence for Thalamocortical Circuit Abnormalities and Associated Cognitive Dysfunctions in Underweight Individuals with Anorexia Nervosa

Biezonski

Cha

Steinglass

et al. 2015

Neuropsychopharmacol

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“…With regards to vWM and in accordance with the current study, a recent neuropsychological assessment found no difference on isolated backwards digit scores between restricting, binge-purging, weight-gained AN subtypes and HC [48]. Others have found slower performance on a memory scanning task requiring a response to pre-specified numbers when they appear within a sequence [57] and conversely, two recent studies have reported superior vWM performance in AN.…”

Section: Discussionsupporting

confidence: 88%

“…People with AN exhibit inefficient visuo-spatial memory and processing [36], cognitive flexibility [63], long-term memory [48], attention [17] and central coherence [38]. However, the results of studies assessing verbal working memory (vWM) in AN have been inconsistent (Table 1).…”

Section: Introductionmentioning

confidence: 99%

Functional MRI investigation of verbal working memory in adults with anorexia nervosa

et al. 2014

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Literature regarding verbal working memory (vWM) in anorexia nervosa (AN) has been inconsistent due to a misunderstanding of the key components of vWM and introduction of confounding stimuli. Furthermore, there are no studies looking at how brain function in people with AN relates to vWM performance. The present study used functional magnetic resonance imaging (fMRI) with a letter n-back paradigm to study the effect of increasing vWM task difficulty on cortical functioning in the largest AN sample to date (n=31). Although the AN group had low BMI and higher anxious and depressive symptomology compared to age-matched controls (HC), there were no between-group differences in accuracy and speed at any task difficulty. fMRI data revealed no regions exhibiting significant differences in activation when groups were compared at each difficulty separately and no regions showing group x condition interaction. Although there was a trend towards lower accuracy as duration of illness increased, this was not correlated with activity in regions associated with vWM. These findings indicate that vWM in AN is as efficient and performed using the same cognitive strategy as HC, and that there may not be a need for therapies to pursue remediation of this particular neurocognitive faculty.

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“…Some participants had a normal BMI (N17) because they were on a relapse of symptomatology at the time of assessment and, thus, they still met the inclusion criteria for the study given that the anorexia nervosa diagnosis was made by an eating disorder specialist based on information other than the BMI (Stedal, Rose, Frampton, Landro, & Lask, 2012). Recent research showed no differences in immediate and delayed recall between underweight and normal-weight patients with AN, whereas both groups scored significantly lower than healthy controls (Nikendei et al, 2011).…”

Section: Methodsmentioning

confidence: 99%

Impaired executive functioning influences verbal memory in anorexia nervosa

et al. 2015

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Memory performance in acute and weight-restored anorexia nervosa patients

Abstract: The findings suggest that impaired memory performance is either a stable trait characteristic or a scar effect of chronic starvation that may play a role in the development and/or persistence of the disorder.

Cited by 59 publications

References 61 publications

Evidence for Thalamocortical Circuit Abnormalities and Associated Cognitive Dysfunctions in Underweight Individuals with Anorexia Nervosa

Evidence for Thalamocortical Circuit Abnormalities and Associated Cognitive Dysfunctions in Underweight Individuals with Anorexia Nervosa

Functional MRI investigation of verbal working memory in adults with anorexia nervosa

Impaired executive functioning influences verbal memory in anorexia nervosa

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