Multimodal neuroimaging in anorexia nervosa

Abstract

Anorexia nervosa (AN) is a severe and complex psychiatric disorder characterized by intense fear about weight gain and finalized to food-related control behaviors. Growing interest has been demonstrated about neurobiological processes subtend to AN physiopathology. The present review aimed to collect neurostructural and neurofunctional available data from 2010 to 2019. Results have been organized according to the neuroimaging technique employed, also including a specific section on electroencephalographic results, mostly neglected in previous reviews. Diffuse cerebral vulnerability has been demonstrated and the contribution of several structures has been identified. Insula, cingulate cortex, parietal and frontal areas are primarily involved both by structural and functional perspectives. Moreover, consistent alterations in white matter integrity and brain electrical activity have been reported. Neuroimaging findings give a substantial contribution to AN pathophysiological description, also in order to understand altered but reversible processes in the passage from acute illness phase to disorder's remission, useful also for defining therapy.

Affective cognition in eating disorders: a systematic review and meta-analysis of the performance on the “Reading the Mind in the Eyes” Test

“…Some of the abnormalities reported in acute AN tend to reverse after remission of symptoms, in particular alterations in white matter microstructures [ 108 ]. Studies on patients with BN and BED reported primarily alterations in circuits involved in appetite, the processing of food stimuli, and impulse control rather than in circuits involved in the understanding of others’ mental states [ 109 ], while structural and functional abnormalities are generally less extensive and pervasive in patients with BN or BED than in those with AN.…”

Neuroimaging Findings in Adolescents and Young Adults with Anorexia Nervosa: A Systematic Review

“…These functional alterations are in line with data emerging from electroencephalography studies, showing decreased electrical activity in frontal and parietal-occipital regions during cognitive tasks. Likewise, altered electrical activity in fusiform gyrus and parahippocampal gyrus is demonstrated during resting-state paradigms [25].…”

Processing of food stimuli in anorexia nervosa: An ERP‐study comparing adolescents and adults

“…Regarding eating disorders such as AN and also Bulimia nervosa (BN), the processing of disorder-relevant stimuli in terms of for example, food stimuli or body pictures was investigated, pointing to an impaired stimuli processing compared to healthy controls (HCs) (Alfano et al, 2020;Mai et al, 2015;Wolz et al, 2015): Novosel et al (2014) investigated the processing of food stimuli in 11 adolescents with AN in comparison to age-matched HCs: they reported a higher LPP in patients with AN while watching stimuli passively, pointing to a stronger AB towards food pictures compared to HCs. Furthermore, within the AN group, a greater AB was found for low calorie, but not high calorie pictures compared to HCs (Novosel et al, 2014).…”

“…To better understand the pathophysiology and the underlying mechanisms of AN, the investigation of the neurobiological, ‐structural or ‐physiological correlates of altered stimuli‐processing is mandatory. While neurostructural and neurofunctional studies of AN often use MRI or fMRI (Kappou et al., 2021; Su et al., 2021), the application of non‐invasive electroencephalography (EEG) and analyses of event‐related potentials (ERPs) are less prevalent in this population (Alfano et al., 2020; Wolz et al., 2015). Especially, due to the high temporal resolution of EEG, it is a very useful and complementary methodology to assess stimuli‐specific neuronal processing.…”