Neural mechanisms of perceptive and affective processing of body stimuli in anorexia nervosa – are there developmental effects?

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 focusses at the neural processing of visual body stimuli of different weight categories in adolescent and adult AN patients. Method 33 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. ResultsDifferential effects on activation depending on the BMI of the women shown in the pictures were found in frontal brain regions, the thalamus, caudate and the fusiform gyrus. Group effects differentiating between AN patients and control participants were seen mainly in the caudate and insula. DiscussionDuring a perceptive task, diminished activation of regions involved in perceptive and evaluative functions as well as emotional reasoning was seen in AN. During evaluation of the neural processing in 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..

Visual perception and dissociation during Mirror Gazing Test in patients with anorexia nervosa: a preliminary study

“…The short version of the Clinician-Administered Dissociative States Scale is composed by 19 items, to be replied on a 5-point Likert scale (0 being "never" and 4 being "almost always"). An overall total score, ranging from 0 to 76, was calculated by summing each single item' response; moreover, the three following subscales were calculated and analysed: (i) Derealisation (summing items: 1, 2, 8, 9, 10, 11,12,13,16,17,18,19; total score ranging from 0 to 48; example: "did it seem like things were unreal, as if you were in a dream? "); (ii) Depersonalization (summing items: 3, 4, 5, 6, 7; total score ranging from 0 to 20; example: "did it seem as if you were looking at things from outside your own body?…”

“…Moreover, from a neurobiological perspective, it has been hypothesized that body image distortion in patients with AN could derive from abnormal functioning of the insula, an area of the brain that integrates interoceptive awareness, involving the sensory process of receiving, accessing and appraising internal bodily signals [ 14 , 15 ]. In particular, the activity of the anterior insula, which may represent motivational tendencies, but is also part of the fear and emotional network, has been found to be diminished in anorexic patients [ 16 ].…”

Anorexia nervosa, conduct disorder, and the juvenile justice system: a case of applying traditional treatment modalities in a non-traditional setting

“…The video call coincided with her decision to discontinue psychotropic medication due to her perception of fat redistribution. It has long been established that AN is associated with a disturbance in body image, and the mirrorless environment of the JJC likely protected our patient from her distorted self-perception [ 28 , 29 ].…”

Increased insula and amygdala activity during selective attention for negatively valenced body parts in binge eating disorder.

“…In line with this, decreased fusiform gyrus activation was observed when women with AN engaged in body checking behaviors (right fusiform gyrus; Suda et al, 2013), and when they processed images of their own body (left fusiform gyrus; Vocks et al, 2010). However, this result was not consistently observed across studies (Castellini et al, 2013; Horndasch et al, 2020; Sachdev et al, 2008; Vocks et al, 2010), with some studies indicating that women with eating disorders display an overactivation in the fusiform gyrus in response to specific body images such as unfamiliar slim bodies (bilateral fusiform gyrus; Vocks et al, 2010), distorted body stimuli (right fusiform gyrus; Miyake et al, 2010) and photographs of their own body (Press et al, 2022).…”