Neurobiological signature of intimacy in anorexia nervosa

Maier, Simon; Spiegelberg, Julia; Zutphen, Linda van; Zeeck, Almut; Elst, Ludger Tebartz van; Hartmann, Armin; Holovics, Lukas; Reinert, Elke; Sandholz, Angelika; Lahmann, Claas; Domschke, Katharina; Glauche, Volkmar; Tüscher, Oliver; Joos, Andreas

doi:10.1002/erv.2663

Cited by 10 publications

(12 citation statements)

References 40 publications

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“…These results suggest the presence of dysfunctional self-evaluative processes and reduced perceptions of social rewards, and finally, they highlight the importance of brain reward networks for pathological behaviors in patients with AN. Consistent with the frequently observed disturbances in interpersonal relationships in patients with AN [93], Maier and colleagues [94] found that both patients with AN and participants who had recovered from AN display decreased activation in the superior parietal cortex and a reduced responsivity in the dorsolateral prefrontal cortex when viewing pictures displaying intimate situations. Similarly, Miyake and colleagues [95] observed a negative relationship between alexithymia, or the inability to articulate and interpret emotional experiences, and activation of the amygdala and posterior and anterior cingulate cortices during the processing of negative interpersonal words.…”

Section: Emotional Processingsupporting

confidence: 59%

Neural Processing of Disorder-Related Stimuli in Patients with Anorexia Nervosa: A Narrative Review of Brain Imaging Studies

Simon

Stopyra

Friederich

2019

JCM

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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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Section: Emotional Processingsupporting

confidence: 59%

Neural Processing of Disorder-Related Stimuli in Patients with Anorexia Nervosa: A Narrative Review of Brain Imaging Studies

Simon

Stopyra

Friederich

2019

JCM

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“…This study was part of a multimodal MRI study, which assessed structural, metabolic and other functional data [see, e.g., (31)(32)(33)(34)(35)(36)]. We replicated the aforementioned food paradigm with 31 AN and 27 NP.…”

Section: Methodsmentioning

confidence: 99%

“…Additionally, other fMRI data were gathered before the food paradigm, which was not the case in the initial study. In the current study, we used the manikins of the International Affective Picture System ( 47 ) assessing the emotional response to the visual stimuli after scanning (outside the scanner) in three dimensions (arousal, valence, dominance), as we used this approach with another paradigm ( 32 ) as part of the multimodal study. In the previous study the Likert scale was applied.…”

Section: Methodsmentioning

confidence: 99%

A Neglected Topic in Neuroscience: Replicability of fMRI Results With Specific Reference to ANOREXIA NERVOSA

et al. 2020

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Functional magnetic resonance imaging (fMRI) studies report impaired functional correlates of cognition and emotion in mental disorders. The validity of preexisting studies needs to be confirmed through replication studies, which there is a lack of. So far, most replication studies have been conducted on non-patients (NP) and primarily investigated cognitive and motor tasks. To fill this gap, we conducted the first fMRI replication study to investigate brain function using disease-related food stimuli in patients with anorexia nervosa (AN). Using fMRI, we investigated 31 AN patients and 27 NP for increased amygdala and reduced midcingulate activation when viewing food and nonfood stimuli, as reported by the original study (11AN, 11NP; Joos et al., 2011). Similar to the previous study, we observed in the within group comparisons (food>non-food) a frontoinsular activation for both groups. Although in AN the recorded activation clustered more prominently and extended into the cingulate cortex. In the between-group comparisons, the increased amygdala and reduced midcingulate activation could not be replicated. Instead, AN showed a higher activation of the cingulate cortices, the pre-/ postcentral gyrus and the inferior parietal lobe. Unlike in the initial study, no significant differences between NP>AN could be observed. The inconsistency of results and the nonreplication of the study could have several reasons, such as high inter-individual variance of functional correlates of emotion processing, as well as intra-individual variances and the smaller group size of the initial study. These results underline the importance of replication for assessing the reliability and validity of results from fMRI research.

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“…A recent review [14] suggests an alternative explanation: ED individuals can recognize others’ basic emotions, but they lose this skill when emotions become more complex and are expressed within a relationship. Relevant to this kind of hypothesis, a dysfunctional middle prefrontal cortex (MPFC) activation has been reported for processing of visual stimuli depicting couples in intimate relationships in acute and recovered AN, pointing to a state-independent alteration of MPFC activation [45,46]. Additionally, the significantly elevated alexithymia scores in both clinical groups may be also associated with MPFC dysfunction, as this is an important hub for the interhemispheric integration and transfer [47].…”

Section: Discussionmentioning

confidence: 99%

Emotional responsiveness task in emotional distress: correlated of functional neuroimaging in anorexia and bulimia

D’Agata

Caroppo

Spalatro

et al. 2020

Preprint

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30Aim: The present study aims to extend the knowledge of the neural correlates of emotion 31 processing in first episode subjects affected by anorexia nervosa (AN) or bulimia nervosa 32 (BN). We applied an emotional distress paradigm targeting negative emotions thought to 33 be relevant for interpersonal difficulties and therapeutic resistance mechanisms. 34 Methods: The current study applied a neuroimaging paradigm eliciting affective responses 35 to 44 female participants with newly diagnosed AN or BN and 20 matched controls. The 36 measurements also included an extensive assessment comprised of clinical scales, 37 neuropsychological tests, measures of emotion processing and empathy. 38 Results: AN and BN did not differ from controls in terms of emotional response, emotion 39 matching, self-reported empathy and cognitive performance. However, scores of eating 40 disorder and psychopathological clinical scores, as well alexithymia levels, were increased 41 in AN and BN. On a neural level, no significant group differences emerged, even when 42 focusing on a region of interest selected a priori: the amygdala.43 Conclusions: Our data are against the hypothesis that participants with AN or BN display a 44 reduced emotional responsiveness. This supports the hypothesis that relational difficulties, 45 as well as therapeutic resistance, are not secondary to simple difficulty in feeling and 46 identifying basic negative emotions in AN and BN participants. Negative emotions fMRI in AN and BN 65 diagnostic criteria of ED (DSM-5 and ICD-10), emerging evidence points to deficits in 66 socioemotional functioning [9]. Consequently, several modern therapeutic models 67 incorporate the role of emotional difficulties, social anxiety and poor social support in the 68 maintenance of the disorder [8].69Empathy represents a core function for social coherence and building relationships [10]. 70Based on the abovementioned socio-emotional difficulties and related problems in ED, one 71 may assume that empathy is systematically altered in ED and its impairment potentially 72 represents a relevant risk factor. Several studies applied self-reported empathy measures Negative emotions fMRI in AN and BN 4 73 or assessed emotion recognition performance but reported mixed results [11][12][13][14]. Thus, it 74 is unclear how much emotion processing, empathy and social competencies are affected 75 in ED and what mechanisms mediate the insurgence of relational difficulties. 76The majority of neuroimaging studies in the field of ED have investigated the 77 neurobiological correlates of body shape, reward and food stimuli [15,16], while the 78 number of studies focusing on emotion/empathy is still scarce and almost limited to the 79 functional magnetic imaging (fMRI) correlates of implicit and/or explicit face emotion 80 processing in patients affected by [17][18][19][20][21][22]. In BN much less is known regarding the 81 neural circuits underlying emotion processing [16] and hardly any neuroimaging study 82 adopted a transdiagnostic approach b...

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Neurobiological signature of intimacy in anorexia nervosa

Cited by 10 publications

References 40 publications

Neural Processing of Disorder-Related Stimuli in Patients with Anorexia Nervosa: A Narrative Review of Brain Imaging Studies

Neural Processing of Disorder-Related Stimuli in Patients with Anorexia Nervosa: A Narrative Review of Brain Imaging Studies

A Neglected Topic in Neuroscience: Replicability of fMRI Results With Specific Reference to ANOREXIA NERVOSA

Emotional responsiveness task in emotional distress: correlated of functional neuroimaging in anorexia and bulimia

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