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

Abstract

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...