Fear Network Unresponsiveness in Women with Anorexia Nervosa

Background The understanding of the cerebral neurobiology of anorexia nervosa (AN) with respect to state- versus trait-related abnormalities is limited. There is evidence of restitution of structural brain alterations with clinical remission. However, with regard to functional brain abnormalities, this issue has not yet been clarified. Methods We compared women with AN (n = 31), well-recovered female participants (REC) (n = 18) and non-patients (NP) (n = 27) cross-sectionally. Functional magnetic resonance imaging was performed to compare neural responses to food versus non-food images. Additionally, affective ratings were assessed. Results Functional responses and affective ratings did not differ between REC and NP, even when applying lenient thresholds for the comparison of neural responses. Comparing REC and AN, the latter showed lower valence and higher arousal ratings for food stimuli, and neural responses differed with lenient thresholds in an occipital region. Conclusions The data are in line with some previous findings and suggest restitution of cerebral function with clinical recovery. Furthermore, affective ratings did not differ from NP. These results need to be verified in intra-individual longitudinal studies.

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“…The participants examined in the current study largely overlap with those of our previous investigations [ 5 , 14 , 19 , 34 , 35 , 45 ].…”

Section: Methodsmentioning

confidence: 84%

State or trait: the neurobiology of anorexia nervosa — contributions of a functional magnetic resonance imaging study

et al. 2022

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“…However, we cannot completely rule out that the signal similarities of the REC and HC subjects can be attributed to a REC subgroup with a particularly good forecast; only long-term follow-up studies would be able to clarify this point [84].…”

Section: Possible Implications Of the Findings: Beyond Density Volume And Integrity Effectsmentioning

confidence: 89%

“…A recent functional study on anxiety processing in AN showed marked dysfunction of key areas of the so-called "fear network," including the anterior insula cortex. [84]. Other studies have shown that functional abnormalities in the insula are not only in acute AN but also in REC subjects [38,39,41,85].…”

Section: Possible Implications Of the Findings: Beyond Density Volume And Integrity Effectsmentioning

confidence: 98%

Insular Cell Integrity Markers Linked to Weight Concern in Anorexia Nervosa—An MR-Spectroscopy Study

Maier

Nickel

Perlov

et al. 2020

JCM

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Objective: An insular involvement in the pathogenesis of anorexia nervosa (AN) has been suggested in many structural and functional neuroimaging studies. This magnetic resonance spectroscopy (MRS) study is the first to investigate metabolic signals in the anterior insular cortex in patients with AN and recovered individuals (REC). Method: The MR spectra of 32 adult women with AN, 21 REC subjects and 33 healthy controls (HC) were quantified for absolute N-acetylaspartate (NAA), glutamate + glutamine (Glx), total choline, myo-inositol, creatine concentrations (mM/L). After adjusting the metabolite concentrations for age and partial gray/white matter volume, group differences were tested using one-way multivariate analyses of variance (MANOVA). Post-hoc analyses of variance were applied to identify those metabolites that showed significant group effects. Correlations were tested for associations with psychometric measures (eating disorder examination), duration of illness, and body mass index. Results: The MANOVA exhibited a significant group effect. The NAA signal was reduced in the AN group compared to the HC group. The REC and the HC groups did not differ in metabolite concentrations. In the AN group, lower NAA and Glx signals were related to increased weight concern. Discussion: We interpret the decreased NAA availability in the anterior insula as a signal of impaired neuronal integrity or density. The association of weight concern, which is a core feature of AN, with decreased NAA and Glx indicates that disturbances of glutamatergic neurotransmission might be related to core psychopathology in AN. The absence of significant metabolic differences between the REC and HC subjects suggests that metabolic alterations in AN represent a state rather than a trait phenomenon.

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“…Furthermore, it cannot theoretically be ruled out that the REC subgroup represents a group with a good prognosis with fewer deficits in the acute phase. Only longitudinal studies can shed light on this issue (Maier et al, ).…”

Section: Discussionmentioning

confidence: 99%

Altered cortical folding and reduced sulcal depth in adults with anorexia nervosa

Nickel

Joos

Elst

et al. 2019

Euro Eating Disorders Rev

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Objective Previous studies on anorexia nervosa (AN) focused on cortical volume and mainly reported grey matter reduction. They also investigated cortical surface parameters, for example, absolute mean curvature (AMC) providing information on cortical folding or sulcal depth (SD). For the first time, we also analysed cortical complexity using fractal dimension (FD) in AN. Method In a cross‐sectional study, we performed surface analyses (AMC, SD, and FD) on 34 women with AN, 24 recovered from AN (REC), and 41 healthy controls (HC). Structural MR data was processed using the Computational Anatomy Toolbox and statistically compared across groups on a vertex‐ and region‐of‐interest‐wise level using statistical parametric mapping. Results We found a lower AMC and SD in AN, especially in temporal areas. FD was increased in the left precentral gyrus in AN. No differences of the parameters AMC, SD, or FD were evident between REC and HC participants. Conclusions Alterations in AMC, SD, and FD in AN patients, but not between the REC and HC groups, suggest that these alterations are state related. The findings concur with other structural AN studies that suggest restitution with clinical recovery. The changes may be due to malnutrition, dehydration, osmotic dysregulation, or hormonal aberrations during the acute stage.

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Fear Network Unresponsiveness in Women with Anorexia Nervosa

Cited by 7 publications

References 8 publications

State or trait: the neurobiology of anorexia nervosa — contributions of a functional magnetic resonance imaging study

State or trait: the neurobiology of anorexia nervosa — contributions of a functional magnetic resonance imaging study

Insular Cell Integrity Markers Linked to Weight Concern in Anorexia Nervosa—An MR-Spectroscopy Study

Altered cortical folding and reduced sulcal depth in adults with anorexia nervosa

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