Intact neural and behavioral correlates of emotion processing and regulation in weight-recovered anorexia nervosa: a combined fMRI and EMA study

Abstract

Altered emotion processing and regulation mechanisms play a key role in eating disorders. We recently reported increased fMRI responses in brain regions involved in emotion processing (amygdala, dorsolateral prefrontal cortex) in acutely underweight anorexia nervosa (AN) patients while passively viewing negatively valenced images. We also showed that patients’ ability to downregulate activity elicited by positively valenced pictures in a brain region involved in reward processing (ventral striatum) was predictive of worse outcomes (increased rumination and negative affect). The current study tries to answer the question of whether these alterations are only state effects associated with undernutrition or whether they constitute a trait characteristic of the disorder that persists after recovery. Forty-one individuals that were weight-recovered from AN (recAN) and 41 age-matched healthy controls (HC) completed an established emotion regulation paradigm using negatively and positively valenced visual stimuli. We assessed behavioral (arousal) and fMRI measures (activity in the amygdala, ventral striatum, and dorsolateral prefrontal cortex) during emotion processing and regulation. Additionally, measures of disorder-relevant rumination and affect were collected several times daily for 2 weeks after scanning via ecological momentary assessment. In contrast to our previous findings in acute AN patients, recAN showed no significant alterations either on a behavioral or neural level. Further, there were no associations between fMRI responses and post-scan momentary measures of rumination and affect. Together, these results suggest that neural responses to emotionally valenced stimuli as well as relationships with everyday rumination and affect likely reflect state-related alterations in AN that improve following successful weight-recovery.

State of Mind Assessment in Relation to Adult Attachment and Text Analysis of Adult Attachment Interviews in a Sample of Patients with Anorexia Nervosa

“…The explanation for the results of this study is consistent with recent and innovative research in the field of neurobiology that has been conducted on AN patients, suggesting that they exhibit general hypoactivity in brain regions that are involved in enteroceptive perception (e.g., the insula), the hypothalamus (involved in regulating the urge to eat), and the cerebellum (involved in controlling and planning movements). However, this takes place in conjunction with increased activity in emotional areas (e.g., the amygdala) and top-down activation in regions of the prefrontal cortex, as if there were a cognitive control downstream of a large emotional activation, without an adequate component to read internal states [ 132 , 133 , 134 , 135 ]. Most importantly, we believe it is key to emphasize the clinical implications of this work in light of the guidelines proposed by the NICE (National Institute for Health and Care Excellence), which emphasize the importance of clinical work that also integrates an elaborative component on emotional strategies.…”

Detecting Suicide Ideation in the Era of Social Media: The Population Neuroscience Perspective

“…Furthermore, arguably an EMA approach in such a setting may allow for analyzing users' mobility patterns as consequences of lockdowns or other restrictions implied by authorities to contain a pandemic disease, and in their functional relationship with mental health outcomes and brain activity, in line with Seidel et al's. ( 68 ) EMA and fMRI research examining emotions and anorexia.…”