Neurocognitive Impairments Are More Severe in the Binge-Eating/Purging Anorexia Nervosa Subtype Than in the Restricting Subtype

Abstract

Objective: To evaluate cognitive function impairment in patients with anorexia nervosa (AN) of either the restricting (ANR) or binge-eating/purging (ANBP) subtype.Method: We administered the Japanese version of the MATRICS Consensus Cognitive Battery to 22 patients with ANR, 18 patients with ANBP, and 69 healthy control subjects. Our participants were selected from among the patients at the Kobe University Hospital and community residents.Results: Compared to the healthy controls, the ANR group had significantly lower visual learning and social cognition scores, and the ANBP group had significantly lower processing speed, attention/vigilance, visual learning, reasoning/problem-solving, and social cognition scores. Compared to the ANR group, the ANBP group had significantly lower attention/vigilance scores.Discussion: The AN subtypes differed in cognitive function impairments. Participants with ANBP, which is associated with higher mortality rates than ANR, exhibited greater impairment severities, especially in the attention/vigilance domain, confirming the presence of impairments in continuous concentration. This may relate to the impulsivity, an ANBP characteristic reported in the personality research. Future studies can further clarify the cognitive impairments of each subtype by addressing the subtype cognitive functions and personality characteristics.

Deep brain stimulation of the nucleus accumbens for treatment-refractory anorexia nervosa: A long-term follow-up study

“…Indeed, patients with BP-AN exhibited higher levels of the core AN psychopathology, such as the restrained food intake, shape/weight concerns, and eating concerns as compared to subjects with R-AN [31]. Moreover, the former report greater neurocognitive impairments than the latter [32], which is consistent with our result on the significantly lower presurgical MMSE score seen in patients with BP-AN. Additionally, the electrolyte disturbances are reported to be more pronounced in BP-AN, which could have an additive effect on the cognitive impact of malnutrition [33].…”

Psychiatric Aspects of Obesity: A Narrative Review of Pathophysiology and Psychopathology

“…Some authors even prompt that the reason for pathologic eating (emotion dysregulation) may be more important than the objective behavior (eating large amount of foods in little time) and subjective experiences (loss of control over eating) in the diagnosis of this disorder [35]. Executive dysfunctions, especially poor cortical inhibitory control and impulsivity are also associated with eating disorders characterized by loss of control (that is, the whole spectrum from binging/purging anorexia nervosa, through bulimia nervosa and binge-eating disorders) [36,37].…”

Mental health dished up—the use of iPSC models in neuropsychiatric research

“…However, some patients also used compensatory behavior such as purging. AN binge-eating/purging has been recognized as a clinically relevant subtype, demonstrating higher levels of core ED psychopathology and more severe cognitive impairments, and therefore may cause significant sample heterogeneity (Reas and Rø 2018 ; Tamiya et al 2018 ). The authors were able to successfully generate iPSC-derived cortical neurons, with no differences in differentiation capability observed.…”