Neurophysiological correlates of disorder-related autobiographical memory in anorexia nervosa

Abstract

Background Anorexia nervosa (AN) is characterized by an overgeneralization of food/body-related autobiographical memories (AM). This is regarded as an emotion regulation strategy with adverse long-term effects implicated in disorder maintenance and treatment resistance. Therefore, we aimed to examine neural correlates of food/body-related AM-recall in AN. Methods Twenty-nine female patients with AN and 30 medication-free age-sex-matched normal-weight healthy controls (HC) underwent functional magnetic resonance imaging while recalling AMs in response to food/body-related and neutral cue words. To control for general knowledge retrieval, participants engaged in a semantic generation and riser detection task. Results In comparison to HC, patients with AN generated fewer and less specific AMs in response to food/body-related words, but not for neutral cue words. Group comparisons revealed reduced activation in regions associated with self-referential processing and memory retrieval (precuneus and angular gyrus) during the retrieval of specific food/body-related AM in patients with AN. Brain connectivity in regions associated with memory functioning and executive control was reduced in patients with AN during the retrieval of specific food/body-related AM. Finally, resting-state functional connectivity analysis revealed no differences between groups, arguing against a general underlying disconnection of brain networks implicated in memory and emotional processing in AN. Conclusions These results indicate impaired neural processing of food/body-related AM in AN, with a reduced involvement of regions involved in self-referential processing. Our findings are discussed as possible neuronal correlates of emotional avoidance in AN and provide new insights of AN-pathophysiology underscoring the importance of targeting dysfunctional emotion regulation strategies during treatment.

Phonological working memory is adversely affected in adults with anorexia nervosa: a systematic literature review

“…Natalia et al [56] reported worse performance for individuals with AN in the backwards condition of the Corsi Blocks/Spatial span and in the TMT. Similarly, Kucharska et al [73] and Terhoeven et al [58] found TMT impairments in their AN sample compared to the HC. In contrast, no significant difference emerged in the visuospatial digit span [74], spatial WM task [42] n-back or SDMT [56].…”

“…Performed worse than HC in 44.4% of the verbal/auditory tasks [ 59 – 61 ], while no difference was found in 55.6% [ 42 , 55 , 57 , 58 ] (Fig. 3 B).…”

“…The backwards verbal digit span was the most recurring measure utilising the phonological loop. Of the studies directly comparing AN and HC cohorts in the verbal digit span, 57% of the studies did not detect any significant difference between the groups [ 55 – 58 ], while 43% found impairments in the AN participants [ 43 , 59 , 60 ] (Fig. 2 B).…”

“…n = 9, meds. n = 13 Harper et al [ 35 ] American F No HC – – 28.20 17.54 N.R N.R 17 Cavalera et al [ 38 ] Italian F 76 22.46 N.R 24.50 N.R N.R 37 (in) 37 Gagnon et al [ 57 ] French-Canadian F 23 25.91 21.47 30.80 19.55 N.R N.R 10 5 5 Brockmeyer et al [ 58 ] German F 40 23.98 21.26 23.73 16.80 N.R N.R 40 23 17 Depression n = 30, anxiety n = 2 Adults Malagoli et al [ 37 ] Italian ...…”

“…n = 4, Meds. n = 16 Ogata et al [ 34 ] Japanese F 10 32.40 18.82 32.17 12.65 N.R N.R 12 12 Terhoeven et al [ 58 ] Greek F 30 23.70 21.20 23.20 15.10 6.10 28 (in) 1 (out) 29 21 8 Adults and adolescents grouped Øverås et al [ 75 ] Norwegian F 34 18.62 N.R 18.75 N.R N.R N.R 36 Cipolletta et al [ 71 ] Italian F 12 23.04 19.88 23.04 16.86 N.R N.R 12 Foerde and Steinglass [ 40 ] American M/F …”