Abstract
This paper systematically reviews the literature pertaining to the use of resting-state functional magnetic resonance imaging (rsfMRI) in anorexia nervosa (AN), classifying studies on the basis of different analysis approaches. We followed PRISMA guidelines. Fifteen papers were included, investigating a total of 294 participants with current or past AN and 285 controls. The studies used seed-based, whole-brain independent component analysis (ICA), network-of-interest ICA based and graph analysis approaches. The studies showed relatively consistent overlap in results, yet little overlap in their analytical approach and/or a-priori assumptions. Functional connectivity alterations were mainly found in the corticolimbic circuitry, involved in cognitive control and visual and homeostatic integration. Some overlapping findings were found in brain areas putatively important in AN, such as the insula. These results suggest altered functional connectivity in networks/areas linked to the main symptom domains of AN, such as impaired cognitive control and body image disturbances. These preliminary evidences suggest that more targeted treatments need to be developed that focus on these two symptom domains. Further studies with multi-approach analyses and longitudinal designs are needed to better understand the complexity of AN.
Highlights
Anorexia nervosa (AN) is a severe mental disorder with the highest rate of mortality in all psychiatric disorders (Arcelus et al, 2011) and it typically affects adolescent girls and young women
Two independent component analysis (ICA)-based resting-state functional magnetic resonance imaging (rsfMRI) studies found altered functional connectivity within the default-mode network (DMN) for participants recovered from AN (Cowdrey et al, 2014) and those with a current AN diagnosis (Boehm et al, 2014), there were differences between the affected areas, while no differences were found in this network in two subsequent network of interest ICA-based study on and patients with AN (Phillipou et al, 2016) and participants recovered from AN (Boehm et al, 2016) respectively
RsfMRI studies provide preliminary evidence of brain alterations at rest in networks/areas involved with the main symptom domains of AN both in patients with current AN and in participants recovered from AN: cognitive inflexibility and altered processing/integration of body signals
Summary
Anorexia nervosa (AN) is a severe mental disorder with the highest rate of mortality in all psychiatric disorders (Arcelus et al, 2011) and it typically affects adolescent girls and young women. Considering neuroimaging findings, this neurobiological model suggests that AN patients may have an imbalance in information processing, linked to alterations of the ventral limbic circuits (which comprises amygdala, anterior insula, anterior ventral striatum, anterior cingulate cortex, and the orbito-frontal cortex), as well as the dorsal executive circuits (which includes dorsal regions of the caudate, dorso-lateral prefrontal cortex, and parietal cortex). These two brain circuits are primarily implicated in inhibitory decision making processes and reward-related behaviours and their alteration might sustain AN symptomatology (Kaye et al, 2013). Other neurobiologically informed models of AN have pointed out the role of anxiety, stress, and fear, the gratifying nature of AN symptoms, and the consequent shift to habitual or compulsive behaviours as possible key factors in the persistence of AN (Zipfel et al, 2015; Treasure et al, 2015)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
