Cognitive Decline in Patients with Anorexia Nervosa: Which Cognitive Domains are Most Vulnerable and Need to be Considered?

Abstract

Objective: Besides physical complaints, patients with anorexia nervosa (AN) often suffer from cognitive problems. However, it is still a matter of debate whether a specific profile of cognitive disturbances underlies the disease, and if so, whether this profile contributes to the maintenance of the illness and also leads to the development of different subtypes of AN. The aim of the present study was to provide a more detailed knowledge on neuropsychological profiles in patients with AN using an extension of the Ravello Profile test-battery by working memory (WM) tests. Method: Twenty-nine AN patients and 20 healthy controls (HC) participated in the study. Neuropsychological performance was assessed by the Ravello Profile and WM tasks such as Digit Span and Corsi Blocks, 2- and 3-Back tasks, Symbol Digit Modalities Test, Paced Auditory Serial and Addition Task, as well as the Verbal Learning and Memory Test. Results: AN patients showed subtle cognitive problems on certain measures including WM performance. Compared to HC, the AN group showed significantly worse performance in verbal short-term and long-term memory, visuospatial WM, inhibition, and switching abilities, subserving successful self-regulation. Discussion: Our results speak in favour of relevance for WM decline in the context of AN. Therefore, tasks assessing visuospatial WM and information processing speed (IPS) should be added to existing test batteries such as the Ravello Profile.