Abstract
Abnormalities and alterations in brain function are commonly associated with the etiology and maintenance of anorexia nervosa (AN). Different symptom categories of AN have been correlated with distinct neurobiological patterns in previous studies. The aim of this literature review is to provide a narrative overview of the investigations into neural correlates of disorder-specific stimuli in patients with AN. Although findings vary across studies, a summary of neuroimaging results according to stimulus category allows us to account for methodological differences in experimental paradigms. Based on the available evidence, the following conclusions can be made: (a) the neural processing of visual food cues is characterized by increased top-down control, which enables restrictive eating, (b) increased emotional and reward processing during gustatory stimulation triggers disorder-specific thought patterns, (c) hunger ceases to motivate food foraging but instead reinforces disorder-related behaviors, (d) body image processing is related to increased emotional and hedonic reactions, (e) emotional stimuli provoke increased saliency associated with decreased top-down control and (f) neural hypersensitivity during interoceptive processing reinforces avoidance behavior. Taken together, studies that investigated symptom-specific neural processing have contributed to a better understanding of the underlying mechanisms of AN.
Highlights
Anorexia nervosa (AN) is a serious mental disorder characterized by self-induced starvation and excessive weight loss, fear of weight gain, body image concerns and food aversion [1]
This narrative review aimed to provide a general overview of the neuroimaging literature investigating symptom-specific neural processing in patients with AN
A number of studies have investigated the neural profiles of different symptom-categories in patients with AN using fMRI
Summary
Anorexia nervosa (AN) is a serious mental disorder characterized by self-induced starvation and excessive weight loss, fear of weight gain, body image concerns and food aversion [1]. Various studies have begun to employ neuroimaging techniques to elucidate the underlying pathophysiology and neurobiological substrate of AN [7,8,9,10]. Theories have been proposed to explain the contribution of aberrant brain function to the development and maintenance of AN. The aim of this review is to provide a narrative overview of recent studies investigating alterations in brain function related to disorder-specific stimuli in patients with AN and to provide a better characterization of the pathophysiological mechanisms underlying AN. We focused on neuroimaging studies employing experimental designs drawing on symptom provocation to assess neural aberrations associated with AN. We describe studies investigating the following: (1) the responsivity to food-related stimuli, (2) hunger, (3) body image, (4) emotional processing and (5) interoceptive processing
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