Reduced resting-state connectivity in areas involved in processing of face-related social cues in female adolescents with atypical anorexia nervosa

Gaia Olivo,Santino Gaudio,Ingemar Swenne,Helena Salonen-Ros,Samantha J Brooks,Anna-Kaisa Tuunainen,Helgi B Schiöth,Elna-Marie Larsson,Christina Zhukovsky

doi:10.1038/s41398-018-0333-1

Abstract

Atypical anorexia nervosa (AN) has a high incidence in adolescents and can result in significant morbidity and mortality. Neuroimaging could improve our knowledge regarding the pathogenesis of eating disorders (EDs), however research on adolescents with EDs is limited. To date no neuroimaging studies have been conducted to investigate brain functional connectivity in atypical AN. We investigated resting-state functional connectivity using 3 T MRI in 22 drug-naïve adolescent patients with atypical AN, and 24 healthy controls. Psychological traits related to the ED and depressive symptoms have been assessed using the Eating Disorders Examination Questionnaire (EDE-Q) and the Montgomery–Åsberg Depression Rating Scale self-reported (MADRS-S) respectively. Reduced connectivity was found in patients in brain areas involved in face-processing and social cognition, such as the left putamen, the left occipital fusiform gyrus, and specific cerebellar lobules. The connectivity was, on the other hand, increased in patients compared with controls from the right inferior temporal gyrus to the superior parietal lobule and superior lateral occipital cortex. These areas are involved in multimodal stimuli integration, social rejection and anxiety. Patients scored higher on the EDE-Q and MADRS-S questionnaires, and the MADRS-S correlated with connectivity from the right inferior temporal gyrus to the superior parietal lobule in patients. Our findings point toward a role for an altered development of socio-emotional skills in the pathogenesis of atypical AN. Nonetheless, longitudinal studies will be needed to assess whether these connectivity alterations might be a neural marker of the pathology.

Highlights

Introduction The Diagnostic and StatisticalManual of Mental Disorders, fifth edition (DSM-5) defined atypical anorexia nervosa (AN) as the presence of all of the criteria for AN, except for a less severe weight loss
The connectivity was, on the other hand, increased in patients compared with controls from the right posterior inferior temporal gyrus (ITG) to the left superior parietal lobule (SPL) extending to the lateral superior occipital cortex (Fig. 1, Table 2)
A significant positive correlation was found between the connectivity from the right pITG to the left SPL and the MADRS-S score (p < 0.005) (Fig. 2)

Summary

Introduction

Introduction The Diagnostic and StatisticalManual of Mental Disorders, fifth edition (DSM-5) defined atypical anorexia nervosa (AN) as the presence of all of the criteria for AN, except for a less severe weight loss. Despite patients with atypical AN are in the near normal-weight range at presentation[1,2], atypical AN can result in significant morbidity and mortality[1]. The medical consequences are comparable to those reported for full-syndrome AN2, and patients can present signs of starvation and medical instability[1]. Neuroimaging could improve our knowledge regarding the pathogenesis of EDs, leading to a better understanding of the complex interrelation between neurobiological and psychosocial aspects of these disorders[5].

Methods

Results

Discussion

Conclusion