Abstract
BackgroundFunctional neuroimaging techniques are widely used to elucidate changes in brain activity, and various questionnaires are used to investigate psychopathological features in patients with eating disorders (ED). It is well known that social skills and interpersonal difficulties are strongly associated with the psychopathology of patients with ED. However, few studies have examined the association between brain activity and social relationships in patients with ED, particularly in patients with extremely low body weight.MethodsIn this study, 22-channel near-infrared spectroscopy was used to quantify regional hemodynamic changes during a letter fluency task (LFT) in 20 female patients with ED with a mean body mass index of 14.0 kg/m2and 31 female controls (CTLs). Symptoms were assessed using the Eating Disorder Inventory-2 and Beck Depression Inventory. We hypothesized that frontal activity in patients with ED would be lower than in CTLs and would show different correlations with psychopathological features compared with CTLs.ResultsThe LFT performance and score on the social insecurity subscale of the Eating Disorder Inventory-2 were significantly higher in the ED group than in the CTL group. The mean change in oxygenated hemoglobin (oxy-Hb) in bilateral frontal regions during the LFT was significantly smaller in the ED group than in the CTL group. Social insecurity score was positively correlated with the concentration of oxy-Hb in the bilateral orbitofrontal cortex in the ED group but not in the CTL group.ConclusionsThese results suggest that activity of the orbitofrontal cortex is associated with social insecurity and disturbed in patients with ED. Therefore, disturbed orbitofrontal cortex activity may underlie the lack of insight and social isolation that is characteristic of patients with ED.
Highlights
Functional neuroimaging techniques are widely used to elucidate changes in brain activity, and various questionnaires are used to investigate psychopathological features in patients with eating disorders (ED)
body mass index (BMI) at the time of near-infrared spectroscopy (NIRS) measurements was significantly lower in the ED group than in the CTL group (Table 1)
letter fluency task (LFT) performance, Beck Depression Inventory (BDI), and Eating Disorder Inventory-2 (EDI-2) score LFT performance was significantly better in the ED group than in the CTL group (Table 1)
Summary
Functional neuroimaging techniques are widely used to elucidate changes in brain activity, and various questionnaires are used to investigate psychopathological features in patients with eating disorders (ED). Few studies have examined the association between brain activity and social relationships in patients with ED, in patients with extremely low body weight. Patients with ED with extremely low body weight often pose a serious clinical problem, there are few studies of this population. The portability, compactness, and non-invasive features of near-infrared spectroscopy (NIRS) make it an ideal tool with which to study functional brain activity in patients with ED. Schizophrenia, and bipolar disorder have been studied using NIRS, and their characteristic time courses of oxy-Hb changes in the frontal lobe have been investigated [8,9,10]. Uehara et al (2007) did not evaluate the relevance of clinical symptoms [11], Suda et al (2010) excluded patients with body mass index (BMI) less than 14.5 kg/m2 to exclude the effect of malnutrition [12], Nagamitsu et al (2011) studied children [13], and Sutoh et al (2013) studied patients with AN with relatively high BMI (mean ± SD, 17.0 ± 3.1 kg/m2) [14]
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