Abstract
Anorexia nervosa (AN) is an eating disorder with increasing prevalence in childhood and adolescence. Sympathetic dysregulation is supposed to be the underlying mechanism of increased cardiovascular risk in AN. Thus, we assess the electrodermal activity (EDA) as a non-invasive index of sympathetic cholinergic activity using linear and nonlinear analysis in adolescent AN with the aim of detecting potential biomarkers for AN-linked cardiovascular risk. We examined 25 adolescent girls with AN and 25 age-matched controls. EDA was continuously recorded during a 5-min resting phase. Evaluated parameters were: time-domain (skin conductance level, non-specific skin conductance responses), frequency-domain (EDA in very low, low, sympathetic, high and very high frequency bands) and nonlinear (approximate, sample, symbolic information entropies, detrended fluctuation analysis (DFA)) parameters of EDA and peripheral skin temperature. Our findings revealed lower EDA values indicating a decrease in the sympathetic nervous activity in female adolescents with the acute phase of AN. Further, we found higher nonlinear index DFA in AN vs. controls. We assumed that nonlinear index DFA could provide novel and independent information on the complex sympathetic regulatory network. We conclude that the parameters of complex EDA analysis could be used as sensitive biomarkers for the assessment of sympathetic cholinergic dysregulation as a risk factor for AN-linked cardiovascular morbidity.
Highlights
Anorexia nervosa (AN) is one of the most frequent eating disorders with the highest morbidity and mortality among intake malfunctions [1,2]
Frequency (EDA-VLF and electrodermal activity (EDA)-Symp) analysis were significantly lower, indicating insufficient sympathetic cholinergic activity already in adolescent anorexia nervosa; (2) in contrast, the index of Detrended fluctuation analysis (DFA)–α2 showed a different pattern compared to the time and spectral EDA characteristics—it was increased in anorectic patients providing independent and novel information related to altered complexity in sympathetic cholinergic regulatory network in anorexia; (3) correlation analysis revealed that body mass index (BMI) is positively associated with skin conductance level (SCL) and PT indicating possible alteration of sympathetically mediated and thermoregulatory mechanisms in AN, which could be induced by extensive reduction in body weight
Our study revealed decreased time and spectral indices of EDA indicating sympathetic underactivity in never-treated AN presenting at adolescent age
Summary
Anorexia nervosa (AN) is one of the most frequent eating disorders with the highest morbidity and mortality among intake malfunctions [1,2]. Patients with AN are characterised by low weight as a result of the restriction of food intake, fear of weight gain, and distortion of self-image, including fear of being or becoming fat [3,4]. Rates of lifetime prevalence of AN range from 1.4% to 3.3% in. Sci. 2020, 10, 4514 women [5]. AN mainly presents in mid- to late adolescence, its occurrence in childhood and early adolescence is increasing [6]
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