Abstract
Social–emotional processing difficulties have been reported in Anorexia Nervosa (AN), yet the neural correlates remain unclear. Previous neuroimaging work is sparse and has not used functional connectivity paradigms to more fully explore the neural correlates of emotional difficulties. Fifty‐seven acutely unwell AN (AAN) women, 60 weight‐recovered AN (WR) women and 69 healthy control (HC) women categorised the gender of a series of emotional faces while undergoing Functional Magnetic Resonance Imaging. The mean age of the AAN group was 19.40 (2.83), WR 18.37 (3.59) and HC 19.37 (3.36). A whole brain and psychophysical interaction connectivity approach was used. Parameter estimates from significant clusters were extracted and correlated with clinical symptoms. Whilst no group level differences in whole brain activation were demonstrated, significant group level functional connectivity differences emerged. WR participants showed increased connectivity between the bilateral occipital face area and the cingulate, precentral gyri, superior, middle, medial and inferior frontal gyri compared to AAN and HC when viewing happy valenced faces. Eating disorder symptoms and parameter estimates were positively correlated. Our findings characterise the neural basis of social–emotional processing in a large sample of individuals with AN.
Highlights
Anorexia Nervosa (AN) is a life-threatening eating disorder, characterised by low body mass index (BMI) and intense fear of weight gain, with undue influence placed on body shape and weight (APA, 2013)
acutely unwell AN (AAN) was defined as having a concurrent diagnosis of AN as defined by DSM-5 criteria, with a percentage of median BMI of less than 85% for participants aged under 18 or a BMI of less than 18.5 for participants aged over 18
The aim of this study was to examine the neural underpinnings of social–emotional difficulties in AN, using a similar FMRI acquisition and analysis method to Fonville and colleagues
Summary
Anorexia Nervosa (AN) is a life-threatening eating disorder, characterised by low body mass index (BMI) and intense fear of weight gain, with undue influence placed on body shape and weight (APA, 2013). Despite AN having a significant burden on health outcomes (Agh et al, 2016), its neurobiology is poorly understood, especially when compared to other severe psychiatric disorders (Berner et al, 2019; Kaye, Wierenga, Bailer, Simmons, & BischoffGrethe, 2013). Despite this uncertainty, models of AN have characterised a range of social–emotional difficulties which may constitute a possible maintenance mechanism in AN, as well as a barrier to treatment. Fully characterising social–emotional difficulties on a neural level would contribute to a greater understanding of the biological mechanisms possibly causing and maintaining the disorder and inform treatment options
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