Looking at my body. Similarities and differences between anorexia nervosa patients and controls in body image visual processing

• Published in: European psychiatry Vol. 28; no. 7; pp. 427 - 435
• Main Authors: Castellini, G, Polito, C, Bolognesi, E, D’Argenio, A, Ginestroni, A, Mascalchi, M, Pellicanò, G, Mazzoni, L.N, Rotella, F, Faravelli, C, Pupi, A, Ricca, V
• Format: Journal Article
• Language: English
• Published: Paris Elsevier SAS 01.09.2013; Elsevier
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Anorexia nervosa; Anorexia Nervosa - physiopathology; Anorexia Nervosa - psychology; Biological and medical sciences; Body Image; Brain - physiopathology; Eating behavior disorders; Eating disorders; Female; Functional magnetic resonance imaging; Functional Neuroimaging; Humans; Image Processing, Computer-Assisted; Internal Medicine; Magnetic Resonance Imaging; Medical sciences; Photic Stimulation; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Self Concept; Surveys and Questionnaires; Functional magnetic resonance imaging; Anorexia nervosa; Body image; Eating disorders; Human; Image processing; Central nervous system; Cognition; Eating disorder; Encephalon; Vision; Information processing; Perception; Body; Comparative study
• ISSN: 0924-9338; 1778-3585
• DOI: 10.1016/j.eurpsy.2012.06.006

Abstract Background Body image distortion is a core symptom of eating disorders. Functional magnetic resonance imaging (fMRI) studies on body image processing, described different patterns of neural response, mainly involving the inferior and superior parietal lobules, and the dorsolateral prefrontal cortex (DLPFC), with conflicting results. Methods The neural response to the view of their own body pictures (normal size and distorted) was evaluated in 18 female anorexia nervosa (AN) restricting type patients, and in 19 healthy female subjects (HC) using fMRI. Clinical assessment was performed by means of the structured clinical interview for DSM-IV and self-reported questionnaires. Results In response to the body image distortion, patients and controls showed an inverse pattern of activation, with the widest extent of activation in the oversize condition in AN, while in the undersize condition in HC. AN and HC showed a similar pattern of neural response to the view of their own body, with an increased activation in the extrastriate body area, superior and inferior parietal lobule and prefrontal areas, although the extent of activation in HC was more limited as compared with AN patients. Increased activity in AN patients, compared with HC, was observed in the DLPFC in response to the oversized body picture and a significant correlation was found in AN patients between DLPFC activation and eating disorder psychopathology. Conclusions Our findings suggest the existence of a continuum from normalcy to pathology in neural response to body image, and confirm the clinical relevance of body image distortion in AN, reinforcing the key role of attentive, executive and self-evaluation networks in AN visual processing of own distorted body image.