Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-22T18:03:30.004Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  15 April 2020

G. Castellini ,
C. Polito ,
E. Bolognesi ,
A. D’Argenio ,
A. Ginestroni ,
M. Mascalchi ,
G. Pellicanò ,
L.N. Mazzoni ,
F. Rotella  and
C. Faravelli
...Show all authors
G. Castellini
Affiliation:
Psychiatric Unit, Department of Neuropsychiatric Sciences, University of Florence, Largo Brambilla 3, 50134Firenze, Italy
C. Polito
Affiliation:
Nuclear Medicine Unit, Department of Clinical Physiopathology, University of Florence, Largo Brambilla 3, 50134Firenze, Italy
E. Bolognesi
Affiliation:
Psychiatric Unit, Department of Neuropsychiatric Sciences, University of Florence, Largo Brambilla 3, 50134Firenze, Italy
A. D’Argenio
Affiliation:
Radiodiagnostic Section, Department of Clinical Physiopathology, University of Florence, Largo Brambilla 3, 50134Firenze, Italy
A. Ginestroni
Affiliation:
Radiodiagnostic Section, Department of Clinical Physiopathology, University of Florence, Largo Brambilla 3, 50134Firenze, Italy
M. Mascalchi
Affiliation:
Radiodiagnostic Section, Department of Clinical Physiopathology, University of Florence, Largo Brambilla 3, 50134Firenze, Italy
G. Pellicanò
Affiliation:
Radiodiagnostic Section, Department of Clinical Physiopathology, University of Florence, Largo Brambilla 3, 50134Firenze, Italy
L.N. Mazzoni
Affiliation:
Section of Health Physics, Azienda Ospedaliero-Universitaria Careggi, 50134Florence, Italy
F. Rotella
Affiliation:
Psychiatric Unit, Department of Neuropsychiatric Sciences, University of Florence, Largo Brambilla 3, 50134Firenze, Italy
C. Faravelli
Affiliation:
Department of Psychology, University of Florence, Via di San Salvi 12, 50135Firenze, Italy
A. Pupi
Affiliation:
Nuclear Medicine Unit, Department of Clinical Physiopathology, University of Florence, Largo Brambilla 3, 50134Firenze, Italy
V. Ricca*
Affiliation:
Psychiatric Unit, Department of Neuropsychiatric Sciences, University of Florence, Largo Brambilla 3, 50134Firenze, Italy
*
*Corresponding author. Psychiatric Unit, Department of Neuropsychiatric Sciences, Florence University School of Medicine, Largo Brambilla 3, 50134, Florence, Italy. Tel.: +390557947487; fax: +39055572740. E-mail address:[email protected] (V. Ricca).
Get access

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.

Keywords

Anorexia nervosaBody imageEating disordersFunctional magnetic resonance imaging
Type
Original article
Information
European Psychiatry , Volume 28 , Issue 7 , September 2013 , pp. 427 - 435
Copyright
Copyright © European Psychiatric Association

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association Diagnostic and statistical manual for mental disorders, 4th edWashington, DC: American Psychiatric Press; 1994.Google Scholar
Beato-Fernández, L, Rodríguez-Cano, T, García-Vilches, I, García-Vicente, A, Poblete-García, V, Castrejon, AS, et al.Changes in regional cerebral blood flow after body image exposure in eating disorders. Psychiatry Res 2009;171(2):129–137.CrossRefGoogle ScholarPubMed
Brooks, SJ, O’Daly, OG, Uher, R, Friederich, HC, Giampietro, V, Brammer, M, et al.Differential neural responses to food images in women with bulimia versus anorexia nervosa. PLoS One 2011;6(7):e22259.CrossRefGoogle ScholarPubMed
Clark, VP, Keil, K, Maisog, JM, Courtney, S, Ungerleidel, LG, Haxby, JVFunctional magnetic resonance imaging of human visual cortex during face matching: a comparison with positron emission tomography. Neuroimage 1996;4(1):1–15.CrossRefGoogle ScholarPubMed
Coull, JT, Nobre, ACWhere and when to pay attention: the neural systems for directing attention to spatial locations and to time intervals as revealed by both PET and fMRI. J Neurosci 1998;18(18):7426–7435.CrossRefGoogle ScholarPubMed
Cowdrey, FA, Park, RJ, Harmer, CJ, McCabe, CIncreased neural processing of rewarding and aversive food stimuli in recovered anorexia nervosa. Biol Psychiatry 2011;70(8):736–743.CrossRefGoogle ScholarPubMed
Cuzzolaro, M, Vetrone, G, Marano, G, Battacchi, MWBUT, Body Uneasiness Test: a new attitudinal body image scale. Psichiatria dell’infanzia e dell’adolescenza 1999;66:417–428.Google Scholar
Downing, PE, Jiang, Y, Shuman, M, Kanwisher, NA cortical area selective for visual processing of the human body. Science 2001;293(5539):2470–2473.CrossRefGoogle ScholarPubMed
Duncan, J, Owen, AMCommon regions of the human frontal lobe recruited by diverse cognitive demands. Trends Neurosci 2000;23(10):475–483.CrossRefGoogle ScholarPubMed
Fairburn, CG, Beglin, SJAssessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord 1994;16(4):363–370.Google ScholarPubMed
Fairburn, CG, Harrison, PJEating disorders. Lancet 2003;361(9355):407–416.CrossRefGoogle ScholarPubMed
First, MB, Spitzer, RL, Gibbon, M, Williams, JBWStructured Clinical Interview for DSM-IV Axis I Disorders-Patient Edition (SCID-I/P version 2.0). New York: Biometrics Research Department, New York State Psychiatric Institute; 1995.Google Scholar
Fossati, P, Hevenor, SJ, Graham, SJ, Grady, C, Keightley, ML, Craik, F, et al.In search of the emotional self: an FMRI study using positive and negative emotional words. Am J Psychiatry 2003;160(11):1938–1945.CrossRefGoogle ScholarPubMed
Friederich, HC, Uher, R, Brooks, S, Giampietro, V, Brammer, M, Williams, SCR, et al.I’m not as slim as that girl: neural bases of body shape self-comparison to media images. NeuroImage 2007;37:674–681.CrossRefGoogle Scholar
Friederich, HC, Brooks, S, Uher, R, Campbell, IC, Giampietro, V, Brammer, M, et al.Neural correlates of body dissatisfaction in anorexia nervosa. Neuropsychologia 2010;48:2878–2885.CrossRefGoogle ScholarPubMed
Friederich, HC, Walther, S, Bendszus, M, Biller, A, Thomann, P, Zeigermann, S, et al.Grey matter abnormalities within cortico-limbic-striatal circuits in acute and weight-restored anorexia nervosa patients. Neuroimage 2012;59(2):1106–1113. 16.CrossRefGoogle ScholarPubMed
Friston, KJ, Holmes, AP, Poline, JB, Grasby, PJ, Williams, SC, Frackowiak, RS, et al.Analysis of fMRI time-series revisited. Neuroimage 1995;2(1):45–53.CrossRefGoogle ScholarPubMed
Garner, DM, Dalle Grave, RTerapia cognitivo comportamentale dei disturbi dell’alimentazione. Verona Giugno: Positive Press; 1999.Google Scholar
Garner, MD, Cash, T.F.Pruzinsky, T.Body Image, A Handbook of Theory, Research, and Clinical Practice. 72 Spring Street, New York, NY: The Guilford Press A Division of Guilford Publications, Inc; 2002. p. 10012.Google Scholar
Grunwald, M, Ettrich, C, Krause, W, Assmann, B, Dähne, A, Weiss, T, et al.Deficits in haptic perception and right parietal theta power changes in patients with anorexia nervosa before and after weight gain. Int J Eat Disord 2001;29(4):417–428.CrossRefGoogle ScholarPubMed
Hrabosky, JI, Cash, TF, Veale, D, Neziroglu, F, Soll, EA, Garner, DM, et al.Multidimensional body image comparisons among patients with eating disorders, body dysmorphic disorder, and clinical controls: a multisite study. Body Image 2009;6(3):155–163.CrossRefGoogle ScholarPubMed
Johnson, S, Baxter, L, Wilder, L, Heiserman, J, Pipe, J, Prigatano, GNeural correlates of self reflection. Brain 2002;125(Pt 8):1808–1814.CrossRefGoogle ScholarPubMed
Kanwisher, N, McDermott, J, Chun, MMThe fusiform face area: a module in human extrastriate cortex specialized for face perception. J Neurosci 1997;17(11):4302–4311.CrossRefGoogle ScholarPubMed
Kaye, WH, Fudge, JL, Paulus, MNew insights into symptoms and neurocircuit function of anorexia nervosa. Nat Rev Neurosci 2009;10(8):573–584.CrossRefGoogle ScholarPubMed
Kelley, WM, Macrae, CN, Wyland, CL, Caglar, S, Inati, S, Heatherton, TFFinding the self? An event-related fMRI study. J Cogn Neurosci 2002;14(5):785–794.CrossRefGoogle ScholarPubMed
Kurosaki, M, Shirao, N, Yamashita, H, Okamoto, Y, Yamawaki, SDistorted images of one's own body activates the prefrontal cortex and limbic/paralimbic system in young women: a functional magnetic resonance imaging study. Biol Psychiatry 2006;59(4):380–386.CrossRefGoogle ScholarPubMed
Levesque, J, Eugène, F, Joannette, Y, Pasquette, V, Mensour, B, Beaudoin, GNeural Circuitry underlying voluntary suppression of sadness. Biol Psychiatry 2003;53(6):502–510.CrossRefGoogle ScholarPubMed
Marsh, R, Maia, TV, Peterson, BSFunctional disturbances within frontostriatal circuits across multiple childhood psychopathologies. Am J Psychiatry 2009;166(6):664–674.CrossRefGoogle ScholarPubMed
McCrea, SMA functional magnetic resonance imaging study of the body schema using full human line drawing figures in an online verbal naming and localization task of single body part words. Behav Brain Res 2007;180(2):235–240.CrossRefGoogle Scholar
McGlynn, SM, Schacter, DLUnawareness of deficits in neuropsychological syndromes. J Clin Exp Neuropsychol 1989;11(2):11143–11205.CrossRefGoogle ScholarPubMed
Merboldt, KD, Fransson, P, Bruhn, H, Frahm, JFunctional MRI of the human amygdala? Neuroimage 2001;14(2):253–257.CrossRefGoogle ScholarPubMed
Miller, EK, Cohen, JDAn integrative theory of prefrontal cortex function. Annu Rev Neurosci 2001;24:167–202.CrossRefGoogle ScholarPubMed
Minnebusch, DA, Daum, INeuropsychological mechanisms of visual face and body perception. Neurosci Biobehav Rev 2009;33(7):1133–1144.CrossRefGoogle ScholarPubMed
Miyake, Y, Okamoto, Y, Onoda, K, Kurosaki, M, Shirao, N, Okamoto, Y, et al.Brain activation during the perception of distorted body images in eating disorders. Psychiatry Res 2010;30(3):183–192.CrossRefGoogle Scholar
Mohr, HM, Röder, C, Zimmermann, J, Hummel, D, Negele, A, Grabhorn, RBody image distortions in bulimia nervosa: investigating body size overestimation and body size satisfaction by fMRI. Neuroimage 2011;56(3):1822–1831.CrossRefGoogle ScholarPubMed
Mohr, HM, Zimmermann, J, Röder, C, Lenz, C, Overbeck, G, Grabhorn, RSeparating two components of body image in anorexia nervosa using fMRI. Psychol Med 2010;40(9):1519–1529.CrossRefGoogle ScholarPubMed
Mond, JM, Hay, PJ, Rodgers, B, Owen, C, Beumont, PJValidity of the Eating Disorder Examination Questionnaire (EDE-Q) in screening for eating disorders in community samples. Behav Res Ther 2004;42(5):551–567.CrossRefGoogle ScholarPubMed
Pietrini, F, Castellini, G, Ricca, V, Polito, C, Pupi, A, Faravelli, CFunctional neuroimaging in anorexia nervosa: a clinical approach. Eur Psychiatry 2011;26(3):176–182.CrossRefGoogle ScholarPubMed
Roberts, ME, Tchanturia, K, Stahl, D, Southgate, L, Treasure, JA systematic review and meta-analysis of set-shifting ability in eating disorders. Psychol Med 2007;37(8):1075–1084.CrossRefGoogle ScholarPubMed
Rolls, ET, Grabenhorst, FThe orbitofrontal cortex and beyond: from affect to decision-making. Prog Neurobiol 2008;86(3):216–244.CrossRefGoogle ScholarPubMed
Schmitz, TW, Kawahara-Baccus, TN, Johnson, SCMetacognitive evaluation, self-relevance, and the right prefrontal cortex. Neuroimage 2004;22(2):941–947.CrossRefGoogle ScholarPubMed
Schwoebel, J, Coslett, BEvidence for multiple, distinct representations of the human body. J Cogn Neurosci 2005;17(4):543–553.CrossRefGoogle ScholarPubMed
Shimada, S, Hiraki, K, Oda, IThe parietal role in the sense of self-ownership with temporal discrepancy between visual and proprioceptive feedbacks. Neuroimage 2005;24(4):1225–1232.CrossRefGoogle ScholarPubMed
Smeets, MA, Kosslyn, SMHemispheric differences in body image in anorexia nervosa. Int J Eat Disord 2001;29(4):409–416.CrossRefGoogle ScholarPubMed
Stein, MB, Simmons, AN, Feinstein, JS, Paulus, MPIncreased amygdala and insula activation during emotion processing in anxietyprone subjects. Am J Psychiatry 2007;164:318–327.CrossRefGoogle ScholarPubMed
Suchan, B, Busch, M, Schulte, D, Grönermeyer, D, Herpertz, S, Vocks, SReduction of gray matter density in the extrastriate body area in women with anorexia nervosa. Behav Brain Res 2010;206:63–67.CrossRefGoogle ScholarPubMed
Talairach, T, Thournoux, PA coplanar stereotactic atlas of the human brain. Thieme Verlag: Stuttgart; 1988.Google Scholar
Thompson, JK, Heinberg, LJ, Altabe, M, Tantleff-Dunn, SExacting beauty. Washington, DC: American Psychological Association; 1999.Google Scholar
Tremblay, L, Schultz, WRelative reward preference in primate orbitofrontal cortex. Nature 1999;398(6729):704–708.CrossRefGoogle ScholarPubMed
Uher, R, Murphy, T, Friederich, HC, Dalgleish, T, Brammer, MJ, Giampietro, V, et al.Functional neuroanatomy of body shape perception in healthy and eating-disordered women. Biol Psychiatry 2005;58(2):990–997.CrossRefGoogle ScholarPubMed
Vocks, S, Busch, M, Grönemeyer, D, Schulte, D, Herpertz, S, Suchan, BNeural correlates of viewing photographs of one's own body and another woman's body in anorexia and bulimia nervosa: an fMRI study. J Psychiatry Neurosci 2010;35(3):163–176.CrossRefGoogle Scholar
Vocks, S, Legenbauer, T, Wächter, A, Wucherer, M, Kosfelder, JWhat happens in the course of body exposure? Emotional, cognitive, and physiological reactions to mirror confrontation in eating disorders. J Psychosom Res 2007;62(2):231–239.CrossRefGoogle ScholarPubMed
Wagner, A, Ruf, M, Braus, DF, Schmidt, MHNeuronal activity changes and body image distortion in anorexia nervosa. Neuroreport 2003;14(17):2193–2197.CrossRefGoogle ScholarPubMed
Zastrow, A, Kaiser, S, Stippich, C, Walther, S, Herzog, W, Tchanturia, K, et al.Neural correlates of impaired cognitive – behavioral flexibility in anorexia nervosa. Am J Psychiatry 2009;166(5):608–616.CrossRefGoogle ScholarPubMed
Zysset, S, Huber, O, Ferstl, E, von Cramon, DYThe anterior frontomedian cortex and evaluative judgment: an fMRI study. Neuroimage 2002;15(4):983–991.CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.