Abnormalities in emotional functioning is one of the key features of eating disorders (ED), such as anorexia nervosa (AN) and bulimia nervosa (BN). These patients show increased levels of alexithymia, problems understanding one's own emotion, which has been simultaneously, associated with difficulties in recognizing others emotions.

In this study, we were interested in the neuronal mechanism of emotion processing from both, self and others perspective, and we aimed to compare the underlying brain activations in eating disorder patients and healthy controls.

A sample of 12 women with ED (10 AN, 2 BN) and 11 age and education matched healthy controls (HC) underwent fMRI examination while performing emotion recognition task, which requires either inferring mental states of depicted figures, or assessing participant's own feelings evoked by the pictures.

The task activated superior temporal sulcus bilaterally, left temporo-parietal junction, and medial prefrontal cortex. Those regions have been consistently identified in literature to be active while thinking about other people. Interestingly, group differences analysis revealed that ED patients group showed higher activations in right supramarginal gyrus, compared to HC group. This structure is critical to overcome egocentricity bias in social judgment. Contrary to ED patients, HC group showed greater activations in cingulate gyrus and insula, regions involved in emotion formation and processing.

We hypothesize that ED patients tend to suppress their own perspective while thinking about emotional states of others more strongly than HC, probably due to alexithymia and the lack of awareness of their mental states.

The authors have not supplied their declaration of competing interest.