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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:valdo.ricca@unifi.it (V. Ricca).
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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

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