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Neurophysiological correlates of disorder-related autobiographical memory in anorexia nervosa

Published online by Cambridge University Press:  18 June 2021

Valentin Terhoeven
Affiliation:
Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
Christoph Nikendei
Affiliation:
Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
Sandra Faschingbauer
Affiliation:
Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
Julia Huber
Affiliation:
Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
Kymberly D. Young
Affiliation:
The Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
Martin Bendszus
Affiliation:
Department of Neuroradiology, University Hospital of Heidelberg, Heidelberg, Germany
Wolfgang Herzog
Affiliation:
Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
Hans-Christoph Friederich
Affiliation:
Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
Joe J. Simon*
Affiliation:
Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
*Corresponding
Author for correspondence: Joe J. Simon, E-mail: joe.simon@med.uni-heidelberg.de

Abstract

Background

Anorexia nervosa (AN) is characterized by an overgeneralization of food/body-related autobiographical memories (AM). This is regarded as an emotion regulation strategy with adverse long-term effects implicated in disorder maintenance and treatment resistance. Therefore, we aimed to examine neural correlates of food/body-related AM-recall in AN.

Methods

Twenty-nine female patients with AN and 30 medication-free age-sex-matched normal-weight healthy controls (HC) underwent functional magnetic resonance imaging while recalling AMs in response to food/body-related and neutral cue words. To control for general knowledge retrieval, participants engaged in a semantic generation and riser detection task.

Results

In comparison to HC, patients with AN generated fewer and less specific AMs in response to food/body-related words, but not for neutral cue words. Group comparisons revealed reduced activation in regions associated with self-referential processing and memory retrieval (precuneus and angular gyrus) during the retrieval of specific food/body-related AM in patients with AN. Brain connectivity in regions associated with memory functioning and executive control was reduced in patients with AN during the retrieval of specific food/body-related AM. Finally, resting-state functional connectivity analysis revealed no differences between groups, arguing against a general underlying disconnection of brain networks implicated in memory and emotional processing in AN.

Conclusions

These results indicate impaired neural processing of food/body-related AM in AN, with a reduced involvement of regions involved in self-referential processing. Our findings are discussed as possible neuronal correlates of emotional avoidance in AN and provide new insights of AN-pathophysiology underscoring the importance of targeting dysfunctional emotion regulation strategies during treatment.

Type
Original Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

*

Valentin Terhoeven and Christoph Nikendei contributed equally.

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