Neural substrates of anorexia nervosa patient’s deficits to decode emotional information

PURPOSE: The aim of the study was to define specific substrates of pathological behaviour patterns by analysing cortical activity using functional magnetic resonance imaging (fMRI) during an emotional processing task. METHODS: In a sample of N = 11 adolescent patients with AN (16.36 years, SD ± 1.36) and N = 11 age-matched controls, we performed a functional MRI study to detect BOLD signal changes in a 3 T MRI scanner while presenting emotional facial stimuli. RESULTS: Young people with AN presented with a generally reduced cortical activation pattern in key areas of emotion recognition for happy and fearful faces. Areas essential for control of social behaviour were associated with symptoms of depression. CONCLUSION: Obviously, there are already indications of cortical patterns in young affected persons, which indicate a changed emotional reaction to potentially aversive stimuli in the sense of a changed top-down process of emotion avoidance. Thus, the current study provides further evidence that the disorder of anorexia nervosa is closely related to deficits in emotion processing in the early course of ontogenesis. Depressive symptoms might additionally trigger pathological behavior. Due to the small sample size, the data should be considered preliminary and require further validation. LEVEL OF EVIDENCE: Level of evidence III: case–control study.