Neural mechanisms underlying social recognition and theory of mind in adolescent patients with bulimia nervosa and transdiagnostic comparison with anorexia nervosa

  • Introduction: Theory of mind (ToM) is important for social interactions and typical development and has been found to be impaired in patients with anorexia nervosa (AN) and bulimia nervosa (BN). Hypoactivation in frontotemporal brain regions seems to be the underlying neural mechanism in AN while whole-brain analyses in BN are lacking. Methods: We used the well-validated social recognition task fMRI paradigm to assess ToM in a total of 72 female adolescents (16 BN, 18 AN and 38 matched healthy controls [HC]). Results: Compared to HCBN, patients with BN showed hyperactivity during ToM-activity in the right frontal pole, middle temporal gyrus and left temporal pole and differed fundamentally from hypoactivation in these regions observed in patients with AN before and after short-term weight rehabilitation. Interaction and overlap analyses confirmed that similar regions were affected in opposite directions in both diseases. Hyperactivations in BN in the right middle temporal gyrus and right frontal pole were associated with clinical BN-severity markers binging and purging frequency. Discussion: The hyperactivation in BN suggest different underlying neural mechanisms for ToM compared to AN. Hyperactivity might correspond to a different but also ineffective cognitive style in patients with BN when approaching social interactions. These important transdiagnostic differences are relevant for future brain-targeted therapeutic approaches.
Author:Ruan Vanessa AndeORCiD, Arne Hartz, Manuel HueckGND, Brigitte DahmenORCiDGND, Georg von PolierORCiDGND, Beate Herpertz-DahlmannORCiDGND, Kerstin KonradORCiDGND, Martin Schulte-RütherORCiD, Jochen SeitzORCiDGND
Parent Title (English):European eating disorders review
Place of publication:Chichester
Document Type:Article
Date of Publication (online):2022/06/14
Date of first Publication:2022/06/14
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2023/12/04
Tag:anorexia nervosa; bulimia nervosa; eating disorders; social recognition; theory of mind
Page Number:15
First Page:486
Last Page:500
Open Access funding enabled and organized by Projekt DEAL.
The data that support the findings are available upon request from to the Data-Access Committee of Department of Child and Adolescent Psychiatry, University Hospital Aachen at (due to sensitive patient data not publicly available).
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - CC BY-NC - Namensnennung - Nicht kommerziell 4.0 International