Women with Anorexia Nervosa do not show altered tactile localization compared to healthy controls

Abstract Background Anorexia nervosa (AN) is a serious psychosomatic disorder with unclear pathomechanisms. Metabolic dysregulation is associated with disruption of redox homeostasis that might play a pivotal role in the development of AN. The aim of our study was to assess oxidative status and carbonyl stress in plasma, urine and saliva of patients with AN and healthy controls. Methods Plasma, spot urine, and saliva were collected from 111 girls with AN (aged from 10 to 18 years) and from 29 age-matched controls. Markers of oxidative stress and antioxidant status were measured using spectrophotometric and fluorometric methods. Results Plasma advanced oxidation protein products (AOPP) and advanced glycation end products (AGEs) were significantly higher in patients with AN than in healthy controls (by 96, and 82%, respectively). Accordingly, urinary concentrations of AOPP and fructosamines and salivary concentrations of AGEs were higher in girls with AN compared with controls (by 250, and 41% in urine; by 92% in saliva, respectively). Concentrations of thiobarbituric acid reactive substances (TBARS) in saliva were 3-times higher in the patients with AN than in the controls. Overall antioxidants were lower in plasma of girls with AN compared to the controls, as shown by total antioxidant capacity and ratio of reduced and oxidized glutathione (by 43, and 31%, respectively). Conclusions This is the first study assessing wide range of markers of oxidative status in plasma, urine and saliva of the patients with AN. We showed that both, higher levels of markers of oxidative stress and lower antioxidants play a role in redox disruption. Restoration of redox homeostasis might be of the clinical relevance

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Overcoming limitations of self-report: an assessment of fear of weight gain in anorexia nervosa and healthy controls using implicit association tests

Journal of Eating Disorders ◽

10.1186/s40337-021-00379-8 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Tiana Borgers ◽

Nathalie Krüger ◽

Silja Vocks ◽

Jennifer J. Thomas ◽

Franziska Plessow ◽

...

Keyword(s):

Anorexia Nervosa ◽

Weight Gain ◽

Normal Weight ◽

Self Report ◽

Healthy Controls ◽

Drive For Thinness ◽

Implicit Association ◽

Association Tests ◽

Implicit Assessment ◽

Fear Of Weight Gain

Abstract Background Fear of weight gain is a characteristic feature of anorexia nervosa (AN), and reducing this fear is often a main target of treatment. However, research shows that 20% of individuals with AN do not report fear of weight gain. Studies are needed that evaluate the centrality of fear of weight gain for AN with a method less susceptible to deception than self-report. Methods We approximated implicit fear of weight gain by measuring implicit drive for thinness using implicit association tests (IATs). We asked 64 participants (35 AN, 29 healthy controls [HCs]) to categorize statements as pro-dieting vs. non-dieting and true vs. false in a questionnaire-based IAT, and pictures of underweight vs. normal-weight models and positive vs. negative words in a picture-based IAT using two response keys. We tested for associations between implicit drive for thinness and explicitly reported psychopathology within AN as well as group differences between AN and HC groups. Results Correlation analyses within the AN group showed that higher implicit drive for thinness was associated with more pronounced eating disorder-specific psychopathology. Furthermore, the AN group showed a stronger implicit drive for thinness than HCs in both IATs. Conclusion The results highlight the relevance of considering fear of weight gain as a continuous construct. Our implicit assessment captures various degrees of fear of weight gain in AN, which might allow for more individually tailored interventions in the future.

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Antimicrobial peptides in patients with anorexia nervosa: comparison with healthy controls and the impact of weight gain

Scientific Reports ◽

10.1038/s41598-020-79302-1 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Marie-Christin Bendix ◽

Michael Stephan ◽

Mariel Nöhre ◽

Wally Wünsch-Leiteritz ◽

Hagen Schmidt ◽

...

Keyword(s):

Anorexia Nervosa ◽

Weight Gain ◽

Antimicrobial Peptides ◽

Pathogenic Bacteria ◽

Innate Immune ◽

Effect Sizes ◽

Healthy Controls ◽

Clinical Observations ◽

The Impact

AbstractClinical observations show that patients with anorexia nervosa (AN) are surprisingly free from infectious diseases. There is evidence from studies in Drosophila melanogaster that starvation leads to an increased expression of antimicrobial peptides (AMPs). AMPs are part of the innate immune system and protect human surfaces from colonization with pathogenic bacteria, viruses and fungi. We compared the expression of AMPs between patients with AN and healthy controls (HC) and investigated the influence of weight gain. Using a standardized skin rinsing method, quantitative determination of the AMPs psoriasin and RNase 7 was carried out by ELISA. Even though non-significant, effect sizes revealed slightly higher AMP concentrations in HC. After a mean weight gain of 2.0 body mass index points, the concentration of psoriasin on the forehead of patients with AN increased significantly. We could not confirm our hypotheses of higher AMP concentrations in patients with AN that decrease after weight gain. On the contrary, weight gain seems to be associated with increasing AMP concentrations.

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Identifying neuroanatomical signatures of anorexia nervosa: a multivariate machine learning approach

Psychological Medicine ◽

10.1017/s0033291715000768 ◽

2015 ◽

Vol 45 (13) ◽

pp. 2805-2812 ◽

Cited By ~ 15

Author(s):

L. Lavagnino ◽

F. Amianto ◽

B. Mwangi ◽

F. D'Agata ◽

A. Spalatro ◽

...

Keyword(s):

Machine Learning ◽

Anorexia Nervosa ◽

Predictive Accuracy ◽

Third Ventricle ◽

Healthy Controls ◽

Drive For Thinness ◽

Individual Subject ◽

Machine Learning Approach ◽

Scan Data ◽

Selection Operator

BackgroundThere are currently no neuroanatomical biomarkers of anorexia nervosa (AN) available to make clinical inferences at an individual subject level. We present results of a multivariate machine learning (ML) approach utilizing structural neuroanatomical scan data to differentiate AN patients from matched healthy controls at an individual subject level.MethodStructural neuroimaging scans were acquired from 15 female patients with AN (age = 20, s.d. = 4 years) and 15 demographically matched female controls (age = 22, s.d. = 3 years). Neuroanatomical volumes were extracted using the FreeSurfer software and input into the Least Absolute Shrinkage and Selection Operator (LASSO) multivariate ML algorithm. LASSO was ‘trained’ to identify ‘novel’ individual subjects as either AN patients or healthy controls. Furthermore, the model estimated the probability that an individual subject belonged to the AN group based on an individual scan.ResultsThe model correctly predicted 25 out of 30 subjects, translating into 83.3% accuracy (sensitivity 86.7%, specificity 80.0%) (p < 0.001; χ2 test). Six neuroanatomical regions (cerebellum white matter, choroid plexus, putamen, accumbens, the diencephalon and the third ventricle) were found to be relevant in distinguishing individual AN patients from healthy controls. The predicted probabilities showed a linear relationship with drive for thinness clinical scores (r = 0.52, p < 0.005) and with body mass index (BMI) (r = −0.45, p = 0.01).ConclusionsThe model achieved a good predictive accuracy and drive for thinness showed a strong neuroanatomical signature. These results indicate that neuroimaging scans coupled with ML techniques have the potential to provide information at an individual subject level that might be relevant to clinical outcomes.

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The anticipation and perception of affective touch in women with and recovered from Anorexia Nervosa

10.1101/2020.02.23.961367 ◽

2020 ◽

Author(s):

Laura Crucianelli ◽

Benedetta Demartini ◽

Diana Goeta ◽

Veronica Nisticò ◽

Alkistis Saramandi ◽

...

Keyword(s):

Anorexia Nervosa ◽

Reward Processing ◽

Healthy Controls ◽

Top Down ◽

Ct Afferents ◽

Tactile Stimuli ◽

Successful Recovery ◽

Secondary Result ◽

Ct System ◽

Tactile System

AbstractDisruptions in reward processing and anhedonia have long being considered as possible contributors to the aetiology and maintenance of Anorexia nervosa (AN). Recently, interoceptive deficits have also been observed in AN, including reduced tactile pleasure. However, the extent to which this tactile anhedonia is specifically liked to an impairment in a specialized, interoceptive C tactile system originating at the periphery, or a more top-down mechanism in the processing of pleasant tactile stimuli remains debated. Here, we investigated two related hypotheses. First, we examined whether the differences, between patients with AN and healthy controls in the perception of pleasantness of touch stimuli delivered in a CT-optimal manner versus a CT non-optimal manner would also be observed in patients recovered from AN. This is important as tactile anhedonia in acute patients may be the secondary result of prolonged malnutrition, rather than a deficit that contributed to the development of the disorder. Second, we examined whether these three groups would also differ in their top-down, anticipatory beliefs about the perceived pleasantness of different materials touching the skin, and to what degree such top-down beliefs and related impairments in alexithymia and interoceptive sensibility would explain any differences in perceived tactile plesantness. To this end, we measured the anticipated pleasantness of various materials touching the skin and the perceived pleasantness of light, dynamic stroking touches applied to the forearm of 27 women with AN, 24 women who have recovered and 30 healthy controls using C Tactile (CT) afferents-optimal (slow) and non-optimal (fast) velocities. Our results showed that both clinical groups anticipated tactile experiences and rated delivered tactile stimuli as less pleasant than healthy controls, but the latter difference was not related to the CT optimality of the stimulation. Instead, differences in how CT optimal touch were perceived were predicted by differences in top-down beliefs, alexithymia and interoceptive sensibility. Thus, this study concludes that tactile anhedonia in AN is not the secondary result of malnutrition but persists as a trait even after otherwise successful recovery of AN and also it not linked to a bottom-up interoceptive deficit in the CT system, but rather to a learned, defective top-down anticipation of pleasant tactile experiences.

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How adolescents with anorexia nervosa and their parents perceive family functioning?

Journal of Health Psychology ◽

10.1177/1359105315597055 ◽

2016 ◽

Vol 22 (2) ◽

pp. 197-207 ◽

Cited By ~ 13

Author(s):

Fiorenzo Laghi ◽

Sara Pompili ◽

Valeria Zanna ◽

Maria Chiara Castiglioni ◽

Michela Criscuolo ◽

...

Keyword(s):

Anorexia Nervosa ◽

Family Functioning ◽

Adolescent Girls ◽

Family Communication ◽

Family Environment ◽

Family Satisfaction ◽

Healthy Controls ◽

Family Adaptability

This study aims at examining whether adolescent girls diagnosed with anorexia nervosa and their parents differ in perceiving the different aspects of family functioning. Moreover, the discrepancy between adolescent girls and healthy controls on Family Adaptability and Cohesion Evaluation Scales dimensions, family communication, and family satisfaction is investigated. The study includes 36 female anorexia patients and their parents and 36 healthy controls. The results showed a different view between mothers and their daughters with regard to the dimension of rigidity. In addition, girls with anorexia nervosa were less satisfied about family environment and rated their families as less communicative, flexible, cohesive, and more disengaged, compared to controls.

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Hormonal and Body Composition Predictors of Soluble Leptin Receptor, Leptin, and Free Leptin Index in Adolescent Girls with Anorexia Nervosa and Controls and Relation to Insulin Sensitivity

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2003-032251 ◽

2004 ◽

Vol 89 (7) ◽

pp. 3486-3495 ◽

Cited By ~ 93

Author(s):

Madhusmita Misra ◽

Karen K. Miller ◽

Cecilia Almazan ◽

Kavitha Ramaswamy ◽

Avichal Aggarwal ◽

...

Keyword(s):

Insulin Resistance ◽

Body Mass Index ◽

Body Composition ◽

Anorexia Nervosa ◽

Body Fat ◽

Adolescent Girls ◽

Leptin Receptor ◽

Percent Body Fat ◽

Healthy Controls ◽

Soluble Leptin Receptor

Abstract Anorexia nervosa (AN) is associated with very low levels of leptin, a cytokine secreted by adipose tissue and known to suppress appetite. Leptin may play a permissive role in onset of puberty and in resumption of gonadal function in conditions of undernutrition. The soluble leptin receptor (sOB-R) is the main leptin binding protein, and the ratio of serum leptin to sOB-R provides a measure of the free leptin index (FLI), which may be a more accurate determinant of leptin function. Determinants of sOB-R and FLI have not been examined in an adolescent population. We examined levels of sOB-R, leptin, and FLI, and body composition and hormonal determinants of these variables in 23 adolescent girls with AN and 21 healthy adolescent girls of comparable maturity prospectively over 1 yr. Measures of insulin resistance and adiponectin were also examined. We determined changes in levels of sOB-R, leptin, and FLI with weight recovery (defined as an increase in body mass index of ≥10%, n = 11), and with resumption of menstrual cycles (n = 13). Girls with AN had significantly higher levels of sOB-R (P = 0.0008) and significantly lower levels of leptin and FLI (P < 0.0001 for both) than healthy controls, and levels of FLI were reduced more than levels of leptin in girls with AN compared with controls. An inverse correlation was noted between levels of leptin and sOB-R for the group as a whole (r = −0.64, P < 0.0001) but not in girls with AN considered alone. The most important predictor of levels of sOB-R was cortisol in the group as a whole (r = 0.61, P < 0.0001) and in girls with AN considered alone (r = 0.66, P = 0.0008). Other independent predictors of sOB-R levels for the entire group were percent body fat (r = −0.44, P = 0.003) and levels of IGF-I (r = −0.37, P = 0.01). The most important predictors of leptin and FLI were body mass index and percent body fat. An inverse relationship was noted between measures of insulin resistance and sOB-R levels, whereas a positive association was noted between these measures and leptin and FLI. Adiponectin values did not differ in girls with AN compared with healthy controls and did not correlate with sOB-R, leptin, or FLI. Weight recovery resulted in significant decreases in levels of the sOB-R (24.7 ± 1.7 to 17.6 ± 1.2 U/ml, P = 0.004), and increases in levels of leptin (4.4 ± 1.0 to 13.7 ± 2.9 μg/liter, P = 0.02). Resumption of menstrual function, but not weight recovery alone, was associated with significant increases in FLI (0.19 ± 0.04 to 0.50 ± 0.09 μg/U × 10−3, P = 0.02). We demonstrate an increase in levels of sOB-R and a decrease in the FLI in adolescent girls with AN, and also demonstrate that cortisol is the most important predictor of levels of sOB-R in this condition. Levels of leptin and FLI, conversely, are primarily predicted by body composition. Weight recovery is associated with a decrease in sOB-R and an increase in leptin. Resumption of menses is associated with significant increases in the FLI, suggesting that free leptin may be an important determinant of menstrual recovery.

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The links between body dysmorphic disorder and eating disorders

European Psychiatry ◽

10.1016/s0924-9338(00)00398-9 ◽

2000 ◽

Vol 15 (5) ◽

pp. 302-305 ◽

Cited By ~ 32

Author(s):

J. Rabe-Jablonska Jolanta ◽

M. Sobow Tomasz

Keyword(s):

Eating Disorders ◽

Anorexia Nervosa ◽

Eating Disorder ◽

Mental Disorders ◽

Bulimia Nervosa ◽

Life Events ◽

Affective Disorders ◽

Body Dysmorphic Disorder ◽

Control Group ◽

Healthy Controls

SummaryThe aim of the study was to search for a body dysmorphic disorder (BDD) period preceding the symptoms meeting the criteria of either anorexia or bulimia nervosa, and an evaluation of the prevalence of BDD symptoms in a control group of girls without any eating disorder. Ninety-three girls (12–21 years old) were included in the study (36 with anorexia nervosa, 17 with bulimia nervosa and 40 healthy controls). The Structured Clinical Interview (SCID), including the BDD module, and a novel questionnaire (for the presence of preceding life events) were used. We found the symptoms of BDD in 25% of anorexia nervosa sufferers for at least six months before observing a clear eating disorder picture. Moreover, other mental disorders were also present among these patients. The results may support the idea that BDD and anorexia nervosa both belong to either OCD or affective disorders spectra.

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