• The Emotional Face of Anorexia Nervosa: The Neural Correlates of Emotional Processing

      Halls, Daniel; Leslie, Monica; Leppanen, Jenni; Sedgewick, Felicity; Surguladze, Simon; Fonville, Leon; Lang, Katie; Simic, Mima; Nicholls, Dasha; Williams, Steven; et al.
      Social-emotional processing difficulties have been reported in Anorexia Nervosa (AN), yet the neural correlates remain unclear. Previous neuroimaging work is sparse and has not used functional connectivity paradigms to more fully explore the neural correlates of emotional difficulties. Fifty-seven acutely unwell AN (AAN) women, 60 weight-recovered AN (WR) women and 69 healthy control (HC) women categorised the gender of a series of emotional faces while undergoing Functional Magnetic Resonance Imaging. The mean age of the AAN group was 19.40 (2.83), WR 18.37 (3.59) and HC 19.37 (3.36). A whole brain and psychophysical interaction connectivity approach was used. Parameter estimates from significant clusters were extracted and correlated with clinical symptoms. Whilst no group level differences in whole brain activation were demonstrated, significant group level functional connectivity differences emerged. WR participants showed increased connectivity between the bilateral occipital face area and the cingulate, precentral gyri, superior, middle, medial and inferior frontal gyri compared to AAN and HC when viewing happy valenced faces. Eating disorder symptoms and parameter estimates were positively correlated. Our findings characterise the neural basis of social-emotional processing in a large sample of individuals with AN.
    • The Neural Correlates of a Central Coherence Task in Young Women with Anorexia Nervosa

      Leslie, Monica; Halls, Daniel; Leppanen, Jenni; Sedgewick, Felicity; Lang, Katie; Fonville, Leon; Simic, Mima; Mandy, William; Nicholls, Dasha; Williams, Steven; et al. (Wiley, 2021-07-18)
      Objective: Heightened detail-processing and low levels of central coherence are common in individuals with anorexia nervosa (AN) and predict poorer prognosis. However, it is unclear whether these processing styles predate the disorder or, rather, emerge during later stages of AN. The current study aimed to address this question by investigating central coherence, and the neural correlates of central coherence, in a sample of young women with AN with shorter duration of illness than previous studies recruiting adult samples. Methods: We recruited 186 participants, including: 73 young women with AN, 45 young women weight-recovered from AN, and 68 age-matched controls. Participants completed the Embedded Figures Task during an fMRI scan. Results: There were no significant differences between the participant groups in performance accuracy or reaction time. There were no other between-groups differences in neural response to the Embedded Figures Task. Conclusions: These findings contrast with evidence from older adults demonstrating differences in the neural underpinning of central coherence amongst participants with AN versus control participants. The current study adds to an increasing literature base demonstrating the resilience of neuropsychological traits and associated brain systems in the early stages of AN.
    • Neural Correlates of Theory of Mind Are Preserved in Young Women with Anorexia Nervosa

      Leslie, Monica; Halls, Daniel; Leppanen, Jenni; Sedgewick, Felicity; Smith, Katherine; Hayward, Hannah; Lang, Katie; Fonville, Leon; Simic, Mima; Mandy, William; et al.
      People with anorexia nervosa (AN) commonly exhibit social difficulties, which may be related to problems with understanding the perspectives of others, commonly known as Theory of Mind (ToM) processing. However, there is a dearth of literature investigating the neural basis of these differences in ToM and at what age they emerge. This study aimed to test for differences in the neural correlates of ToM processes in young women with AN, and young women weight-restored from AN, as compared to healthy control participants (HC). Based on previous findings in AN, we hypothesised that young women with current or prior AN, as compared to HCs, would exhibit a reduced neural response in the medial prefrontal cortex, the inferior frontal gyrus, and the temporo-parietal junction whilst completing a ToM task. We recruited 73 young women with AN, 45 weight-restored young women, and 70 young women without a history of AN to take part in the current study. Whilst undergoing a functional magnetic resonance imaging (fMRI) scan, participants completed the Frith-Happé task, which is a commonly-used measure of ToM with demonstrated reliability and validity in adult populations. In this task, participants viewed the movements of triangles, which depicted either action movements, simple interactions, or complex social interactions. Viewing trials with more complex social interactions in the Frith-Happé task was associated with increased brain activation in regions including the right temporo-parietal junction, the bilateral medial prefrontal cortex, the cerebellum, and the dorsolateral prefrontal cortex. There were no group differences in neural activation in response to the ToM contrast. Overall, these results suggest that the neural basis of spontaneous mentalising is preserved in most young women with AN.