title: Social insecurity in relation to orbitofrontal activity in patients with eating disorders: a near-infrared spectroscopy study.
abstract: BACKGROUND
  Functional neuroimaging techniques are widely used to elucidate changes in brain activity, and various questionnaires are used to investigate psychopathological features in patients with eating disorders (ED). It is well known that social skills and interpersonal difficulties are strongly associated with the psychopathology of patients with ED. However, few studies have examined the association between brain activity and social relationships in patients with ED, particularly in patients with extremely low body weight.
  
  
  METHODS
  In this study, 22-channel near-infrared spectroscopy was used to quantify regional hemodynamic changes during a letter fluency task (LFT) in 20 female patients with ED with a mean body mass index of 14.0 kg/m(2) and 31 female controls (CTLs). Symptoms were assessed using the Eating Disorder Inventory-2 and Beck Depression Inventory. We hypothesized that frontal activity in patients with ED would be lower than in CTLs and would show different correlations with psychopathological features compared with CTLs.
  
  
  RESULTS
  The LFT performance and score on the social insecurity subscale of the Eating Disorder Inventory-2 were significantly higher in the ED group than in the CTL group. The mean change in oxygenated hemoglobin (oxy-Hb) in bilateral frontal regions during the LFT was significantly smaller in the ED group than in the CTL group. Social insecurity score was positively correlated with the concentration of oxy-Hb in the bilateral orbitofrontal cortex in the ED group but not in the CTL group.
  
  
  CONCLUSIONS
  These results suggest that activity of the orbitofrontal cortex is associated with social insecurity and disturbed in patients with ED. Therefore, disturbed orbitofrontal cortex activity may underlie the lack of insight and social isolation that is characteristic of patients with ED.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Katayama
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Kohmura
authors.affiliation: Department of Psychiatry, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi-ken 466-8550, Japan. tanakas@med.nagoya-u.ac.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tanaka
authors.forename: Miho
authors.initials: M
authors.lastname: Imaeda
authors.forename: Naoko
authors.initials: N
authors.lastname: Kawano
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Noda
authors.forename: Kazuo
authors.initials: K
authors.lastname: Nishioka
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ando
authors.forename: Branko
authors.initials: B
authors.lastname: Aleksic
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Iidaka
authors.forename: Norio
authors.initials: N
authors.lastname: Ozaki
mesh_terms: D000328:Adult; D001068:Feeding and Eating Disorders / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology*; D059907:Functional Neuroimaging / Q000379:methods; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D009483:Neuropsychological Tests; D010555:Personality Inventory; D017397:Prefrontal Cortex / Q000503:physiopathology*; D011569:Psychiatric Status Rating Scales; D012917:Social Adjustment; D019265:Spectroscopy, Near-Infrared / Q000379:methods; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D006454:Hemoglobins