title: Neural activations are related to body-shape, anxiety, and outcomes in adolescent anorexia nervosa.
abstract: Anorexia nervosa (AN) is an illness that frequently begins during adolescence and involves weight loss. Two groups of adolescent girls (AN-A, weight-recovered following AN) and (HC-A, healthy comparison) completed a functional magnetic resonance imaging task involving social evaluations, allowing comparison of neural activations during self-evaluations, friend-evaluations, and perspective-taking self-evaluations. Although the two groups were not different in their whole-brain activations, anxiety and body shape concerns were correlated with neural activity in a priori regions of interest. A cluster in medial prefrontal cortex and the dorsal anterior cingulate correlated with the body shape questionnaire; subjects with more body shape concerns used this area less during self than friend evaluations. A cluster in medial prefrontal cortex and the cingulate also correlated with anxiety such that more anxiety was associated with engagement when disagreeing rather than agreeing with social terms during self-evaluations. This data suggests that differences in the utilization of frontal brain regions during social evaluations may contribute to both anxiety and body shape concerns in adolescents with AN. Clinical follow-up was obtained, allowing exploration of whether brain function early in course of disease relates to illness trajectory. The adolescents successful in recovery used the posterior cingulate and precuneus more for friend than self evaluations than the adolescents that remained ill, suggesting that neural differences related to social evaluations may provide clinical predictive value. Utilization of both MPFC and the precuneus during social and self evaluations may be a key biological component for achieving sustained weight-recovery in adolescents with AN.
authors.affiliation: Department of Psychiatry, University of Texas at Southwestern Medical School, Dallas, TX, 75390, USA.
authors.forename: Jie
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Psychiatry, University of Texas at Southwestern Medical School, Dallas, TX, 75390, USA.
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Harper
authors.affiliation: Department of Psychiatry, University of Texas at Southwestern Medical School, Dallas, TX, 75390, USA.
authors.forename: Erin A
authors.initials: EA
authors.lastname: Van Enkevort
authors.affiliation: Department of Psychiatry, University of Texas at Southwestern Medical School, Dallas, TX, 75390, USA; Psychiatry, Children's Medical Center, Dallas, TX, USA.
authors.forename: Kelsey
authors.initials: K
authors.lastname: Latimer
authors.affiliation: Department of Psychiatry, University of Texas at Southwestern Medical School, Dallas, TX, 75390, USA; Psychiatry, Children's Medical Center, Dallas, TX, USA.
authors.forename: Urszula
authors.initials: U
authors.lastname: Kelley
authors.affiliation: Department of Psychiatry, University of Texas at Southwestern Medical School, Dallas, TX, 75390, USA; Psychiatry, Children's Medical Center, Dallas, TX, USA; Psychiatry, Texas Health Presbyterian Hospital of Dallas, Dallas, TX, 75321, USA. Electronic address: Carrie.McAdams@UTSouthwestern.edu.
authors.forename: Carrie J
authors.initials: CJ
authors.lastname: McAdams
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000150:complications / Q000473:pathology / Q000523:psychology; D001007:Anxiety / Q000209:etiology*; D049628:Body Size; D001921:Brain / Q000000981:diagnostic imaging*; D001931:Brain Mapping; D059026:Diagnostic Self Evaluation; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007398:Interpersonal Relations; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D010100:Oxygen / Q000097:blood; D011569:Psychiatric Status Rating Scales; D020127:Recovery of Function / Q000502:physiology*; D012933:Social Identification; D055815:Young Adult
chemical_list: D010100:Oxygen
keywords: Eating disorders; Identity; Self-perception; Social cognition; fMRI