Portal de Periódicos da CAPES

Anorexia nervosa as a disorder of the subcortical–cortical interoceptive-self

2022; Springer Science+Business Media; Volume: 27; Issue: 8 Linguagem: Inglês

10.1007/s40519-022-01510-7

1590-1262

Lorenzo Lucherini Angeletti, Matteo Innocenti, Federica Felciai, Emanuele Ruggeri, Emanuele Cassioli, Eleonora Rossi, Francesco Rotella, Giovanni Castellini, Giovanni Stanghellini, Valdo Ricca, Georg Northoff,

Body Image and Dysmorphia Studies

Abstract Purpose Anorexia nervosa (AN) is characterized by a diminished capacity in perceiving the physiological correlates of interoceptive sensations, namely bodily self-consciousness. Given the neural division of self-processing into interoceptive-, exteroceptive- and mental-self, we hypothesize neural deficits in the interoceptive-processing regions in AN. Methods To prove this, we reviewed resting state (rs), task and rest-task studies in AN literature. Results Neuronal data demonstrate the following in AN: (i) decreased rs-functional connectivity (rsFC) of subcortical–cortical midline structures (SCMS); (ii) reduced rsFC between medial (default-mode network/DMN and salience network/SN) and lateral (executive-control network/ECN) cortical regions; (iii) decreased rsFC in mainly the regions of the interoceptive-self; (iv) altered activity with overall increased activity in response to sensory/body image stimuli, especially in the regions of the interoceptive-self; (v) lack of a clear task-related distinction between own’s and others’ body image. Conclusion These data may indicate that rs-hypoconnectivity between SCMS, as neural correlate of a reduced intero-exteroceptive integration resulting in self-objectification, might be linked to overall increased activity in interoceptive regions during sensory/body image stimuli in AN, engendering an “anxious bodily self.” Level of evidence I: Systematic review.