Aberrant somatosensory perception in Anorexia Nervosa

Utrecht University, Faculty of Social and Behavioural Sciences, Experimental Psychology, Helmholtz Institute, Utrecht, The Netherlands.
Psychiatry Research (Impact Factor: 2.68). 05/2012; 200(2-3). DOI: 10.1016/j.psychres.2012.05.001
Source: PubMed

ABSTRACT Anorexia Nervosa (AN) patients have a disturbed experience of body size and shape. Previously it has been shown that these body representation disturbances extend to enlarged perception of tactile distances. Here we investigated whether misperception of tactile size could be related to inaccurate elementary somatosensory perception. Tactile size perception was measured with the Tactile Estimation Task (TET) (see Keizer et al., 2011). Elementary somatosensory perception was assessed with a pressure detection task and two point discrimination (TPD). Compared to controls (n=28), AN patients (n=25) overestimated tactile size, this effect was strongest for the abdomen. Elementary tactile perception deviated in AN as well: Patients had a lower threshold for detecting pressure on their abdomen, and a higher threshold for TPD on both the arm and abdomen. Regression results implied that group membership predicted tactile size estimation on the arm. Both group membership and TPD predicted tactile size estimation on the abdomen. Our results show that AN patients have a disturbance in the metric properties of the mental representation of their body as they overestimate the size of tactile stimuli compared to controls. Interestingly, AN patients and controls differ in elementary somatosensory perception as well. However, this could not solely explain misperception of tactile distances, suggesting that both bottom-up and top-down processes are involved.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Body image distortion is a central symptom of Anorexia Nervosa (AN). Even if corporeal awareness is multisensory majority of AN studies mainly investigated visual misperception. We systematically reviewed AN studies that have investigated different nonvisual sensory inputs using an integrative multisensory approach to body perception. We also discussed the findings in the light of AN neuroimaging evidence. Methods PubMed and PsycINFO were searched until March, 2014. To be included in the review, studies were mainly required to: investigate a sample of patients with current or past AN and a control group and use tasks that directly elicited one or more nonvisual sensory domains. Results Thirteen studies were included. They studied a total of 223 people with current or past AN and 273 control subjects. Overall, results show impairment in tactile and proprioceptive domains of body perception in AN patients. Interoception and multisensory integration have been poorly explored directly in AN patients. A limitation of this review is the relatively small amount of literature available. Conclusions Our results showed that AN patients had a multisensory impairment of body perception that goes beyond visual misperception and involves tactile and proprioceptive sensory components. Furthermore, impairment of tactile and proprioceptive components may be associated with parietal cortex alterations in AN patients. Interoception and multisensory integration have been weakly explored directly. Further research, using multisensory approaches as well as neuroimaging techniques, is needed to better define the complexity of body image distortion in AN. Key Findings The review suggests an altered capacity of AN patients in processing and integration of bodily signals: body parts are experienced as dissociated from their holistic and perceptive dimensions. Specifically, it is likely that not only perception but memory, and in particular sensorimotor/proprioceptive memory, shapes bodily experience in patients with AN.
    PLoS ONE 10/2014; 9(10):e110087. DOI:10.1371/journal.pone.0110087 · 3.53 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To accurately interpret tactile information, the brain needs to have an accurate representation of the body to which to refer the sensations. Despite this, body representation has only recently been incorporated into the study of tactile perception. Here, we investigate whether distortions of body representation affect tactile sensations. We perceptually altered the length of the arm and the width of the waist using a tendon vibration illusion and measured spatial acuity and sensitivity. Surprisingly, we found reduction in both tactile acuity and sensitivity thresholds when the arm or waist was perceptually altered, which indicates a general disruption of low-level tactile processing. We postulate that the disruptive changes correspond to the preliminary stage as the body representation starts to change and may give new insights into sensory processing in people with long-term or sudden abnormal body representation such as are found in eating disorders or following amputation. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    Journal of Experimental Psychology Human Perception & Performance 12/2014; DOI:10.1037/a0038514 · 3.11 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Obese people's distortions in visually-based mental body-parts representations have been reported in previous studies, but other sensory modalities have largely been neglected. In the present study, we investigated possible differences in tactilely-based body-parts representation between an obese and a healthy-weight group; additionally we explore the possible relationship between the tactile- and the visually-based body representation. Participants were asked to estimate the distance between two tactile stimuli that were simultaneously administered on the arm or on the abdomen, in the absence of visual input. The visually-based body-parts representation was investigated by a visual imagery method in which subjects were instructed to compare the horizontal extension of body part pairs. According to the results, the obese participants overestimated the size of the tactilely-perceived distances more than the healthy-weight group when the arm, and not the abdomen, was stimulated. Moreover, they reported a lower level of accuracy than did the healthy-weight group when estimating horizontal distances relative to their bodies, confirming an inappropriate visually-based mental body representation. Our results imply that body representation disturbance in obese people is not limited to the visual mental domain, but it spreads to the tactilely perceived distances. The inaccuracy was not a generalized tendency but was body-part related.
    Psychiatry Research 09/2014; 220(3). DOI:10.1016/j.psychres.2014.08.020 · 2.68 Impact Factor