Disruption of Spatial Task Performance in Anorexia Nervosa

University of Bologna, Italy
PLoS ONE (Impact Factor: 3.23). 01/2013; 8(1):e54928. DOI: 10.1371/journal.pone.0054928
Source: PubMed


In anorexia nervosa (AN), body distortions have been associated with parietal cortex (PC) dysfunction. The PC is the anatomical substrate for a supramodal reference framework involved in spatial orientation constancy. Here, we sought to evaluate spatial orientation constancy and the perception of body orientation in AN patients. In the present study, we investigated the effect of passive lateral body inclination on the visual and tactile subjective vertical (SV) and body Z-axis in 25 AN patients and 25 healthy controls. Subjects performed visual- and tactile-spatial judgments of axis orientations in an upright position and tilted 90° clockwise or counterclockwise. We observed a significant deviation of the tactile and visual SV towards the body (an A-effect) under tilted conditions, suggesting a multisensory impairment in spatial orientation. Deviation of the Z-axis in the direction of the tilt was also observed in the AN group. The greater A-effect in AN patients may reflect reduced interoceptive awareness and thus inadequate consideration of gravitational inflow. Furthermore, marked body weight loss could decrease the somatosensory inputs required for spatial orientation. Our study results suggest that spatial references are impaired in AN. This may be due to particular integration of visual, tactile and gravitational information (e.g. vestibular and proprioceptive cues) in the PC.

Download full-text


Available from: Olivier Cottencin,
  • Source
    • "Both Guardia et al. (2010) (2012) and Keizer et al. (2011, 2013) used interesting methodologies to reach this goal. Their data, even if preliminary, suggest that both conscious (i.e., the choice of a door-like aperture matching the perceived size of the body) and unconscious (i.e., the adaptive postural changes required to enter a door-like aperture) egocentric body-related judgments are impaired in AN (Guardia et al., 2012; Keizer et al., 2013). In both studies, AN patients significantly overestimated the size of their real body. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Clinical psychology is starting to explain eating disorders (ED) as the outcome of the interaction among cognitive, socio-emotional and interpersonal elements. In particular two influential models-the revised cognitive-interpersonal maintenance model and the transdiagnostic cognitive behavioral theory-identified possible key predisposing and maintaining factors. These models, even if very influential and able to provide clear suggestions for therapy, still are not able to provide answers to several critical questions: why do not all the individuals with obsessive compulsive features, anxious avoidance or with a dysfunctional scheme for self-evaluation develop an ED? What is the role of the body experience in the etiology of these disorders? In this paper we suggest that the path to a meaningful answer requires the integration of these models with the recent outcomes of cognitive neuroscience. First, our bodily representations are not just a way to map an external space but the main tool we use to generate meaning, organize our experience, and shape our social identity. In particular, we will argue that our bodily experience evolves over time by integrating six different representations of the body characterized by specific pathologies-body schema (phantom limb), spatial body (unilateral hemi-neglect), active body (alien hand syndrome), personal body (autoscopic phenomena), objectified body (xenomelia) and body image (body dysmorphia). Second, these representations include either schematic (allocentric) or perceptual (egocentric) contents that interact within the working memory of the individual through the alignment between the retrieved contents from long-term memory and the ongoing egocentric contents from perception. In this view EDs may be the outcome of an impairment in the ability of updating a negative body representation stored in autobiographical memory (allocentric) with real-time sensorimotor and proprioceptive data (egocentric).
    Frontiers in Human Neuroscience 05/2014; 8:236. DOI:10.3389/fnhum.2014.00236 · 3.63 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Beside language, space is to date the most widely recognized lateralized systems. For example, it has been shown that even mental representations of space and the spatial representation of abstract concepts display lateralized characteristics. For the most part, this body of literature describes space as distal or something outside of the observer or actor. What has been strangely absent in the literature on the whole and specifically in the spatial literature until recently is the most proximal space imaginable - the body. In this review, we will summarize three strands of literature showing laterality in body representations. First, evidence of hemispheric asymmetries in body space in health and, second in body space in disease will be examined. Third, studies pointing to differential contributions of the right and left hemisphere to illusory body (space) will be summarized. Together these studies show hemispheric asymmetries to be evident in body representations at the level of simple somatosensory and proprioceptive representations. We propose a novel working hypothesis, whereby neural systems dedicated to processing action-oriented information about one's own body space may ontogenetically serve as a template for the perception of the external world.
    Frontiers in Psychology 02/2014; 5:123. DOI:10.3389/fpsyg.2014.00123 · 2.80 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: L’anorexie mentale est une maladie psychiatrique extrêmement grave qui apparaît, le plus souvent, chez la jeune fille, à l’adolescence. Cette pathologie mentale se traduit notamment par une restriction alimentaire drastique, mettant en jeu la vie de la jeune fille, et par une surestimation de la silhouette et du poids du corps. L’objectif de cette revue est de voir quels peuvent être les apports issus de la psychologie cognitive et de la neuropsychologie dans la compréhension de cette maladie. Les études montrent que l’organisation perceptive, la flexibilité mentale, la mémoire de travail et la cohérence centrale sont des composantes qui sont particulièrement affectées. L’intégration multisensorielle, sous-tendue par le cortex pariétal, serait également perturbée chez certaines patientes. Mais surtout, les études sur la surestimation du corps révèlent que cette illusion s’ancrerait dans une représentation sensorimotrice du corps : le schéma corporel. La prise de conscience de la maigreur étant une condition indispensable à la réussite du processus de renutrition, les thérapies ne doivent pas négliger dans leur programme des techniques centrées sur une meilleure conscience et acceptation du corps. La réalité virtuelle ou le contact réel avec le corps par le biais de massages, lorsque c’est possible émotionnellement pour la patiente, pourrait être utilisés en adjonction à la psychothérapie.
    Journal de Thérapie Comportementale et Cognitive 09/2014; 24(3). DOI:10.1016/j.jtcc.2014.06.002
Show more