Neurocognitive Impairments Are More Severe in the Binge-Eating/Purging Anorexia Nervosa Subtype Than in the Restricting Subtype

Abstract

Objective: To evaluate cognitive function impairment in patients with anorexia nervosa (AN) of either the restricting (ANR) or binge-eating/purging (ANBP) subtype. Method: We administered the Japanese version of the MATRICS Consensus Cognitive Battery to 22 patients with ANR, 18 patients with ANBP, and 69 healthy control subjects. Our participants were selected from among the patients at the Kobe University Hospital and community residents. Results: Compared to the healthy controls, the ANR group had significantly lower visual learning and social cognition scores, and the ANBP group had significantly lower processing speed, attention/vigilance, visual learning, reasoning/problem-solving, and social cognition scores. Compared to the ANR group, the ANBP group had significantly lower attention/vigilance scores. Discussion: The AN subtypes differed in cognitive function impairments. Participants with ANBP, which is associated with higher mortality rates than ANR, exhibited greater impairment severities, especially in the attention/vigilance domain, confirming the presence of impairments in continuous concentration. This may relate to the impulsivity, an ANBP characteristic reported in the personality research. Future studies can further clarify the cognitive impairments of each subtype by addressing the subtype cognitive functions and personality characteristics.

Keywords: MCCB Japanese version; anorexia nervosa binge-eating/purging subtype; anorexia nervosa restricting subtype; neurocognitive impairment; subtype personality characteristics.

Figure 1

Multivariate analysis of covariance for all MCCB-J domains and overall cognitive composite T-scores of the subjects. Mean T-scores for all MCCB-J domains and overall cognitive composite scores for the subjects. Error bars show standard deviation. ANBP, anorexia nervosa, binge-eating/purging subtype; ANR, anorexia nervosa, restricting subtype; MCCB-J, MATRICS Consensus Cognitive Battery, Japanese-language version. ^†Significant pairwise differences between the healthy controls and both the ANBP and ANR groups (p < 0.05).^‡Significant pairwise difference between the ANBP and ANR groups (p = 0.009). ^§Significant pairwise difference between the ANBP group and the healthy controls (p < 0.005).

Figure 2

Multivariate analysis of covariance for MCCB-J subtest T-scores of the subjects. Mean T-scores for all MCCB-J subtest scores for the subjects. Error bars show standard deviation. ANBP, anorexia nervosa, binge-eating/purging type subtype; ANR, anorexia nervosa, restricting subtype; BACS-SC, Brief Assessment of Cognition in Schizophrenia–Symbol Coding test; BVMT-R, Brief Visuospatial Memory Test-Revised; CPT-IP, Continuous Performance Test–Identical Pairs; Fluency, Category Fluency–Animal Naming test; HVLT-R, Hopkins Verbal Learning Test-Revised; LNS, University of Maryland–Letter-Number Span test; MCCB, MATRICS Consensus Cognitive Battery, Japanese-language version; MSCEIT-ME, Mayer-Salovey-Caruso Emotional Intelligence Test, Managing Emotions component; NAB, Neuropsychological Assessment Battery–Mazes; SD, standard deviation; TMT-A, Trail Making Test, part A; WMS-SS, Wechsler Memory Scale III Spatial Span test. ^†Significant pairwise differences between the healthy controls and both the ANBP and ANR groups (p < 0.05).^‡Significant pairwise difference between the ANBP and ANR groups (p = 0.008). ^§Significant pairwise difference between the ANBP group and the healthy controls (p < 0.01).