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. 2019 Feb;131(3-4):61-67.
doi: 10.1007/s00508-018-1440-y. Epub 2019 Jan 17.

Body image disturbances, fear and associations with the amygdala in anorexia nervosa

Nathalie T Burkert  1 , Karl Koschutnig  2 , Franz Ebner  3 , Wolfgang Freidl  4
Affiliations

Body image disturbances, fear and associations with the amygdala in anorexia nervosa

Nathalie T Burkert et al. Wien Klin Wochenschr. 2019 Feb.

Abstract

Background: Anorexia nervosa (AN) is a severe illness with a high mortality rate which mainly affects young women. Studies found a localized volume loss of the amygdala in patients with AN, a brain region responsible for affective responses. Patients with AN were found to have body image distortions, and suffer from the comorbid disorders depression, anxiety disorder, and obsession. Therefore, the purpose of this study was to analyze a possible connection between comorbidities, body image disturbances, and the volume of the amygdala in patients with AN.

Methods: In this study 21 females suffering from restrictive-type AN and 21 age-matched normal controls (NC) were tested. Demographic data as well as body image perceptions and comorbidities were assessed. Volumes of cortical structures were measured with a magnetic resonance (MR) scanner. Analyses of variance were conducted to analyze group differences, and correlations between the volume of the amygdala and comorbidities and body image perceptions were calculated.

Results: The results showed a significantly lower grey matter volume in the amygdala in AN patients compared to the NC. Persons with AN showed more body image disturbances and suffered more often from depression, and phobias than NC. The volume of the amygdala showed a non-significant mid-level association with phobia and with uncertainty concerning their body in AN patients.

Conclusion: The study indicates that phobic anxiety and body image in patients with AN could be related to the volume of the amygdala. The results contribute to a better understanding of the pathophysiology of the disease.

Keywords: Amygdala; Anorexia nervosa; Body image; Comorbidities; MRI measurement.

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Conflict of interest statement

Conflict of interest

N.T. Burkert, K. Koschutnig, F. Ebner, and W. Freidl declare that, except for income which they received from their primary employers and the abovementioned funding, no further financial support or compensation has been received from any individual or corporate entity for research of professional service over the past 4 years. The authors declare that there are no personal financial holdings that could be perceived as constituting a potential conflict of interest.

Ethical standards

The study was carried out in compliance with the Declaration of Helsinki. Written informed consent was obtained from all participants, or from their parents if they were under age. The ethics committee of the Medical University of Graz approved this study (EK-number: 23-217 ex 10/11).

Figures

Fig. 1
Fig. 1
Association between the volume of the amygdala with phobia and uncertainty. Volume (in mm3) of the amygdala and its associations with phobia (using a scale from 0 not at all to 4 very much) and uncertainty concerning body and attractiveness (using a scale from 0 not at all to 12 high uncertainty) in AN vs. NC; AN women with anorexia nervosa, restrictive type, NC healthy control women. N = 42
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