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Altered insula activation during pain anticipation in individuals recovered from anorexia nervosa: Evidence of interoceptive dysregulation

Strigo, Irina A and Matthews, Scott C and Simmons, Alan N and Oberndorfer, Tyson and Klabunde, Megan and Reinhardt, Lindsay E and Kaye, Walter H (2013) 'Altered insula activation during pain anticipation in individuals recovered from anorexia nervosa: Evidence of interoceptive dysregulation.' International Journal of Eating Disorders, 46 (1). 23 - 33. ISSN 0276-3478

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Abstract

Objective: Recent evidence raises the possibility that symptoms of anorexia nervosa (AN) could be related to impaired interoception. Pain is an interoceptive process with well-characterized neuroanatomical pathways that may overlap to a large degree with neural systems that may be dysregulated in individuals with AN, such as the insula. Method: Functional magnetic resonance imaging (fMRI) was used to assess neural substrates of pain anticipation and processing in 10 healthy control women (CW) and 12 individuals recovered from AN (REC AN) in order to avoid the confounding effects of malnutrition. Painful heat stimuli were applied while different colors signaled the intensity of the upcoming stimuli. Results: REC AN compared with CW showed greater activation within right anterior insula (rAI), dorsolateral prefrontal cortex (dlPFC) and cingulate during pain anticipation, and greater activation within dlPFC and decreased activation within posterior insula during painful stimulation. Greater anticipatory rAI activation correlated positively with alexithymic feelings in REC AN participants. Discussion: REC AN showed a mismatch between anticipation and objective responses, suggesting altered integration and, possibly, disconnection between reported and actual interoceptive state. Alexithymia assessment provided additional evidence of an altered ability to accurately perceive bodily signals in women recovered from AN. © 2012 by Wiley Periodicals, Inc.

Item Type: Article
Divisions: Faculty of Science and Health > Psychology, Department of
Depositing User: Elements
Date Deposited: 15 Nov 2019 10:23
Last Modified: 15 Nov 2019 10:23
URI: http://repository.essex.ac.uk/id/eprint/25535

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