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Impaired Central Processing of Emotional Faces in Anorexia Nervosa

From the Departments of Neurology (O.P.) and Psychology (O.P., R.S.), Ludwig-Maximilians-University of Munich, Germany; Department of Clinical and Cognitive Neuroscience (B.M.H.), University of Heidelberg, Central Institute of Mental Health; and Swartz Center for Computational Neuroscience (K.G.), Institute for Neural Computation, University of California, San Diego, California.

Address correspondence and reprint requests to Olga Pollatos, Leopoldstr. 13, 80802 Munich, Germany. E-mail: pollatos{at}psy.uni-muenchen.de

Objectives: To elucidate the potential relationship between classification of emotional faces and impaired central processing in eating disorders and to investigate the potential mediatory role of alexithymia and depression in this relationship.

Methods: Visual-evoked potentials (VEPs) to emotional faces and classification performance were assessed in 12 anorexic females and matched healthy controls.

Results: Patients with anorexia nervosa showed no modulation of emotional face processing and displayed significantly increased N200 amplitudes in response to all emotional categories and decreased VEPs in response to unpleasant emotional faces in the P300 time range as compared with healthy controls. They also made more mistakes in emotional face recognition, in particular, for neutral, sad, and disgusted content.

Conclusions: There are marked differences in evoked potentials and emotion recognition performances of patients with anorexia nervosa and controls in facial processing. Differences in brain dynamics might contribute to difficulties in the correct recognition of facially expressed emotions, deficits in social functioning, and in turn the maintenance of eating disorders.

Key Words: anorexia nervosa • emotional faces • emotional processing • VEPs • EEG • alexithymia

Abbreviations: ED = eating disorder; ERP = event-related potential; VEP = visual-evoked potential; AN = anorexia nervosa; MDD = major depressive disorder; EEG = electroencephalography; TAS = Toronto Alexithymia Scale; BMI = body mass index; BDI = Beck Depression Inventory; STAI = State Trait Anxiety Inventory.