Background: There is evidence that patients with anorexia nervosa (AN) demonstrate specific cerebral activation patterns in response to visual food stimulation. We postulated that cerebral activation patterns could represent different perceptions of high-calorie images during hunger and satiety and could be determined by patients' subjective ratings.
Methods: After 6 h of starvation and also in a state of satiety, 12 female patients with AN and 12 normal-weight women were assessed by use of fMRI with high-calorie food images. All patients suffered from a restrictive type of AN. Heart rates, subjective ratings of satiety and valences of the visual stimuli were assessed.
Results: Food stimuli presented during a state of hunger were associated with significant activation of the anterior cingulate cortex and insula in the control group and of the prefrontal and central cortices and insula in the AN group. During the hunger state activation in AN of the dorsal posterior cingulate cortex was revealed compared to the controls. In the state of satiety, activation of the left insula was observed in the AN group. Use of the food valence judgment as a covariate confirmed the insula activation and revealed additional activation of the orbitofrontal, cingulate and medial temporal cortices.
Conclusion: Our results indicate differences in cerebral activation patterns due to different perceptions of high-calorie food images, modulated by feelings of hunger or satiety, among AN patients with modulation by subjective ratings of food valence.
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