Event-Related Potentials During Recognition of Semantic and Pictorial Food Stimuli in Patients With Anorexia Nervosa and Healthy Controls With Varying Internal States of Hunger

Objective: To elucidate maladaptive central processing of food cues during recognition tasks in anorexia nervosa (AN), while considering influences of nutritional preload and presentation modality (word versus picture). Methods: Event-related potentials to food-related word and pictorial stimuli were assessed during recognition tasks in 16 patients with AN, 16 control participants with food intake before the study, and 16 control participants with a fasting period before the study. Results: Patients with AN showed a P3b amplitude reduction especially at the midline parietal site compared with satiated controls (5.7 [standard deviation = 3.3] versus 8.7 [3.1] mu V, p < .03). Subtle recognition deficits in patients with AN were indicated by smaller "old/new" effects compared with satiated ( p = .049) and fasting controls (p < .003) for pictorial stimuli. Hunger-modulated enhanced old/new effects for food pictures compared with neutral pictorial stimuli could be observed in fasting controls only (2.7 [2.6] versus 0.8 [2.2] mu V, p < .01). Conclusions: The presented data provide evidence for a midline parietal P3b amplitude reduction in patients with AN, which might point to reduced network activation in AN even during satiety. Observed subtle recognition deficits either represent a stable trait characteristic or a "scar" effect of chronic starvation that may play a role in the development and/or persistence of the disorder.