Cognitive remediation, brain function and central coherence: An anorexia nervosa pilot study

TY - JOUR

T1 - Cognitive remediation, brain function and central coherence

T2 - An anorexia nervosa pilot study

AU - Fonville, Leon

AU - Giampietro, Vincent

AU - Davies, Helen

AU - Lounes, Naima

AU - Simmons, Andrew

AU - Williams, Steven

AU - Tchanturia, Kate

PY - 2014/9/16

Y1 - 2014/9/16

N2 - Objectives: Cognitive remediation therapy (CRT) for anorexia nervosa (AN) is an intervention designed to improve the thinking processes of AN patients as well as their general cognitive functioning. While previous behavioural studies have shown promising results, no studies to date have assessed the neuronal effects of CRT in AN. Methods: In this study, nine patients and fourteen healthy controls (HC) performed a variant of the embedded figures test (EFT) during functional magnetic resonance imaging at two separate occasions to assess central coherence. Patients received 10 sessions of CRT in between scans, and controls did not receive any training. Results: While both groups showed improvement on the task over time, there was no indication of greater improvement in performance after CRT. Neuroimaging data did reveal that on complex embedded figures (CEF), those with AN showed a stronger decrease in task-related activation during the follow-up scan in the fusiform gyrus and middle occipital gyrus as well as greater task-related deactivation in the medial frontal gyrus extending into the precuneus. Conclusions: This greater neural efficiency in AN after CRT could be indicative of successfully adopting a more global strategy on the EFT and suggests that CRT affects central coherence on a neural level.

AB - Objectives: Cognitive remediation therapy (CRT) for anorexia nervosa (AN) is an intervention designed to improve the thinking processes of AN patients as well as their general cognitive functioning. While previous behavioural studies have shown promising results, no studies to date have assessed the neuronal effects of CRT in AN. Methods: In this study, nine patients and fourteen healthy controls (HC) performed a variant of the embedded figures test (EFT) during functional magnetic resonance imaging at two separate occasions to assess central coherence. Patients received 10 sessions of CRT in between scans, and controls did not receive any training. Results: While both groups showed improvement on the task over time, there was no indication of greater improvement in performance after CRT. Neuroimaging data did reveal that on complex embedded figures (CEF), those with AN showed a stronger decrease in task-related activation during the follow-up scan in the fusiform gyrus and middle occipital gyrus as well as greater task-related deactivation in the medial frontal gyrus extending into the precuneus. Conclusions: This greater neural efficiency in AN after CRT could be indicative of successfully adopting a more global strategy on the EFT and suggests that CRT affects central coherence on a neural level.

KW - Anorexia

KW - Attention to detail

KW - Central coherence

KW - Cognitive remediation therapy

KW - fMRI

UR - http://www.scopus.com/inward/record.url?scp=84908096631&partnerID=8YFLogxK

U2 - 10.1186/s12991-014-0025-z

DO - 10.1186/s12991-014-0025-z

M3 - Article

AN - SCOPUS:84908096631

SN - 1744-859X

VL - 13

JO - Annals of General Psychiatry

JF - Annals of General Psychiatry

M1 - 25

ER -