Neural basis of a multidimensional model of body image distortion in anorexia nervosa

Body image distortion is a key symptom of anorexia nervosa (AN). The majority of the neuroimaging studies on body image distortion in AN conceptualized it as an unidimensional symptom. However, behavioural research considers such symptom as a multidimensional construct. Our paper systematically reviews the functional magnetic resonance (fMRI) studies on body image distortion in AN and classifies them according to a speculative model of body image distortion, that consists of the three most widely accepted components in the behavioural research: perceptive, affective and cognitive. We found that: (1) the perceptive component is mainly related to alterations of the precuneus and the inferior parietal lobe; (2) the affective component is mainly related to alterations of the prefrontal cortex, the insula and the amygdala; (3) the cognitive component has been weakly explored. These evidences seem to confirm that specific neural alterations are related to the components of the body image distortion in AN. Further neuroimaging studies are needed to better understand the complexity of the body image distortion in AN.

► Neuroimaging helps to understand the neural correlates of body image distortion in AN.
► Behavioural research conceptualizes such symptom as a multidimensional construct.
► We classify the fMRI studies in accordance to a model composed by the most widely accepted components.
► The posterior parietal network is related to the perceptive component of body image distortion in AN.
► The prefrontal cortex–insula–amygdala network is related to the affective component of body image distortion in AN.