Blunted neural response to implicit negative facial affect in anorexia nervosa

•FMRI study of BOLD response to positive and negative facial affect in AN.•Blunted prefrontal and amygdala BOLD response to negative facial effect in AN.•Atypical increase in insula BOLD response to positive facial affect in AN.

BackgroundPeople with anorexia nervosa (AN) have difficulties in a wide range of social-emotional processes. Previous work suggests atypical involvement of the prefrontal cortex (PFC), amygdala, insula, and fusiform gyri during social-emotional processing in AN.MethodsTwenty women with AN and twenty healthy comparison (HC) women were presented with happy, fearful, and neutral faces during a functional magnetic resonance imaging study. Group differences were investigated in the following regions of interest: lateral PFC, amygdala, insula, and fusiform gyri.ResultsThe HC participants showed significantly increased recruitment of the ventrolateral PFC and amygdala in the fearful > neutral contrast relative to the AN participants. The AN participants showed a significantly increased recruitment of a small cluster in the right posterior insula in the happy > neutral contrast.ConclusionsThese findings are in line with the hypothesis that people with AN have a blunted response to negative and atypical exaggerated response to positive emotionally provoking stimuli.