Neuropsychological Impairments in Anorexia Nervosa: A Spanish Sample Pilot Study

Abstract

This work was aimed at obtaining a profile of neuropsychological impairments in young Spanish participants with anorexia nervosa (AN) to demonstrate that right-hemisphere and frontal capacity impairments are present not only in the acute phase but also after weight recovery in a Spanish sample compared with a healthy control group. Twelve patients with AN in the acute phase (body mass index [BMI] < 17) were compared both to 16 healthy control subjects and 12 weight-recovered AN participants (BMI ≥ 17) matched by age, IQ, and educational level by utilizing a wide neuropsychological battery. Differences were found between AN groups only for long-term verbal memory, which worsens as BMI increases. Among participants with AN as a group, results showed differences in speed of information processing, working memory, visual memory, and inhibition, unrelated to attentional capabilities. We cannot support the hypothesis of a specific right cerebral dysfunction in patients with AN. A general cognitive dysfunction, primarily in information processing, working memory, visual and verbal memory, as well as frontal impairments such as impulsivity and poor behavioral control, appeared unrelated to BMI. We support previous works affirming that neuropsychological impairments in AN are not a consequence of the illness but a risk factor for it to develop.

Key words:

• adolescent
• cognitive
• health promotion

ACKNOWLEDGEMENTS

The authors acknowledge Colegio San Antonio de Padua (Carcaixent, Valencia, Spain) and Centro de Psicología y Realidad Virtual PREVI (Valencia, Spain) for their support and for providing some of the participants included in this work. We also thank anonymous reviewers for their comments and suggestions for the final form of the manuscript.

Notes

Note. Height not included. BMI = body mass index; K-BIT = Kaufman-Brief Intelligence Test; TAVEC = Test de Aprendizaje Verbal España-Complutense; FR = Free Recall; WMS = Wechsler Memory Scale; LT = long term; BAI = Beck Anxiety Inventory.

*Significant after Benjamini & Yekutieli's modified FDR correction for six multiple comparisons among demographic variables.

HCG = healthy control group; 2ANG = both anorexia nervosa group and the weight-recovery group collapsed; BMI = body mass index; FIQ = full IQ.

*Significant after Benjamini & Yekutieli's modified FDR correction for six multiple comparisons among demographic variables.

 ROD = Reverse Order Digits; L&N = Letter & Numbers subscale; ROCFT = Rey-Osterrieth Complex Figure time for copy; Stroop-W = Stroop Word task; Stroop-C = Stroop Color task; Stroop-WC = Stroop Word and Color Task; TAVEC = Test de Aprendizaje Verbal España-Complutense; F = Free Recall; TSD = Total Symbol Digit score; ST = short term; LT = long term; WMS = Wechsler Memory Scale; BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory.

*Significant after Benjamini & Yekutieli's modified FDR correction for 33 multiple comparisons among cognitive variables.

**Significant after Benjamini & Yekutieli's modified FDR correction for 2 multiple comparisons among psychiatric variables.

BMI = Body Mass Index; WMS = Wechsler Memory Scale; ROD = Reverse Order Digits; L&N = Letters and Numbers; TSD = Total Symbol Digit; BAI = Beck Anxiety Inventory; TAVEC = Test de Aprendizaje Verbal España-Complutense; ST = short term; LT = long term; FR = Free Recall; Stroop-W = Stroop Word task; Stroop-C = Stroop Color task; Stroop-WC = Stroop Word and Color Task.

Note. N = 24. KBIT FIQ = K-BIT Full IQ; DOD = Direct Order Digits; TMT = Trail-Making Test; Stroop-W = Stroop Word task; Stroop-C = Stroop Color task; Stroop-WC = Stroop Word and Color Task; TSD = Total Symbol Digit; ROD = Reverse Order Digits; L&N = Letter and Number Test; ESD = Error Symbol Digit; FR = Free Recall; CR = Cued Recall; ST = short term; LT = long term; WMS = Wechsler Memory Scale; TH-Mov = Tower of Hanoi Movements; TH-E = Tower of Hanoi Errors; TH-T = Tower of Hanoi Time; DoF = degrees of freedom; ROCFT = Rey-Osterrieth Complex Figure Test.

SEM = standard error of mean; BMI = body mass index; ESD = Errors Symbol Digit; K-BIT = Kaufman-Brief Intelligence Test; VIQ = Verbal IQ; PIQ = Performance IQ; FIQ = Full IQ; Stroop-W = Stroop Word task; Stroop-C = Stroop Color task; Stroop-WC = Stroop Word and Color task; TH-Mov = Tower of Hanoi Movement; TH-E = Tower of Hanoi Errors; TH-T = Tower of Hanoi Time; DOD = Direct Order Digits; ROD = Reverse Order Digits; L&N = Letter and Number subtest; TMT = Trail-Making Test; ROCFT = Rey-Osterrieth Complex Figure Test; TSD = Total Symbol Digit; TAVEC = Test de Aprendizaje Verbal España-Complutense; WMS = Wechsler Memory Scale–Logical Memory subtest; BDI-II = Beck Depression Inventory; BAI = Beck Anxiety Inventory; ST = short term; LT = long term; FR = Free Recall; CR = Cued Recall.