Die Power des Frontalkortex in Anorexia nervosa - und wo er versagt. Analyse der emotionsfokussierten Brain-Body-Interaktion und zentraler neuronaler Umschaltstellen zur Ableitung eines neuen Therapierationals
Theoretical background: Anorexia nervosa (AN) is a severe illness with alarming mortality rates. The disorder is characterized by a sustained high level of anticipatory cognitive control which is thought to be reflected in a general prefrontal hyperactivity. Moreover, disrupted brain circuits suggest a poor integration and regulation of autonomic, sensory and affective information. Due to prefrontal inhibition, AN patients show a lack of emotional arousal leading to emotional dysregulations and problems in social functioning. Methods: We will use high-resolution functional magnetic resonance imaging to quantify brain activity during resting state, induced emotional reactivity and emotional awareness. Co-activations of different brain regions will be assessed in terms of functional connectivity. The correlation coefficient of the signal extracted from regions of interest with other voxels will be estimated. To elicit and analyze emotional reactions, we have constructed the picture viewing task. Here, a series of 58 selected, predominantly positively connoted pictures is shown. Each picture is presented for 20 seconds and is then rated by the subjects in terms of experienced valence, arousal and dominance. To evaluate the effectiveness of the task, we collected a pilot data set of 10 healthy individuals. To enhance emotional arousal in AN patients, we will apply a skin conductance biofeedback (SCBF) training to improve affective processing. Over four weeks of training, three sessions per week, patients and healthy controls in the intervention group will perform the biofeedback training elevating their individual skin conductance. To evaluate the effectiveness of SCBF in terms of emotional reactivity, we collected a pilot training data set. Summary: This project will investigate neuro-functional underpinnings of emotional dysregulation in the brain of anorexia nervosa patients and the application of skin conductance biofeedback to enhance emotional experience.