Gastrointestinal Interoception and Relapse in Anorexia Nervosa

Area of Science:

• Neuroscience
• Gastroenterology
• Psychiatry

Background:

• Anorexia nervosa (AN) has high relapse rates post-weight restoration, potentially linked to disrupted gastrointestinal (GI) interoception.
• Understanding GI interoception markers is crucial for predicting and preventing relapse in AN.

Purpose of the Study:

• To investigate behavioral, computational, neural, and physiological markers of GI interoception in weight-restored individuals with AN.
• To assess the association between these GI interoception markers and relapse risk.

Main Methods:

• A randomized crossover trial involving females with weight-restored AN and healthy comparators (HCs).
• Participants ingested a vibrating capsule for gut stimulation, with assessments including behavioral detection, electroencephalography, and computational modeling.
• Interoceptive accuracy, prior beliefs, precision, learning rates, gastric-evoked potentials (GEPs), and hunger were measured.

Main Results:

• Individuals with AN exhibited lower perceptual accuracy and higher miss rates compared to HCs.
• Computational modeling revealed maladaptive priors, altered interoceptive precision, and learning asymmetries in the AN group.
• Initial priors, response bias, and stomach unpleasantness predicted relapse; miss rate, interoceptive precision difference, and initial priors predicted symptom severity.

Conclusions:

• GI interoception is significantly disrupted in weight-restored individuals with AN.
• Specific interoceptive markers are associated with relapse and symptom severity, suggesting their utility in treatment monitoring.
• Ingestible mechanosensory probes and computational modeling show promise for relapse prevention strategies in eating disorders.