The processing of body driven conflicts in Anorexia Nervosa: An EEG study

Conflict and error monitoring are crucial for cognitive control and might result impaired in psychiatric disorders, including Anorexia Nervosa (AN). Indeed, individuals suffering from AN can how impairments in processing conflicting body-related representations and adapting behavioural adjustments following errors. Although recent studies suggest that patients with AN are emotionally and perceptually sensitive to the processing of body-related stimuli, the neurophysiological mechanisms underlying their performance monitoring remain underexplored. The N2, error-related negativity (ERN), and mid-frontal theta activity (MFθ) are key electrocortical markers of conflict and error processing. While recent evidence indicates altered patterns of these signals during the processing of neutral conflicts (i.e., letters), it remains unclear whether encoding of conflicting body-related stimuli is also affected by the body representation distortion that characterizes AN symptomatology. This study investigates the neural signatures of performance monitoring in AN by examining both event-related potentials and oscillatory activity during exposure to conflicting body stimuli. The results may provide novel insights into the neurocognitive mechanisms underlying body representation in AN, with potential therapeutic implications. We will recruit 24 female AN patients and 24 healthy controls (HC). Participants will complete a Body-Flanker task, involving congruent and incongruent trials, with underweight and overweight body silhouettes presented in both upright and inverted orientations. EEG will be recorded using a 64-channel system, and neural data will be analysed in the time domain (amplitude/latency) and frequency domain (theta power). Behavioural measures (reaction time, accuracy, and performance index) and neural indices (N2, ERN, mid-frontal theta power, and other potentials indexing body-related perceptual processing) will be subjected to 2×2×2 mixed ANOVAs with factors: Group (AN, HC), Orientation (Upright, Inverted), and Congruency (Congruent, Incongruent). Additionally, EEG and behavioural measures will be correlated with psychometric scores from psychiatric assessments. We hypothesize impaired performance monitoring and altered neural responses to conflicting body stimuli in AN patients.