Executive functioning in anorexia nervosa patients and their unaffected relatives.

Elisa Galimberti a,b,n, Emma Fadda a,b, Maria Cristina Cavallini b, Riccardo Maria Martoni b, Stefano Erzegovesi b, Laura Bellodi b,c

a Experimental Neurology Institute, INSPE, Vita-Salute San Raffaele University, Italy
b Department of Clinical Neuroscience, San Raffaele Scientific Institute, Milan, Italy
c School of Psychology, Vita-Salute San Raffaele University, Milan, Italy

Abstract :

Formal genetic studies suggested a substantial genetic influence for Anorexia Nervosa (AN) but currently results are inconsistent. The use of neurocognitive endophenotype approach may facilitate our understanding of the AN pathophysiology. We investigated decision-making, set-shifting and planning in AN patients (n1⁄429) and their unaffected relatives (n1⁄429) compared to healthy probands (n1⁄429) and their relatives (n1⁄429). The Iowa Gambling Task (IGT), the Tower of Hanoi (ToH) and the Wisconsin Sorting Card Test (WCST) were administered. Probands/relatives concordance rates and heritability index were also calculated. Impaired IGT and WCST performances were found in both AN probands and their relatives instead planning appeared to be preserved. IGT heritability index suggested the presence of genetic effects that influence this measure. No evidence for genetic effect was found for WCST. Results suggest the presence of a shared dysfunctional executive profile in women with AN and their unaffected relatives, characterized by deficient decision-making and set-shifting. Concordance analysis strongly suggests that these impairments aggregate in AN families supporting the hypothesis that they may constitute a AN biological markers. Decision-making impairment presents a moderate heritability, suggesting that decision-making may be a candidate endophenotype for AN.

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