Who am I? How do I look? Neural differences in self-identity in anorexia nervosa.

Anorexia nervosa (AN) patients exhibit a disparity in their actual physical identity and their cognitive understanding of their physical identity. Functional magnetic resonance imaging (fMRI) tasks have contributed to understanding the neural circuitry involved in processing identity in healthy individuals. We hypothesized that women recovering from AN would show altered neural responses while thinking about their identity compared with healthy control women. We compared brain activation using fMRI in 18 women recovering from anorexia (RAN) and 18 healthy control women (CON) using two identity-appraisal tasks. These neuroimaging tasks were focused on separable components of identity: one consisted of adjectives related to social activities and the other consisted of physical descriptive phrases about one's appearance. Both tasks consisted of reading and responding to statements with three different perspectives: Self, Friend and Reflected. In the comparisons of the RAN and CON subjects, we observed differences in fMRI activation relating to self-knowledge ('I am', 'I look') and perspective-taking ('I believe', 'Friend believes') in the precuneus, two areas of the dorsal anterior cingulate, and the left middle frontal gyrus. These data suggest that further exploration of neural components related to identity may improve our understanding of the pathology of AN.