Advertisement

Experimental Brain Research

, Volume 217, Issue 1, pp 79–87 | Cite as

Diminished size–weight illusion in anorexia nervosa: evidence for visuo-proprioceptive integration deficit

  • Laura K. CaseEmail author
  • Rachel C. Wilson
  • Vilayanur S. Ramachandran
Research Article

Abstract

Individuals with anorexia nervosa (AN) experience pronounced body image distortion in combination with a pernicious desire to maintain a dangerously low body weight. Relatively little is known, however, about the mechanism underlying body image distortion in AN. Despite having normal visual perception, individuals with AN both feel and see themselves as large-bodied and show deficits in interoception and haptic perception, suggesting a potential deficit in visual and tactile integration. The size–weight illusion (SWI) arises when two objects of equal weight but different sizes are held. Typical individuals experience a strong and robust illusion that the smaller object feels much heavier than the larger object because of an implicit assumption that weight scales with size. The current study compared the strength of the SWI in individuals with AN to healthy control participants. Individuals with AN exhibited a markedly reduced SWI relative to controls, even though their ability to discriminate weight was unaffected. Because the SWI is strongly modulated by visual appearance, we believe our finding reflects decreased integration of visual and proprioceptive information in anorexia. This finding may explain the puzzling observation that visual perception of the body in a mirror does not correct an AN patient’s distorted body image. We speculate that methods to correct visuo-proprioceptive integration in constructing body image may help rehabilitate patients’ judgments of size and weight regarding their own bodies. We also suggest that a dysfunction in interactions between inferior parietal lobule (concerned with body image), insula, and hypothalamus may underlie AN.

Keywords

Anorexia nervosa Eating disorders Sensory integration Size–weight illusion Parietal lobe 

Notes

Acknowledgments

The authors would like to thank Dr. Walter Kaye for assistance with recruiting patients and Dr. Lisa Williams for construction of the size–weight stimuli and contributions to study design. The authors are grateful for the support of Herb Lurie, Dick Geckler, and Abe Pollin.

Conflict of interest

The authors report no conflicts of interest with the current research.

References

  1. Alais D, Burr D (2004) The ventriloquist effect results from near-optimal bimodal integration. Curr Biol 14(3):257–262PubMedGoogle Scholar
  2. Amazeen EL, Turvey MT (1996) Weight perception and the haptic size–weight illusion are functions of the inertia tensor. J Exp Psychol Hum Percept Perform 22(1):213–232PubMedCrossRefGoogle Scholar
  3. American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders (4th edn, text rev). American Psychiatric Association, Washington, DCGoogle Scholar
  4. Anderson NH (1970) Averaging model applied to the size–weight illusion. Percept Psychophys 8:1–4CrossRefGoogle Scholar
  5. Birmingham CL, Su J, Hlynsky JA, Goldner EM, Gao M (2005) The mortality rate from anorexia nervosa. Int J Eat Disord 38:143–146PubMedCrossRefGoogle Scholar
  6. Blechert J, Ansorge U, Tuschen-Caffier B (2010) A body-related dot-probe task reveals distinct attentional patterns for bulimia nervosa and anorexia nervosa. J Abnorm Psychol 119:575–585PubMedCrossRefGoogle Scholar
  7. Buckingham G, Goodale MA (2010) Lifting without seeing: the role of vision in perceiving and acting upon the size weight illusion. PLos One 5:e9709PubMedCrossRefGoogle Scholar
  8. Casper RC, Halmi KA, Goldberg SC, Eckert ED, Davis JM (1979) Disturbances in body image estimation as related to other characteristics and outcome in anorexia nervosa. Br J Psychiatry 134:60–66PubMedCrossRefGoogle Scholar
  9. Charpentier A (1891) Analyse experimentale: De quelques elements de la sensation de poids. Archives de Physiologie Normale et Pathologique 3:122–135Google Scholar
  10. Chouinard PA, Large ME, Chang EC, Goodale MA (2009) Dissociable neural mechanisms for determining the perceived heaviness of objects and the predicted weight of objects during lifting: an fMRI investigation of the size–weight illusion. Neuroimage 44:200–212PubMedCrossRefGoogle Scholar
  11. Critchley M (1953) The parietal lobes. Edward Arnold & Co., LondonGoogle Scholar
  12. Ellis RR, Lederman SJ (1993) The role of haptic versus visual volume cues in the size–weight illusion. Atten Percept Psychophys 53(3):315–324Google Scholar
  13. Ellis RR, Lederman SJ (1998) The golf-ball illusion: evidence for top-down processing in weight perception. Perception 27:193–201PubMedCrossRefGoogle Scholar
  14. Epstein J, Wiseman CV, Sunday SR, Klapper F, Alkalay L, Halmi KA (2001) Neurocognitive evidence favors “top down” over “bottom up” mechanisms in the pathogenesis of body size distortions in anorexia nervosa. Eat Weight Disord 6(3):140–147PubMedGoogle Scholar
  15. Fassino S, Pierò A, Gramaglia C, Abbate-Daga G (2004) Clinical, psychopathological and personality correlates of interoceptive awareness in anorexia nervosa, bulimia nervosa and obesity. Psychopathology 37:168–174PubMedCrossRefGoogle Scholar
  16. Flanagan JR, Beltzner MA (2000) Independence of perceptual and sensorimotor predictions in the size–weight illusion. Nat Neurosci 3:737–741PubMedCrossRefGoogle Scholar
  17. Gescheider GA (1997) Psychophysics: the fundamentals. Lawrence Erlbaum Associates, MahwahGoogle Scholar
  18. Grandy MS, Westwood DA (2006) Opposite perceptual and sensorimotor responses to a size–weight illusion. J Neurophysiol 95:3887–3892PubMedCrossRefGoogle Scholar
  19. Grunwald M, Ettrich C, Krause W, Assmann B, Daehne A, Weiss T, Gertz H-J (2001) Haptic perception in anorexia nervosa before and after weight gain. J Clin Exp Neuropsychol 23:520–529PubMedCrossRefGoogle Scholar
  20. Grunwald M, Ettrich C, Busse F, Assmann B, Daehne A, Gertz H-J (2002) Angle paradigm: a new method to measure right parietal dysfunctions in anorexia nervosa. Arch Clin Neuropsychol 17:485–496PubMedGoogle Scholar
  21. Guardia D, Lafargue G, Thomas P, Dodin V, Cottencin O, Luyat M (2010) Anticipation of body-scaled action is modified in anorexia nervosa. Neuropsychologia 48:3961–3966PubMedCrossRefGoogle Scholar
  22. Hoek HW, van Hoeken D (2003) Review of the prevalence and incidence of eating disorders. Int J Eat Disord 34:383–396PubMedCrossRefGoogle Scholar
  23. Jenmalm P, Schmitz C, Forssberg H, Ehrsson HH (2006) Lighter or heavier than predicted: neural correlates of corrective mechanisms during erroneously programmed lifts. J Neurosci 26:9015–9021PubMedCrossRefGoogle Scholar
  24. Kawai S, Henigman F, MacKenzie CL, Kuang AB, Faust PH (2007) A reexamination of the size–weight illusion induced by visual size cues. Exp Brain Res 179:443–456PubMedCrossRefGoogle Scholar
  25. Kaye WH, Fudge JL, Paulus M (2009) New insights into symptoms and neurocircuit function of anorexia nervosa. Nat Rev Neurosci 10:573PubMedCrossRefGoogle Scholar
  26. Keizer A, Aldegonda M, Smeets M, Dijkerman HC, van den Hout M, Klugkist I, van Elburg A, Postma A (2011) Tactile body image disturbance in anorexia nervosa. Psychiatry Res 190:115–120PubMedGoogle Scholar
  27. Komatsu H, Nagamitsu S, Ozono S, Yamashita Y, Ishibashi M, Matsuishi T (2010) Regional cerebral blood flow changes in early-onset anorexia nervosa before and after weight gain. Brain Dev 32:625–630PubMedCrossRefGoogle Scholar
  28. Matsumoto R, Kitabayashi Y, Narumoto J, Wada Y, Okamoto A, Ushijima Y et al (2006) Regional cerebral blood flow changes associated with interoceptive awareness in the recovery process of anorexia nervosa. Prog Neuropsychopharmacol Biol Psychiatry 30:1265–1270PubMedCrossRefGoogle Scholar
  29. McGeoch PD, Brang D, Song T, Lee RR, Huang M, Ramachandran VS (2011) Xenomelia: a new right parietal syndrome. J Neurol Neurosurg Psychiatry. doi: 10.1136/jnnp-2011-300224
  30. Mohr C, Porter G, Benton CP (2007) Psychophysics reveals a right hemispheric contribution to body image distortions in women but not men. Neuropsychologia 45(13):2942–2950PubMedCrossRefGoogle Scholar
  31. Mohr HM, Zimmerman J, Röder C, Lenz C, Overbeck G, Grabhorn R (2010) Separating two components of body image in anorexia nervosa using fMRI. Psychol Med 40(9):1519–1529PubMedCrossRefGoogle Scholar
  32. Nico D, Daprati E, Nighoghossian N, Carrier E, Duhamel JR, Sirigu A (2010) The role of the right parietal lobe in anorexia. Psychol Med 40:1531–1539PubMedCrossRefGoogle Scholar
  33. Oberman LM, Ramachandran VS (2008) Preliminary evidence for deficits in multisensory integration in autism spectrum disorders: the mirror neuron hypothesis. Soc Neurosci 3(3):348–355PubMedCrossRefGoogle Scholar
  34. Pollatos O, Kurz A-L, Albrecht J, Schreder T, Kleemann AM, Schöpf V, Kopietz R, Wiesmann M, Schandry R (2008) Reduced perception of bodily signals in anorexia nervosa. Eat Behav 9:381–388PubMedCrossRefGoogle Scholar
  35. Ramachandran VS, Brang D, McGeoch PD, Rosar W (2009) Sexual and food preference in apotemnophilia and anorexia: interactions between ‘beliefs’ and ‘needs’ regulated by two-way connections between body image and limbic structures. Perception 38:775–777PubMedCrossRefGoogle Scholar
  36. Ross HE (1966) Sensory information necessary for the size–weight illusion. Nature 212:650PubMedCrossRefGoogle Scholar
  37. Ross HE, Gregory RL (1970) Weight illusions and weight discrimination—a revised hypothesis. Q J Exp Psychol 22:318–328PubMedCrossRefGoogle Scholar
  38. Russo N, Foxe JJ, Brandwein AB, Altschuler T, Gomes H, Molholm S (2010) Multisensory processing in children with autism: high-density electrical mapping of auditory–somatosensory integration. Autism Res 3(5):253–267PubMedCrossRefGoogle Scholar
  39. Sachdev P, Mondraty N, Wen W, Gulliford K (2008) Brains of anorexia nervosa patients process self-images differently from non-self-images: an fMRI study. Neuropsychologia 46:2161–2168PubMedCrossRefGoogle Scholar
  40. Sheehan D, Janavs J, Harnett-Sheehan K, Sheehan M, Gray C (2009) Mini international neuropsychiatric interview, English version 6.0.0 (DSM-IV)Google Scholar
  41. Smeets MAM, Ingleby JD, Hoek HW, Panhuysen GEM (1999) Body size perception in anorexia nervosa: a signal detection approach. J Psychosom Res 46:465–477PubMedCrossRefGoogle Scholar
  42. Tomasino SJ (1996) Does right parietal cortex and vestibular dysfunction underlie body image distortion? J Nerv Ment Dis 184:758PubMedGoogle Scholar
  43. Warren MA, Freestone T, Thomas AJ (1989) Undernutrition during early adult life significantly affects neuronal connectivity in rat visual cortex. Exp Neurol 103:290–292PubMedCrossRefGoogle Scholar
  44. Williams LE, Ramachandran VS, Hubbard EM, Braff DL, Light GA (2009) Superior size–weight illusion performance in patients with schizophrenia: evidence for deficits in forward models. Schizophr Res 121:101–106CrossRefGoogle Scholar
  45. Zipfel S, Loewe B, Reas DL, Deter H-C, Herzog W (2000) Long-term prognosis in anorexia nervosa: lessons from a 21-year follow-up study. Lancet 355:721–722PubMedCrossRefGoogle Scholar
  46. Zucker NL, Losh M, Bulik CM, LaBar KS, Piven J, Pelphrey KA (2007) Anorexia nervosa and autism spectrum disorders: guided investigation of social cognitive endophenotypes. Psychol Bull 133:976–1006PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Laura K. Case
    • 1
    Email author
  • Rachel C. Wilson
    • 1
  • Vilayanur S. Ramachandran
    • 1
  1. 1.Center for Brain and CognitionUniversity of CaliforniaLa Jolla, San DiegoUSA

Personalised recommendations