Neurocognitive endophenotypes for eating disorders: a preliminary high-risk family study

Eating disorders (ED) are psychiatric disorders with a neurobiological, psychological and socio-environmental basis. Specific neuropsychological and brain structure and function characteristics have been identified in ED. However, evidence has often relied on patients in the acute phase or recovered, precluding an understanding of whether such differences are a direct effect of ED or precede the development of ED. In order to address this challenge, we carried out the first ‘children at risk’ study in this field, by investigating healthy offspring of women with ED (high-risk design). The aim of this preliminary study was to investigate neurocognitive and neural differences in children at high-risk for ED compared to control children. Sixteen (16) girls at high-risk for ED and 20 control girls (age range: 8-15), completed a battery of neuropsychological tests assessing executive functions. Children also underwent a resting-state fMRI scan in order to extract resting-state networks functional connectivity (FC), using an independent component analysis.Girls at high-risk for ED performed worse on a cognitive flexibility task compared to controls adjusting for age and IQ (F=5.53, p=0.02). Moreover, compared to controls, those at high-risk for ED showed reduced FC in the default-mode, sensorimotor and dorsal attentional networks, as well as increased FC in the medial visual network (all p<0.05 FDR corrected). This is the first study on girls at high-risk for ED. Differences identified in cognitive flexibility and in FC are in line with those identified in individuals with ED, strongly pointing to a role as potential endophenotypes of ED.