Table 1.

Main studies on neuropsychology of anorexia nervosa

Authors	Journal	Sample	Mean age and sex	Tests	Follow-up	Results
Kaye et al54	Int J Eat Disord	9 AN, 7 BN	22 AN, 19 BN Females	MMFT		AN patients took a greater amount of time to respond after the sample stimulus item was presented. In contrast, the BN patients responded more quickly after the sample item was presented. AN were less impulsive than BN patients.
Gillberg et al33	Compr Psychiatry	51 AN, 51 C	21 NR	WAIS-R	4.9 years	AN group scored lower than C on the object assembly subtest.
Green et al11	J Psychiat Res	12 AN, 17 C	26 AN, 21 C Females	BVT, SRT, FAT, TFTT, IFRT	12 weeks	AN group recalled fewer words, displayed poorer reaction times and motor speed than C group. Despite having gained weight there was no corresponding improvement in cognitive performance.
Kingston et al27	Psychol Med	46 AN, 41 C	22.1 AN, 22 C Females	DS, LS, TMT, BD, Stroop, PC, Rey, TCF, SD, PM, AMT, MP, SDMT	Until weight gain of at least 10%	AN group had a worse performance on attention, visuospatial capacity and immediate memory. Only attention improved with treatment.
Sebastian et al30	Cogn Ther Res	10 ED 30 WPG 30 C	22.73 21.23 20.36 Females	VS, FRMT		A memory bias for fatness words was found in ED patients. The three groups did not differ in the recall of non-fat or neutral words.
Bradley et al28	J Clin Exp Neuropsychol	20 AN, 20 C (12 AN retested after weight gain)	15.7 Females	WISC-R LAT CFT, DSPALT, DVMS, CPT	Mean 8.5 months	The two groups did not differ on any of the tests used. AN patients who recovered performed significantly better than C on the Card Rotations Test and Coding F’s.
Cooper et al86	Br J Clin Psychol	12 AN, 12 BN, 18 C	Age NR Females	Stroop		Both patient groups showed attentional bias for eating- and weight-related words. Only AN patients showed attentional bias for body shape-related words.
Hermans et al29	J Abnorm Psychol	12 AN, 12 C	21.08 AN 24.67 C Sex ratio (M/F), 1/11	CR, WCT		Strong explicit memory bias for anorexia-related words in AN but not in C. There was no evidence for a similar bias in implicit memory.
Mathias et al20	J Clin Exp Neuropsychol	34 AN (26 inpatients, 8 outpatients) 31 C	22 AN, 20.08 C Females	WAIS-R, NART-R, WMS-R, RAVLT, Rey, AMT, COWA, TMT		AN patients were deficient in their ability to recall meaningful prose and visuospatial information.
Rieger et al16	Int J Eat Disord	16 AN, 17 BN, 32 C	20.9 AN. 23.9 BN, 20.3 C Females	VPDT		ED patients detected target probes more slowly than C when they appeared in the same location as stimulus words connoting a thin physique. The contrary (faster detection) occurs with words connoting a large physique.
Sackville et al14	Int J Eat Disord	20 AN, 53 C (LDR-HDR)	19.07 Females	Stroop		AN patients, but not unrestrained or restrained eaters, had delayed color-naming latencies for both thin and fat word categories and, to a lesser extent, for high caloric density food words.
Lauer et al18	J Psychiatr Res	12 AN, 14 BN	19.7 AN, 21.9 BN Females	LCT (d2), TMT, DTD, FPR, MVMT, RSPMT, DLPST	7 months	Initial testing: AN and BN showed similar impaired performance on attention and problem solving abilities. Their mnemonic functions were preserved. Both improved after treatment.
Grunwald et al52	Int J Eat Disord	10 AN, 10 C	15.9 AN, 16.14 C Females	HET	Mean 14.5 months	AN patients showed poorer performance than control individuals.
Neumärker et al50	Eur Child Adoles Psy	18 AN, 25 C	14.5 AN, 15.8 C NR	CFT20, VOC, NS	103.83 days	Initial testing: number-processing performance was lower in patients. With the treatment the prevalence of patients with a subnormal performance was similar to the normal population.
Mendlewicz et al12	Neuropsychobiology	16 AN, 16 C	17.8 AN, 18.7 C Females	Stroop		Authors did not find specific cognitive deficits in AN.
Bayless et al51	Ann Clin Psychiatry	59 AN	24.3 Females	WAIS-III, WL I-II, BVRT, COWA, TMT, WRAT-3		Mild cognitive impairments in several tasks. No conclusions about the reversibility with weight gain.
Fassino et al35	Int J Eat Disord	20 AN-R 20 C	23.8 23.1 Females	Stroop WCST		AN-R patients showed nonspecific attentional biases with a decrease in abstraction capacity and cognitive flexibility similar to those patients with OCD.
Murphy et al32	J Clin Exp Neuropsychol	16 AN, 16 BN, 16 C	22.3 AN, 22 BN, 25.3 C Females	MWT-B, WIP, BSRT, COWA, AHQ, Rey, SDMT, TMT, CAL		In the conditional-associative learning task, AN patients displayed an impaired performance with neutral material but not with individually threatening material. Such a deficit was not evident in BN or in C.
Seed et al19	Int J Neuropsychoph	20 AN, 20 C	29.12 AN, 29.31 C Females	Tailored version of CDR		AN patients showed selective impairments on attention, long-term memory and working memory.
Moser et al25	Int J Eat Disord	28 AN	26.43 Females	RBANS	32.79 days	Although standard scores were improved in the immediate memory, visuospatial/constructional, language, and attention domain standard scores, only the immediate memory domain improvement was statistically significant.
Pieters et al22	J Psychiatr Res	32 AN 32 C	18 AN, 17.7 C Females	Drawing and copying tasks		AN patients were significantly faster in a drawing task and showed shorter reaction times in copying tasks. Movement times did not differ significantly between the two groups. In the most complex copying task, a significant group × complexity interaction for reaction time (patients shorter) and re-inspection time (patients longer) was found. Patients also made more errors than controls.
Cavedini et al8	Psychiatry Res	59 AN (26 AN-R, 33 AN-P), 82 C	21.7 AN, 23.4 C Females (96%–97%)	GT, WST, OAT, WCST		AN patients showed deficits on decision-making. While AN-R patients showed an inability to produce an advantageous long-term strategy in the GT, the AN-P patients did not follow either a clearly advantageous or a clear disadvantageous behavioral strategy.
Tchanturia et al36,78	J Int Neuropsychol Soc	34 AN, 19 BN, 35 C	26.7 AN, 26.5 BN, 24.8 C NR	NART-R, TMT, BT, PST, VFT, CBT HIT		Anorectic patients show impairments on simple alternation and perceptual shift and bulimic patients show difficulties in mental flexibility and perceptual shift.
Pieters et al23	J Clin Exp Neuropsychol	17 AN, 17 C	17.75 AN, 17.61 C Females	Drawing and copying tasks	2–5 months	AN patients showed shorter reaction times in copying tasks and shorter drawing time in the drawing task than normal controls, and this pattern persisted after weight restoration.
Steinglass et al3,37	J Int Neuropsychol Soc	15 AN, 11 C	25.6 AN, 24 C Females	WASI, CVLT, Stroop, TMT, COWA, WCST		Patients made more perseverative errors on the WCST, indicating a problem in set shifting.
Tchanturia et al47	J Int Neuropsychol Soc	29 AN, 14 R-AN, 29 C	28.5 AN, 28.9 R-AN, 26.3 C Females	IGT, NART		AN patients performed poorly in the IGT compared to the C and to the recovered AN participants.
Tokley et al40	J Clin Exp Neuropsychol	24 AN, 24 C	21.79 AN, 22.04 C Females	Object assembly, GEFT, TMT, SWT		Women with AN showed a significant deficit in abstract thinking performance, which could not be explained by a more general intellectual deficit or diminished information processing speed. The AN sample also showed a greater preoccupation with detail relative to the control group.
Chui et al53	Pediatrics	66 AN, 42 C	21.3 AN, 20.7 C Females	SBWJ, HVLT-R, VRS (WMS-R)	Mean 6.4 years	AN subjects showed impairments in verbal abilities, cognitive efficiency, reading, mathematics and long-term verbal memory.
Redgrave et al13	Brain Imaging	6 AN, 6 C	18–45 Females	Stroop task		AN patients showed attentional bias to blocks of fat and thin words.
Southgate et al38	Psyquiatr Res	20 AN, 14 BN, 26 C	26.80 AN, 25.71 BN, 27.27 C Females	MFFT		AN patients scored significantly higher on the efficiency dimension score than the control group.
Brogan et al49	J Int Neuropsychol Soc	22 AN, 17 B, 18 Ob, 20 C	29.09 AN, 29.94 BN, 52.11 Ob, 27.75 C Females	IGT		The three clinical groups were significantly impaired on the IGT compared with the C group on both overall task performance and task learning; however, the three clinical groups were not significantly different from each other.
Guillaume et al45	Neuropsychology	49 AN, 38 BN, 83 C	23.3 AN, 23 BN, 28 C Females	NART, IGT		No significant differences in IGT performance were observed between patients and healthy controls, or between restrictive and purging types of anorexia nervosa.
Hatch et al92	Int J Eat Disord	37 AN, 45 C	15.16 AN, NR for C	IntegNeuro cognitive battery	89 days	Cognitive impairments appear to normalize with refeeding and weight gain.
Abbate-Daga et al39	BMC Psychiatry	30 AN (restrictive), 30 C	24.13 AN, 24.67 C NR	TMT, WCST, HSCT, IGT		AN patients showed mental rigidity in both verbal and nonverbal domains.
Giel et al15	Biol Psychiatry	19 AN, 38 C	24.4 AN, 24.3 C Females	Eye-tracking, food/ non-food pictures		AN patients allocated overall less attention to food pictures but showed no early attentional bias toward food pictures. Attentional engagement for food pictures was most pronounced in fasted healthy control subjects.
Sarrar et al21	Psychoneuroendocrinology	30 AN, 28 C	16.2 AN, 16.7 C Females	p-ORT, TMT, DST, CFT-20-R	2.8 months	Subtle deficits in cognitive flexibility were found in AN patients compared to C. After weight gain, the AN group improved relative to their baseline values in most of the variables but did not reach C values. They still showed slight impairments.
Shott et al31	Neuropsychology	21 AN, 19 C	25.2 AN, 27.3 C	Implicit category learning task (Gabor patches)		AN patients were less accurate on implicit category learning relative to C. Even when AN patients used the appropriate (ie, implicit) strategy they were still impaired relative to C who also used the same strategy.
Cardi et al59	World J Biol Psychiatry	29 AN, 17 BN, 13 R-AN, 9 R-BN, 50 C	27.3 ED, 29.5 ED-R, 25.3 C Females	Dot probe task with faces		Patients with a lifetime diagnosis of ED showed an attentional bias to reject faces and a difficulty disengaging attention from these stimuli.

Abbreviations: AN, anorexia nervosa; AHQ, Annett handedness questionnaire; AMT, Austin Maze test; BD, block design; BN, bulimia nervosa; BSRT, Buschke’s selective reminding test; BT, Brixton test; BVRT, Benton visual retention test (revised); BVT, Bakan vigilance task; C, control; CAL, conditional associative learning; CBT, cat bat task; CDR, cognitive drug research; CFT, coding F’s task; CFT20, culture fail intelligence test 20; CFT-20-R, culture fail intelligence test-20 (revised); COWA, controlled oral word association test; CPT, continuous performance test; CR, cued recall; CVLT, California verbal learning test; DLPST, daily living problem solving task; DS, digit symbol; DSPALT, digit symbol paired associates learning task; DST, digit symbol test; DTD, dual task design; DVMS, Denman verbal memory scale; ED, eating disorders; F, females; FAT, focused attention task; FPR, free paragraph recall; FRMT, free recall memory test; GEFT, group embedded figures test; GT, gambling task; HDR, high in dietary restraint; HET, haptic exploration tasks; HIT, haptic illusion task; HSCT, Hayling sentence completion task; HVLT-R, Hopkins verbal learning test (revised); IFRT, immediate free recall task; IGT, Iowa gambling test; LAT, lateral asymmetry tests; LCT (d2), letter cancellation task (d2); LDR, low in dietary restraint; LS, letter symbol; M, males; MMFT, matching familiar figure test; MP, Milner pathway in reverse; MVMT, Munich verbal memory test; MWT-B, verbal intelligence; NART, National adult reading test ; NART-R, National adult reading test (revised); NS, number sequence; OAT, object alternation test; PC, picture completion; PM, prose memory; p-ORT, cognitive flexibility computer based test; PST, picture set test; RAVLT, Rey auditory verbal learning test; RBANS, repeatable battery for the assessment of neuropsychological status; RSPMT, Raven standard progressive matrices T; SBWJ, standard battery of the Woodcock-Johnson III; SD, symbol digit; SDMT, symbol digit modality test; SRT, simple reaction time; SWT, spot the word test; TCF, Taylor complex figure; TFTT, two-finger tapping task; TMT, trail making test; VFT, verbal fluency task; VOC, vocabulary battery; VPDT, visual probe detection task; VRS (WMS-R), visual reproduction subscale of the Wechsler Memory Scale (revised); VS, verbal stimuli; WAIS-III, Wechsler adult intelligence scale III; WAIS-R, Wechsler adult intelligence scale (revised); WASI, Wechsler abbreviate scale of intelligence; WCT, word completion test; WCST, Wisconsin card sorting test; WIP, reduced version of the WAIS, German translation; WISC-R, Wechsler intelligence scale for children (revised); WL I-II, word lists I and II of the Wechsler memory scale III; WMS-R, Wechsler memory scale (revised); WPG, weight-preoccupied group; WRAT-3, Wide range achievement test 3; WST, Weigl’s sorting test.