Systematic reduction of gray matter volume in anorexia nervosa, but relative enlargement with clinical symptoms in the prefrontal and posterior insular cortices: a multicenter neuroimaging study.

Although brain morphological abnormalities have been reported in anorexia nervosa (AN), the reliability and reproducibility of previous studies were limited due to insufficient sample sizes, which prevented exploratory analysis of the whole brain as opposed to regions of interest (ROIs). Objective was to identify brain morphological abnormalities in AN and the association with severity of AN by brain structural magnetic resonance imaging (MRI) in a multicenter study, and to conduct exploratory analysis of the whole brain. Here, we conducted a cross-sectional multicenter study using T1-weighted imaging (T1WI) data collected between May 2014 and February 2019 in Japan. We analyzed MRI data from 103 female AN patients (58 anorexia nervosa restricting type [ANR] and 45 anorexia nervosa binge-purging type [ANBP]) and 102 age-matched female healthy controls (HC). MRI data from five centers were preprocessed using the latest harmonization method to correct for intercenter differences. Gray matter volume (GMV) was calculated from T1WI data of all participants. Of the 205 participants, we obtained severity of eating disorder symptom scores from 179 participants, including 87 in the AN group (51 ANR, 36 ANBP) and 92 HC using the Eating Disorder Examination Questionnaire (EDE-Q) 6.0. GMV reduction were observed in the AN brain, including the bilateral cerebellum, middle and posterior cingulate gyrus, supplementary motor cortex, precentral gyrus medial segment, and thalamus. In addition, the orbitofrontal cortex (OFC), ventromedial prefrontal cortex (vmPFC), rostral anterior cingulate cortex (ACC), and posterior insula volumes showed positive correlations with severity of symptoms. This multicenter study was conducted with a large sample size to identify brain morphological abnormalities in AN. The findings provide a better understanding of the pathogenesis of AN and have potential for the development of brain imaging biomarkers of AN. Trial Registration: UMIN000017456. https://center6.umin.ac.jp/cgi-open-bin/icdr/ctr_view.cgi?recptno=R000019303 .

Comprehensive elucidation of resting-state functional connectivity in anorexia nervosa by a multicenter cross-sectional study.

BACKGROUND: Previous research on the changes in resting-state functional connectivity (rsFC) in anorexia nervosa (AN) has been limited by an insufficient sample size, which reduced the reliability of the results and made it difficult to set the whole brain as regions of interest (ROIs). METHODS: We analyzed functional magnetic resonance imaging data from 114 female AN patients and 135 healthy controls (HC) and obtained self-reported psychological scales, including eating disorder examination questionnaire 6.0. One hundred sixty-four cortical, subcortical, cerebellar, and network parcellation regions were considered as ROIs. We calculated the ROI-to-ROI rsFCs and performed group comparisons. RESULTS: Compared to HC, AN patients showed 12 stronger rsFCs mainly in regions containing dorsolateral prefrontal cortex (DLPFC), and 33 weaker rsFCs primarily in regions containing cerebellum, within temporal lobe, between posterior fusiform cortex and lateral part of visual network, and between anterior cingulate cortex (ACC) and thalamus (p < 0.01, false discovery rate [FDR] correction). Comparisons between AN subtypes showed that there were stronger rsFCs between right lingual gyrus and right supracalcarine cortex and between left temporal occipital fusiform cortex and medial part of visual network in the restricting type compared to the binge/purging type (p < 0.01, FDR correction). CONCLUSION: Stronger rsFCs in regions containing mainly DLPFC, and weaker rsFCs in regions containing primarily cerebellum, within temporal lobe, between posterior fusiform cortex and lateral part of visual network, and between ACC and thalamus, may represent categorical diagnostic markers discriminating AN patients from HC.

Intentional binding and self-transcendence: Searching for pro-survival behavior in sense-of-agency.

Sense-of-agency (SoA) is implicated in a wide range of pro-survival behavioral capacities from a classical psychological perspective. However, in recent years, SoA has primarily been considered a sensorimotor process indexed by intentional binding, and pro-survival behavioral capacity has been considered multifactorial. To revisit their association, considering such conceptual updates, we examined the relationship between intentional binding and eight factors of pro-survival behavioral capacity (as defined by the power-to-live questionnaire). The level of intentional binding measured using the Libet clock method was significantly correlated with, and contributed to, the self-transcendence factor of the power-to-live questionnaire. The results demonstrated the contribution of the sensorimotor processes of SoA to pro-survival behavioral quality in the domain of self-transcendence, which may be explained by a recent social-cognitive hypothesis for the development from contingency detection to social embeddedness and moral compliance.

Evaluation of energy density and macronutrients after extremely brief time exposure.

Many food decisions are made rapidly and without reflective processing. The ability to determine nutritional information accurately is a precursor of food decisions and is important for a healthy diet and weight management. However, little is known about the cognitive evaluation of food attributes based on visual information in relation to assessing nutritional content. We investigated the accuracy of visual encoding of nutritional information after brief and extended time exposures to food images. The following questions were addressed: (1) how accurately do people estimate energy and macronutrients after brief exposure to food images, and (2) how does estimation accuracy change with time exposure and the type of nutritional information? Participants were first asked to rate the energy density (calories) and macronutrient content (carbohydrates/fat/protein) of different sets of food images under three time conditions (97, 500 or 1000 ms) and then asked to perform the task with no time constraints. We calculated estimation accuracy by computing the correlations between estimated and actual nutritional information for each time exposure and compared estimation accuracy with respect to the type of nutritional information and the exposure time. The estimated and actual energy densities and individual macronutrient content were significantly correlated, even after a brief exposure time (97 ms). The degree of accuracy of the estimations did not differ with additional time exposure, suggesting that <100 ms was sufficient to predict the energy and macronutrients from food images. Additionally, carbohydrate estimates were less accurate than the estimates of other nutritional variables (proteins, fat and calories), regardless of the exposure time. These results revealed rapid and accurate assessment of food attributes based on visual information and the accuracy of visual encoding of nutritional information after brief and extended time exposure to food imagery.

The pitfall of empathic concern with chronic fatigue after a disaster in young adults.

BACKGROUND: Empathic concern (EC) is an important interpersonal resilience factor that represents positive adaptation, such as "relating to others" (a factor of posttraumatic growth [PTG]) after disaster. However, controversy exists regarding whether the changes in EC (e.g., the intra-personal change between the acute phase and the disillusionment phase) positively or negatively affect mental health after a disaster. We hypothesized that increased EC may increase chronic fatigue due to over-adjustment (hypothesis 1). We also hypothesized that increasing the changes in "relating to others" could decrease the changes in chronic fatigue (hypothesis 2). METHODS: Forty-nine young, healthy volunteers (M/F: 36/13; age at 3 months after the disaster [3 months]: mean ± SD: 21.1 ± 1.7 years) underwent assessments of EC using the Japanese version of the Interpersonal Reactivity Index, chronic fatigue using the Japanese version of the Checklist Individual Strength (CIS-J) questionnaire, and "relating to others" using the Japanese version of the PTG inventory during the acute phase (3 months) and the disillusionment phase (1 year after the disaster). Pearson product moment correlations at 3 months and 1 year were determined for all scores related to EC. The changes (delta = degree of change from 3 months to 1 year) or scores at 1 year were entered into linear structural equation systems to test the hypotheses. RESULTS: The delta of EC positively affected the delta of the CIS-J, and the delta of relating to others negatively affected the delta of the CIS-J. Both the EC and relating to others scores were negatively associated with the CIS-J score at 1 year. These results were in accordance with hypothesis 1 and 2. CONCLUSIONS: We demonstrated the opposite effects of 2 types of ECs, i.e., stability (inherent disposition) and flexibility (degree of change), on the degree of chronic fatigue. Increasing EC with increasing chronic fatigue, but not the change in relating to others, may be a red flag for individuals during the disillusionment phase.

Anxiety increases visual attention to hedonic foods: A preliminary eye-tracking study on the impact of the interplay between integral and incidental affect on foods.

Two types of affect influence consumers' attention: incidental affect unrelated to a particular perception or judgment and integral affect directly related to the particular options under consideration. Although integral and incidental affect likely coexist on a regular basis, the claim that both concurrently guide consumers' attention has thus far received little attention. To fill this gap, the present study investigated the effects of the interplay of integral and incidental affect on the visual processing of food. Food labels play an essential role in attracting consumer attention. Food labels include sources of integral affect (e.g., food type, pictures), and consumers often view food labels under the influence of incidental affect (e.g., an unrelated anxiety-inducing message or personal experience). According to the appraisal tendency framework, incidental experiences of anxiety can enhance affective processing of food due to the uncertainty associated with anxiety. In our study, participants were first subjected to manipulation of an incidental emotion (anxiety, anger, or neutral). Then, they passively viewed food labels, including pictures and nutrient labels, for hedonic and healthy foods. Subject's eye movements were tracked during this stage of the study. Our results showed that the induction of incidental anxiety, but not anger or neutral feelings, led to greater visual attention on hedonic foods only. These findings shed light on the interplay between incidental and integral affect in consumer information processing, demonstrating that the co-occurrence of incidental anxiety and integral hedonic feelings enhance visual attention to food.

Approach or avoidance: Neural correlates of intelligence evaluation from faces.

Intelligence is among the key determinants of power and social status in modern societies. In this functional magnetic resonance imaging study, we examined the neural correlates of intelligence evaluation from faces. Participants underwent scans while they evaluated the perceived intelligence and friendliness of faces. We found that medial orbitofrontal cortex activity increased linearly with friendliness ratings. The relationship between perceived intelligence and brain activity was positively linear in the right caudate nucleus and U-shaped (i.e., strong responses to unintelligent-looking or intelligent-looking faces) in the right anterior insula/inferior frontal gyrus. Perceived intelligence was also significantly positively correlated with both friendliness and attractiveness. Furthermore, intelligence rating scores had a positive linear effect on reaction times in the friendliness rating task, suggesting that participants had greater conflicts when making friendliness judgments for faces that appeared to belong to intelligent individuals. In addition, the degree of this effect predicted individual differences in the positive linear modulatory effect of intelligence scores in the right caudate nucleus. Our interpretation was that the activity in the caudate nucleus revealed an approach-avoidance conflict with regard to highly intelligent people, that is, they were perceived as attractive but also potentially threatening. Although our interpretations are merely suggestive because we did not measure the approach-avoidance behaviors directly, our findings have important implications for understanding the dynamics of human interaction in modern societies that increasingly allocate power and status based on intelligence.

Neural bases of the adaptive mechanisms associated with reciprocal partner choice.

In our society, partner choice is often reciprocal and, therefore, compromising one's choice may be adaptive depending on one's own market price. To reveal the neural mechanisms underlying this adaptive process, functional magnetic resonance imaging (fMRI) was performed on 27 male subjects during virtual partner choice tasks involving a dance-partner choice or a part-time job choice. Following the evaluation of a rival, the subjects chose a partner either in the face of competition with a rival (reciprocal choice condition) or during no competition (nonreciprocal condition). Irrespective of the type of partner choice situation, the posterior cingulate cortex (PCC) and right temporoparietal junction (TPJ) were specifically activated during reciprocal partner choice. The PCC was also activated during the evaluation of a rival relative to the self, which indicates the involvement of this region in the processing of one's own market price. Activation in the right TPJ was related to the individual tendency to avoid choosing a higher-value candidate when the rival-value was high in the reciprocal choice condition, which indicates that this region plays a role in market-adaptive strategy. Taken together with extant anatomical knowledge, the two-component neurobiological structure underlying the adaptive mechanism of partner choice identified in this study seems to represent the hierarchical evolution of the human socio-cognitive system.

Neural Mechanism for Mirrored Self-face Recognition.

Self-face recognition in the mirror is considered to involve multiple processes that integrate 2 perceptual cues: temporal contingency of the visual feedback on one's action (contingency cue) and matching with self-face representation in long-term memory (figurative cue). The aim of this study was to examine the neural bases of these processes by manipulating 2 perceptual cues using a "virtual mirror" system. This system allowed online dynamic presentations of real-time and delayed self- or other facial actions. Perception-level processes were identified as responses to only a single perceptual cue. The effect of the contingency cue was identified in the cuneus. The regions sensitive to the figurative cue were subdivided by the response to a static self-face, which was identified in the right temporal, parietal, and frontal regions, but not in the bilateral occipitoparietal regions. Semantic- or integration-level processes, including amodal self-representation and belief validation, which allow modality-independent self-recognition and the resolution of potential conflicts between perceptual cues, respectively, were identified in distinct regions in the right frontal and insular cortices. The results are supportive of the multicomponent notion of self-recognition and suggest a critical role for contingency detection in the co-emergence of self-recognition and empathy in infants.

The neural bases underlying social risk perception in purchase decisions.

Social considerations significantly influence daily purchase decisions, and the perception of social risk (i.e., the anticipated disapproval of others) is crucial in dissuading consumers from making purchases. However, the neural basis for consumers' perception of social risk remains undiscovered, and this novel study clarifies the relevant neural processes. A total of 26 volunteers were scanned while they evaluated purchase intention of products (purchase intention task) and their anticipation of others' disapproval for possessing a product (social risk task), using functional magnetic resonance imaging (fMRI). The fMRI data from the purchase intention task was used to identify the brain region associated with perception of social risk during purchase decision making by using subjective social risk ratings for a parametric modulation analysis. Furthermore, we aimed to explore if there was a difference between participants' purchase decisions and their explicit evaluations of social risk, with reference to the neural activity associated with social risk perception. For this, subjective social risk ratings were used for a parametric modulation analysis on fMRI data from the social risk task. Analysis of the purchase intention task revealed a significant positive correlation between ratings of social risk and activity in the anterior insula, an area of the brain that is known as part of the emotion-related network. Analysis of the social risk task revealed a significant positive correlation between ratings of social risk and activity in the temporal parietal junction and the medial prefrontal cortex, which are known as theory-of-mind regions. Our results suggest that the anterior insula processes consumers' social risk implicitly to prompt consumers not to buy socially unacceptable products, whereas ToM-related regions process such risk explicitly in considering the anticipated disapproval of others. These findings may prove helpful in understanding the mental processes involved in purchase decisions.

High-gamma activity in an attention network predicts individual differences in elderly adults' behavioral performance.

The current study used a magnetoencephalogram to investigate the relationship between high-gamma (52-100 Hz) activity within an attention network and individual differences in behavioral performance among healthy elderly adults. We analyzed brain activity in 41 elderly subjects performing a 3-stimulus visual oddball task. In addition to the average amplitude of event-related fields in the left intraparietal sulcus (IPS), high-gamma power in the left middle frontal gyrus (MFG), the strength of high-gamma imaginary coherence between the right MFG and the left MFG, and those between the right MFG and the left thalamus predicted individual differences in reaction time. In addition, high-gamma power in the left MFG was correlated with task accuracy, whereas high-gamma power in the left thalamus and left IPS was correlated with individual processing speed. The direction of correlations indicated that higher high-gamma power or coherence in an attention network was associated with better task performance and, presumably, higher cognitive function. Thus, high-gamma activity in different regions of this attention network differentially contributed to attentional processing, and such activity could be a fundamental process associated with individual differences in cognitive aging.

Irony comprehension: social conceptual knowledge and emotional response.

Verbal irony conveys various emotional messages, from criticism to humor, that differ from the meaning of the actual words. To understand irony, we need conceptual knowledge of irony in addition to an understanding of context. We investigated the neural mechanism of irony comprehension, focusing on two overlooked issues: conceptual knowledge and emotional response. We studied 35 healthy subjects who underwent functional MRI. During the scan, the subject examined first-person-view stories describing verbal interactions, some of which included irony directed toward the subject. After MRI, the subject viewed the stories again and rated the degree of irony, humor, and negative emotion evoked by the statements. We identified several key findings about irony comprehension: (1) the right anterior superior temporal gyrus may be responsible for representing social conceptual knowledge of irony, (2) activation in the medial prefrontal cortex and the right anterior inferior temporal gyrus might underlie the understanding of context, (3) modulation of activity in the right amygdala, hippocampus, and parahippocampal gyrus is associated with the degree of irony perceived, and (4) modulation of activity in the right dorsolateral prefrontal cortex varies with the degree of humor perceived. Our results clarified the differential contributions of the neural loci of irony comprehension, enriching our understanding of pragmatic language communication from a social behavior point of view.

Developmental changes in brain activation involved in the production of novel speech sounds in children.

Older children are more successful at producing unfamiliar, non-native speech sounds than younger children during the initial stages of learning. To reveal the neuronal underpinning of the age-related increase in the accuracy of non-native speech production, we examined the developmental changes in activation involved in the production of novel speech sounds using functional magnetic resonance imaging. Healthy right-handed children (aged 6-18 years) were scanned while performing an overt repetition task and a perceptual task involving aurally presented non-native and native syllables. Productions of non-native speech sounds were recorded and evaluated by native speakers. The mouth regions in the bilateral primary sensorimotor areas were activated more significantly during the repetition task relative to the perceptual task. The hemodynamic response in the left inferior frontal gyrus pars opercularis (IFG pOp) specific to non-native speech sound production (defined by prior hypothesis) increased with age. Additionally, the accuracy of non-native speech sound production increased with age. These results provide the first evidence of developmental changes in the neural processes underlying the production of novel speech sounds. Our data further suggest that the recruitment of the left IFG pOp during the production of novel speech sounds was possibly enhanced due to the maturation of the neuronal circuits needed for speech motor planning. This, in turn, would lead to improvement in the ability to immediately imitate non-native speech.

Spinal fMRI of interoceptive attention/awareness in experts and novices.

Many disciplines/traditions that promote interoceptive (inner sensation of body parts) attention/awareness (IAA) train practitioners to both attend to and be aware of interoceptive sensory experiences in body parts. The effect of such practices has been investigated in previous imaging studies but limited to cerebral neural activity. Here, for the first time, we studied the impact of these practices on the spinal neural activity of experts and novices. We also attempted to clarify the effect of constant and deep breathing, a paradigm utilized in concentration practices to avoid mind wandering, on IAA-related spinal neural activity. Subjects performed IAA tasks with and without a deep and constant breathing pattern in two sessions. Results showed that neural activity in the spinal segment innervating the attended-to body area increased in experts (P = 0.04) when they performed IAA and that this increase was significantly larger for experts versus novices in each of the sessions (P = 0.024). The significant effects of IAA and expertise on spinal neural activity are consistent with and elaborate on previous reports showing similar effects on cerebral neural activity. As the spinal cord directly innervates body parts, the results might indicate that IAA has an instantaneous (possibly beneficial) effect on the physical body after extended training.

Reduced body-image disturbance by body-image interventions is associated with neural-response changes in visual and social processing regions: a preliminary study.

Introduction: Body-image disturbance is a major factor in the development of eating disorders, especially among young women. There are two main components: perceptual disturbance, characterized by a discrepancy between perceived and actual body size, and affective disturbance, characterized by a discrepancy between perceived and ideal body size. Interventions targeting body-image disturbance ask individuals to describe their own body without using negative expressions when either viewing it in a mirror or imagining it. Despite the importance of reducing body-image disturbance, its neural mechanisms remain unclear. Here we investigated the changes in neural responses before and after an intervention. We hypothesized that neural responses correlated with the degree of body-image disturbance would also be related to its reduction, i.e., a reduction in perceptual and affective disturbances would be related to changes in attentional and socio-cognitive processing, respectively. Methods: Twenty-eight young adult women without known psychiatric disorders underwent a single 40-min intervention. Participants completed tasks before and after the intervention, in which they estimated their perceived and ideal body sizes using distorted silhouette images to measure body-image disturbance. We analyzed the behavioral and neural responses of participants during the tasks. Results: The intervention did not significantly reduce body-image disturbance. Analysis of individual differences showed distinct changes in neural responses for each type of disturbance. A decrease in perceptual disturbance was associated with bodily visuospatial processing: increased activation in the left superior parietal lobule, bilateral occipital gyri, and right cuneus. Reduced affective disturbance was associated with socio-cognitive processing; decreased activation in the right temporoparietal junction, and increased functional connectivity between the left extrastriate body area and the right precuneus. Discussion: We identified distinct neural mechanisms (bodily visuospatial and socio-cognitive processing) associated with the reduction in each component of body-image disturbance. Our results imply that different neural mechanisms are related to reduced perceptual disturbance and the expression thereof, whereas similar neural mechanisms are related to the reduction and expression of affective disturbance. Considering the small sample size of this study, our results should be regarded as preliminary.

Perceiving humanness across ages: neural correlates and behavioral patterns.

Humanness perception, which attributes fundamental and unique human characteristics to other objects or people, has significant consequences for people's interactions. Notably, the failure to perceive humanness in older adults can lead to prejudice. This study investigates the effect of a target's age on humanness perception in terms of two dimensions: agency (the ability to act and do) and experience (the ability to feel and sense). We also examined brain activity using a magnetic resonance imaging (MRI) scanner in order to understand the underlying neural mechanisms. Healthy university students viewed the facial images of older and younger individuals and judged the humanness of each individual in terms of agency and experience while inside the MRI scanner. The results indicated that older adults were rated higher on experience, and no difference was found in ratings for agency between younger and older face images. Analysis of brain imaging data indicated that positive functional connectivity between the ventral and dorsal regions of the medial prefrontal cortex (mPFC) was greater when judging the humanness of younger faces than older faces. We also found that the negative functional connectivity between the left inferior frontal gyrus and postcentral gyrus was greater when judging the humanness of older faces as compared to that of younger faces. Although the current study did not show distinct brain activities related to humanness perception, it suggests the possibility that different brain connectivities are related to humanness perception regarding targets belonging to different age groups.

Neural correlates of adaptive social responses to real-life frustrating situations: a functional MRI study.

BACKGROUND: Frustrating situations are encountered daily, and it is necessary to respond in an adaptive fashion. A psychological definition states that adaptive social behaviors are "self-performing" and "contain a solution." The present study investigated the neural correlates of adaptive social responses to frustrating situations by assessing the dimension of causal attribution. Based on attribution theory, internal causality refers to one's aptitudes that cause natural responses in real-life situations, whereas external causality refers to environmental factors, such as experimental conditions, causing such responses. To investigate the issue, we developed a novel approach that assesses causal attribution under experimental conditions. During fMRI scanning, subjects were required to engage in virtual frustrating situations and play the role of protagonists by verbalizing social responses, which were socially adaptive or non-adaptive. After fMRI scanning, the subjects reported their causal attribution index of the psychological reaction to the experimental condition. We performed a correlation analysis between the causal attribution index and brain activity. We hypothesized that the brain region whose activation would have a positive and negative correlation with the self-reported index of the causal attributions would be regarded as neural correlates of internal and external causal attribution of social responses, respectively. RESULTS: We found a significant negative correlation between external causal attribution and neural responses in the right anterior temporal lobe for adaptive social behaviors. CONCLUSION: This region is involved in the integration of emotional and social information. These results suggest that, particularly in adaptive social behavior, the social demands of frustrating situations, which involve external causality, may be integrated by a neural response in the right anterior temporal lobe.

Why people hesitate to help: Neural correlates of the counter-dynamics of altruistic helping and individual differences in daily helping tendencies.

Recent psychological and neuroimaging studies on altruism-egoism dilemmas have promoted our understanding of the processes underlying altruistic motivation; however, little attention has been paid to the egoistic counter-dynamics that prompt hesitancy to help. These counter-dynamics may involve the construction of reasons not to help based on contextual elaboration and explain individual differences in the tendency to help others in daily life. In this functional magnetic resonance imaging (fMRI) study, we explored the neural correlates of altruism-egoism dilemmas during empathy-driven helping decisions, with particular attention to the counter-dynamics related to individual helping tendency traits. We used two context-rich helping decision scenarios. In the empathy dilemma (Emp) scenario, empathy-driven motivation to help a poor person was associated with a cost, whereas in the economic-dilemma (Eco) scenario, self-beneficial motivation to help a non-poor person was associated with a cost. Our results showed activation of the right anterior prefrontal cortices, supramarginal gyrus, and posterior cingulate cortex (PCC) for the altruism-egoism dilemma (i.e., Emp > Eco). A significant negative effect of the helping tendency trait score was observed on PCC activation; interestingly, this effect was observed for both Emp and Eco dilemmas. The identified neural correlates of altruism-egoism dilemmas appear to be related to the construction of decision reasons based on contextual elaboration in naturalistic situations. In contrast to the classical view, our results suggest a two-stage model that includes an altruistic helping decision followed by counter-dynamics to determine the individual helping tendency.

Neural mechanisms of perceptual and affective body-image disturbance during own-body and ideal-body estimation.

Body-image disturbance is a core feature of eating disorders and can predict their development in healthy individuals. There are two components of body-image disturbance: perceptual disturbance (associated with overestimation of body size) and affective disturbance (associated with body dissatisfaction). Previous behavioral studies have hypothesized that attention to particular body parts and negative body-related emotions resulting from social pressure are associated with the respective degrees of perceptual and affective disturbance; however, the neural representations that underlie this hypothesis have not been elucidated. Thus, this study investigated the brain regions and connectivity associated with the degree of body-image disturbance. Specifically, we examined the brain activations associated with participants' estimation of the width of their actual and ideal bodies; we sought to determine which brain regions and functional connectivity from body-related visual processing regions were correlated with the degree of each component of body-image disturbance. The degree of perceptual disturbance was positively correlated with excessive width-dependent brain activations in the left anterior cingulate cortex when estimating one's body size; it was positively correlated with the functional connectivity between the left extrastriate body area and left anterior insula. The degree of affective disturbance was positively correlated with excessive width-dependent brain activation in the right temporoparietal junction and negatively correlated with functional connectivity between the left extrastriate body area and right precuneus when estimating one's ideal body size. These results support the hypothesis that perceptual disturbance is associated with attentional processing, whereas affective disturbance is associated with social processing.