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Table 1 Overview of associations between neuropsychological function and clinical measures in patients with AN. Significant associations are highlighted in bold

From: Is set-shifting and central coherence in anorexia nervosa influenced by body mass index, anxiety or depression? A systematic review

Authors Sample N (mean age) Test Anxiety Depression BMI/WfH ED severity
Tchanturia et al., 2002 [29] AN = 30 (25.2) AN-REC = 16 (30.0) HC = 23 (27.6) Haptic Illusion Task (SS) Cognitive Shift Task (SS) Group differences in the Haptic Illusion Task remained after covarying for anxiety. Group differences in the cognitive shift task disappeared when controlling for anxiety. N/A N/A
Tchanturia et al., 2004 [30] AN = 34 (26.7) BN = 19 (26.5) HC = 35 (24.8) Trail Making Test (SS)
Brixton Spatial Anticipation Test (SS)
Picture Set Test (SS)
Verbal Fluency Task (SS)
CatBat Task (SS)
Haptic Illusion Task (SS)
N/A
Holliday et al., 2005 [31] AN = 47 (26.3) AN sisters = 47 (27.6) HC = 47 (26.5) Haptic Illusion Task (SS)
Brixton Spatial Anticipation Test (SS)
Trail Making Test (SS)
CatBat Task (SS)
Anxiety scores correlated with the Haptic Illusion Task. Depression scores correlated with the Haptic Illusion Task. N/A
Fowler et al., 2006 [20] AN = 25 (16.9)
HC = 25 (17.6)
Intra/Extra Dimensional Set Shift Test (SS) N/A
Steinglass et al., 2006 [32, 33] AN = 15 (25.6)
HC = 11 (24.0)
Wisconsin Card Sorting Test (SS)
Lopez et al., 2008 [5] AN = 42 (28.4)
HC = 42 (26.3)
Rey Complex Figure Test (CC)
Embedded Figures Test (CC)
Sentence Completion Task (CC)
Homograph Reading Task (CC)
BMI correlated with number of errors in the initial pronunciation in the Homograph Reading Task. N/A
Kim et al., 2010 [34] AN = 40 (22.8)
BN = 28 (23.0)
HC = 34 (22.7)
Trail Making Test (SS) Depression slightly correlated with set-shifting.
Roberts et al., 2010 [35] AN = 35 (23.7)
AN-BP = 33 (25.6)
BN = 30 (26.4)
AN-REC = 30 (32.1)
AN sister = 30 (24.2)
BN sister = 20 (27.6)
HC = 88 (28.4)
Trail Making Test (SS)
Wisconsin Card Sorting Test (SS)
Brixton Spatial Anticipation Test (SS)
Haptic illusion Task (SS)
Increased anxiety in the poor set-shifting group, but effects were small Increased depression in the poor set-shifting group, but effects were small. Those with poor set-shifting had higher score on the YBC-EDS
Tenconi et al., 2010 [36] AN = 153 (26.2)
HC = 120 (27.4)
Wisconsin Card Sorting Test (SS)
Trail Making Test (SS)
Rey Complex Figure Test CC)
Overlapping Figures Test (CC)
State anxiety had a moderate correlation with Trail Making Test and Overlapping Figures Test.
Harrison et al., 2011 [26] AN = 50 (16–55)
BN = 48 (16–55)
AN-REC = 35 (16–55)
HC = 89 (16–55)
Fragmented Pictures Task (CC)
Rey Complex Figure Test (CC)
Group Embedded Figures Test (CC)
Negative correlation between BMI and Fragmented Picture Task, but not significant after correcting for multiple comparisons. Those with reduced central coherence had higher EDE-Q Global score
McAnarney et al., 2011 [27] AN-R = 24 (14–20)
HC = 37 (14–20)
Wisconsin Card Sorting Test (SS)
Intra/Extradimensional Set Shift test (SS)
N/A N/A No significant correlations. N/A
Bühren et al., 2012 [37] AN = 28 (15.6)
HC =27 (15.0)
Visual Set-Shifting Task (SS) N/A N/A
Danner et al., 2012 [38] AN = 16 (25.6)
AN-REC = 15 (24.3)
HC = 15 (25.8)
Berg’s Card Sorting Test (SS)
Rey Complex Figure Test (CC)
A better copy accuracy on the Rey Complex Figure Task was related to higher levels of anxiety. N/A
Galimberti et al., 2012 [39] AN-R = 24 (26.7)
AN-BP = 12 (27.1)
BN = 16 (25.3)
HC = 40 (25.9)
Intra/Extradimensional Set shift test (SS) N/A
Giel et al., 2012 [40] AN = 15 (23.9)
UD = 20 (36.3)
HC = 35 (30.2)
Trail Making Test (SS)
Wisconsin Card Sorting Test (SS)
Parametric Go/No-Go Test (SS)
N/A Significant medium correlations were found in both AN and UD patients.
Shott et al., 2012 [28] ADOL-AN = 15 (14.8)
ADOL-C = 16 (14.0)
ADULT-AN = 26 (26.2)
ADULT – C = 33 (26.0)
Category Learning Task (SS)
Galimberti et al., 2013 [41] AN = 29 (24.1)
HC = 29 (28.6)
Wisconsin Card Sorting Test (SS) N/A N/A
Tapajoz et al., 2013 [42] AN = 24 (24.5)
BN = 24 (24.4)
HC = 24 (25.2)
Rey Complex Figure Task (CC)
Van Autreve et al., 2013 [43] AN-R = 31 (26.0)
AN-BP = 20 (20.0)
HC = 26 (19.0)
Block design (CC)
Object Assembly (CC)
Wisconsin Card Sorting Test (SS)
Trail Making Test (SS)
Task Switching Paradigm (SS)
Trait anxiety in the AN-BP group correlated with Object Assembly. N/A
Zuchova et al., 2013 [44] AN = 31 (25.6) Rey Complex Figure Task (CC) N/A N/A Significant correlations between recall accuracy and EDE-Q total score and CR-EAT
Abbate Daga et al., 2014 [45] AN = 94 (24.7)
HC = 59 (25.1)
Wisconsin Card Sorting Test (SS) N/A AN individuals with poor set-shifting reported higher BDI scores than those with intact set-shifting. N/A
Aloi et al., 2015 [46] AN-RES = 45 (22.8)
BED = 45 (30.6)
HC = 45 (25.6)
Rey Complex Figure Test (CC)
Trail Making Test (SS)
Wisconsin Card sorting Test (SS)
N/A BMI was associated with poor cognitive flexibility, extreme weight conditions performed worse than HC. N/A
Lang et al., 2015 [22] AN = 41 (15.1)
HC = 43 (15.1)
Wisconsin Card Sorting Test (SS)
Rey Complex Figure Test (CC)
Fragmented Pictures Task (CC)
N/A
Renwick et al., 2015 [29] AN-R = 44
AN-BP = 33
EDNOS-AN = 23
Total N = 100 (24.7)
Wisconsin Card Sorting Test (SS)
Brixton Spatial Anticipation Test (SS)
Rey Complex Figure Test (CC)
N/A N/A N/A
Øverås et al., 2015 [47] AN-R = 30 (19.1)
HC = 45 (18.3)
Wisconsin Card Sorting Test (SS) Significant correlations with Wisconsin Card Sorting Test. Significant correlations with Wisconsin Card Sorting Test. Significant correlations with Wisconsin Card Sorting Test. N/A
Elzakkers et al., 2016 [48] AN = 70 (27.3) Rey Complex Figure Test (CC)
Wisconsin Card sorting Test (SS)
N/A N/A N/A
Roberts et al., 2016 [49] AN = 54 (24.2) Wisconsin Card Sorting Test (SS)
Brixton Spatial Anticipation Test (SS)
Trail Making Test (SS)
Haptic illusion Task (SS)
Rey Complex Figure Test (CC)
Group Embedded Figures Test (CC)
N/A N/A The group with both poor set-shifting and global processing had a lower lifetime BMI than patients with one neurocognitive inefficiency. N/A
Röβner et al., 2016 AN = 69 (14.3)
HC = 63 (14.1)
Trail Making Test (SS) N/A N/A
Van Noort et al., 2016 [24] EO-AN =30 (12.2)
AN = 30 (15.9)
HC = 60 (16.2)
Rey Complex Figure Test (CC)
Trail Making Test (SS)
N/A N/A N/A
Van Noort et al., 2016 [24] AN = 20 (15.6)
HC = 20 (15.7)
Trail Making Test (SS)
Rey Complex Figure Test (CC)
N/A N/A N/A
Weider et al., 2016 [50] AN = 41 (28.2)
BN = 40 (27.7)
HC = 41 (27.7)
Rey Complex Figure Test (CC) N/A N/A Significant low central coherence index became non-significant when adjusting for nadir BMI. N/A
Bentz et al., 2017 [25] FeAN = 43 (16.1)
AN-REC = 28 (18.4)
HC = 41 (17.7)
Verbal fluency Task (SS)
Design fluency Task (SS)
Trail Making Test (SS)
Group Embedded Figures Test (CC)
N/A N/A
Perpiña et al., 2016 [51] AN-R = 18 (22.3)
ED.AN = 21 (23.1)
BP-G = 47 (24.5)
OB = 27 (47.8)
HC = 39 (31.9)
Wisconsin Card Sorting Test (SS) Positive relationship between anxiety and “total errors” on Wisconsin Card sorting Test. Negative relationship between anxiety and “total categories completed” on the Wisconsin Card Sorting Test. A positive relationship between depression and “total errors” on Wisconsin card sorting test, and negative correlations between depression and Iowa gambling task in all groups. N/A
Øverås et al., 2017 [52] AN =35 (18.8)
HC = 34 (18.7)
Rey Complex Figure Test (CC)
Wisconsin Card Sorting Test (SS)
N/A
Brown et al., 2018 [18] AN = 10 (14.5)
HC = 14 (13.7)
AN parent =10 (44.7)
HC parent =14 (46.9)
Rey Complex Figure Test (CC)
Group Embedded Figure Test (CC)
Trail Making Test (SS)
Verbal Fluency Test (SS)
Higher levels of anxiety could affect cognitive function. Higher levels of depression could affect cognitive function. N/A N/A
Hamatani et al., 2018 [53] AN = 22 (31.5)
HC = 33 (28.0)
Rey Complex Figure Test (CC) N/A
Herbrich et al., 2018 [21] AN-R = 90 (14.4)
AN-BP = 21 (15.2)
HC = 63 (14.0)
Trail Making Test (SS)
Group Embedded Figures Test (CC)
Rey Complex Figure Test (CC)
Wisconsin Card Sorting Test (SS)
Negative correlation between BMI and Trail Making Test-4 in the AN-R group. Negative correlation between BMI and Group Embedded Figures Test in the AN-BP group. N/A
Leppanen et al., 2018 [54] AN = 145 (25.0) Rey Complex Figure Test (SS)
Brixton Spatial Anticipation Test (SS)
N/A N/A N/A
Oldershaw et al., 2018 [55] AN = 71 (26.6) Wisconsin Card Sorting Test (SS)
Brixton Spatial Anticipation test (SS)
Trail Making Test (SS)
Group Embedded Figure Test (CC)
N/A N/A N/A
Berner et al. 2019 [56] IAN = 40 (24.3)
RAN = 24 (25.6)
HC = 42 (22.0)
Cued Color-Shape Switching Task (SS) N/A
Sproch et al. 2019 [57] AN CRT = 135 (23.9)
AN CC = 140 (22.2)
Wisconsin Card Sorting Test (SS)
Comprehensive Trail Making Test (SS)
N/A N/A N/A
  1. ADOL-AN adolescent patients with AN, ADOL – C adolescent controls, ADULT – AN adult patients with AN, ADULT – C adult control women, AN anorexia nervosa, AN-BP anorexia nervosa binge/purge subtype, AN CC anorexia nervosa control condition, AN CRT anorexia nervosa cognitive remediation therapy, AN-R anorexia nervosa restrictive subtype, AN-RES anorexia nervosa restrictive subtype, AN-REC anorexia nervosa recovered, BDI Beck’s Depression Inventory, BED binge eating disorder, BN bulimia nervosa, CC Central Coherence, ED eating disorder, ED.AN eating disorder not otherwise specified anorexia nervosa type, EO-AN early onset anorexia nervosa, FeAN first-episode AN; HC, healthy controls, IAN ill with AN, subthreshold AN or atypical AN, N/A not applicable, BP-G binge/purge group, OB obese group, RAN remitted from AN, SS set shifting, UD patients with unipolar depression, WfH weight for height ratio.s