{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T17:04:24Z","timestamp":1788455064219,"version":"build-2803163510"},"reference-count":82,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T00:00:00Z","timestamp":1711584000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Patients with Anorexia Nervosa (AN) exhibit significant cognitive and neural disturbances compared to healthy individuals when processing food and body-related stimuli. These disturbances not only contribute to the manifestation and chronification of their pathological eating behaviour but also underscore the complex interplay of cognitive, emotional, and neurobiological factors in AN. However, the precise underlying cognitive and neural mechanisms of these disturbances remain a compelling area of investigation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This study presents a protocol developed for conducting a cross-sectional quasi-experimental study using a mixed model ANOVA approach with a crossover design. Our participants will consist of 20 patients with an active diagnosis of AN, 20 Overweight\/obese individuals, and 20 Healthy Controls (HCs) with a normal BMI. An integrated eye-tracking and EEG methodology will be used in conjunction, with the primary aim of assessing participants\u2019 cognitive and neural processing towards high and low-calorie food stimuli. On an exploratory level, by utilizing the same methods, the present study will also investigate AN patients\u2019 responses towards high weight, normal weight, low weight, and self-body pictures, as well as towards images from the International Affective Picture System (IAPS) characterized by elevated valence and arousal levels. Additionally, behavioural methods such as yes or no questions, and self-reported questionnaires will be administered. The EEG and eye-tracking data will be analysed at early (50\u2013300 ms) and late (350\u2013500 ms) time intervals.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Discussion<\/jats:title>\n<jats:p>The investigation of the underlying cognitive and neural processes employed by patients with AN during the processing of food and body-related stimuli can help us develop a better understanding of the cognitive and neural mechanisms that contribute to the manifestation and maintenance of the disorder and assist in the development of more effective screening methods.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Ethical approval and consent to participate<\/jats:title>\n<jats:p>Ethical approval for the study has been obtained by the Cyprus National Bioethics Committee on 27.04.2023 (\u0395\u0395\u0392\u039a\/\u0395\u03a0\/2023\/19), and by the University of Cyprus (20.02.2023). Written informed consent will be obtained from all participants.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0299529","type":"journal-article","created":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T18:07:35Z","timestamp":1711649255000},"page":"e0299529","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Exploring the neurofunctional impairments and cognitive biases concerning food and body related stimuli in anorexia nervosa: An integrated EEG and eye-tracking study protocol"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5028-7773","authenticated-orcid":true,"given":"Panagiotis","family":"Loizou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgia","family":"Panagiotou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panos","family":"Zanos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelos","family":"Paraskevopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,3,28]]},"reference":[{"issue":"1","key":"pone.0299529.ref001","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1192\/bjp.173.1.11","article-title":"Excess mortality of mental disorder","volume":"173","author":"C Harris","year":"1998","journal-title":"The British journal of psychiatry"},{"issue":"1","key":"pone.0299529.ref002","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.amjmed.2015.06.031","article-title":"Medical complications of anorexia nervosa and bulimia","volume":"129","author":"P Westmoreland","year":"2016","journal-title":"The American Journal of Medicine"},{"issue":"1","key":"pone.0299529.ref003","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1192\/bjp.bp.108.054742","article-title":"Excess mortality, causes of death and prognostic factors in anorexia nervosa","volume":"194","author":"FC Papadopoulos","year":"2009","journal-title":"British Journal of Psychiatry"},{"issue":"6","key":"pone.0299529.ref004","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1097\/YCO.0000000000000739","article-title":"Incidence, prevalence and mortality of anorexia nervosa and bulimia nervosa.","volume":"34","author":"AE Van Eeden","year":"2021","journal-title":"Current Opinion in Psychiatry"},{"issue":"11","key":"pone.0299529.ref005","doi-asserted-by":"crossref","first-page":"3824","DOI":"10.3390\/ijerph17113824","article-title":"Incidence of anorexia nervosa in women: A systematic review and meta-analysis","volume":"17","author":"L Mart\u00ednez-Gonz\u00e1lez","year":"2020","journal-title":"International Journal of Environmental Research and Public Health"},{"key":"pone.0299529.ref006","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425596","volume-title":"Diagnostic and statistical manual of mental disorders: DSM-5.","author":"American Psychiatric Association D, American Psychiatric Association","year":"2013"},{"issue":"3","key":"pone.0299529.ref007","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1016\/j.biopsych.2006.03.040","article-title":"The prevalence and correlates of eating disorders in the national comorbidity survey replication","volume":"61","author":"JI Hudson","year":"2007","journal-title":"Biological Psychiatry"},{"issue":"6","key":"pone.0299529.ref008","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1097\/YCO.0000000000000278","article-title":"Epidemiology of Eating Disorders in Europe.","volume":"29","author":"A Keski-Rahkonen","year":"2016","journal-title":"Current Opinion in Psychiatry."},{"issue":"8","key":"pone.0299529.ref009","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1038\/s41588-019-0439-2","article-title":"Genome-wide association study identifies eight risk loci and implicates metabo-psychiatric origins for anorexia nervosa","volume":"51","author":"HJ Watson","year":"2019","journal-title":"Nature Genetics"},{"issue":"2","key":"pone.0299529.ref010","doi-asserted-by":"crossref","first-page":"427","DOI":"10.3758\/s13415-020-00777-6","article-title":"Keep your interoceptive streams under control: An active inference perspective on anorexia nervosa.","volume":"20","author":"L Barca","year":"2020","journal-title":"Cognitive, Affective, & Behavioral Neuroscience."},{"issue":"1","key":"pone.0299529.ref011","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40337-018-0217-z","article-title":"What can food-image tasks teach us about anorexia nervosa? 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