Disruptions in reward processing and anhedonia have long been observed in Anorexia
Nervosa (AN). Interoceptive deficits have also been observed in AN, including reduced
tactile pleasure. However, the extent to which this tactile anhedonia is specifically
liked to an impairment in a specialised, interoceptive C-tactile system originating
at the periphery, or a more top-down mechanism in the processing of tactile pleasantness
remains debated. Here, we investigated differences between patients with and recovered
from AN (RAN) and healthy controls (HC) in the perception of pleasantness of touch
delivered in a CT-optimal versus a CT-non-optimal manner, and in their top-down, anticipatory
beliefs about the perceived pleasantness of touch. To this end, we measured the anticipated
pleasantness of various materials touching the skin and the perceived pleasantness
of light, dynamic touch applied to the forearm of 27 women with AN, 24 women who have
recovered and 30 HCs using C Tactile (CT) afferents-optimal (slow) and non-optimal
(fast) velocities. Our results showed that both clinical groups anticipated tactile
experiences and rated delivered tactile stimuli as less pleasant than HCs, but the
latter difference was not related to the CT optimality of the stimulation. Instead,
differences in the perception of CT-optimal touch were predicted by differences in
top-down beliefs, alexithymia and interoceptive sensibility. Thus, tactile anhedonia
in AN might persist as a trait even after otherwise successful recovery of AN and
it is not linked to a bottom-up interoceptive deficit in the CT system, but rather
to a learned, defective top-down anticipation of tactile pleasantness.