title: Increased resting state functional connectivity in the fronto-parietal and default mode network in anorexia nervosa.
abstract: The etiology of anorexia nervosa (AN) is poorly understood. Results from functional brain imaging studies investigating the neural profile of AN using cognitive and emotional task paradigms are difficult to reconcile. Task-related imaging studies often require a high level of compliance and can only partially explore the distributed nature and complexity of brain function. In this study, resting state functional connectivity imaging was used to investigate well-characterized brain networks potentially relevant to understand the neural mechanisms underlying the symptomatology and etiology of AN. Resting state functional magnetic resonance imaging data was obtained from 35 unmedicated female acute AN patients and 35 closely matched healthy controls female participants (HC) and decomposed using spatial group independent component analyses (ICA). Using validated templates, we identified components covering the fronto-parietal "control" network, the default mode network (DMN), the salience network, the visual and the sensory-motor network. Group comparison revealed an increased functional connectivity between the angular gyrus and the other parts of the fronto-parietal network in patients with AN in comparison to HC. Connectivity of the angular gyrus was positively associated with self-reported persistence in HC. In the DMN, AN patients also showed an increased functional connectivity strength in the anterior insula in comparison to HC. Anterior insula connectivity was associated with self-reported problems with interoceptive awareness. This study, with one of the largest sample to date, shows that acute AN is associated with abnormal brain connectivity in two major resting state networks (RSN). The finding of an increased functional connectivity in the fronto-parietal network adds novel support for the notion of AN as a disorder of excessive cognitive control, whereas the elevated functional connectivity of the anterior insula with the DMN may reflect the high levels of self- and body-focused ruminations when AN patients are at rest.
authors.affiliation: Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany.
authors.forename: Ilka
authors.initials: I
authors.lastname: Boehm
authors.affiliation: Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Geisler
authors.affiliation: Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: King
authors.affiliation: Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany.
authors.forename: Franziska
authors.initials: F
authors.lastname: Ritschel
authors.affiliation: Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Seidel
authors.affiliation: Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany.
authors.forename: Yacila
authors.initials: Y
authors.lastname: Deza Araujo
authors.affiliation: Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany.
authors.forename: Juliane
authors.initials: J
authors.lastname: Petermann
authors.affiliation: Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany.
authors.forename: Heidi
authors.initials: H
authors.lastname: Lohmeier
authors.affiliation: Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany.
authors.forename: Jessika
authors.initials: J
authors.lastname: Weiss
authors.affiliation: Department of Psychiatry, Otto-von-Guericke University Magdeburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Walter
authors.affiliation: Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany.
authors.forename: Veit
authors.initials: V
authors.lastname: Roessner
authors.affiliation: Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Eating Disorder Services and Research Center, Faculty of Medicine, University Hospital C. G. Carus, Technische Universität Dresden Dresden, Germany ; MGH/MIT/HMS Martinos Center for Biomedical Imaging, Massachusetts General Hospital Charlestown, MA, USA ; Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital Boston, MA, USA.
authors.forename: Stefan
authors.initials: S
authors.lastname: Ehrlich
keywords: anorexia nervosa; cognitive control; default mode network; fMRI; fronto-parietal network; insula; interoceptive awareness; resting state connectivity