title: Reduced functional connectivity in the thalamo-insular subnetwork in patients with acute anorexia nervosa.
abstract: The neural underpinnings of anorexia nervosa (AN) are poorly understood. Results from existing functional brain imaging studies using disorder-relevant food- or body-stimuli have been heterogeneous and may be biased due to varying compliance or strategies of the participants. In this study, resting state functional connectivity imaging was used. To explore the distributed nature and complexity of brain function we characterized network patterns in patients with acute AN. Thirty-five unmedicated female acute AN patients and 35 closely matched healthy female participants underwent resting state functional magnetic resonance imaging. We used a network-based statistic (NBS) approach [Zalesky et al., 2010a] to identify differences between groups by isolating a network of interconnected nodes with a deviant connectivity pattern. Group comparison revealed a subnetwork of connections with decreased connectivity including the amygdala, thalamus, fusiform gyrus, putamen and the posterior insula as the central hub in the patient group. Results were not driven by changes in intranodal or global connectivity. No network could be identified where AN patients had increased coupling. Given the known involvement of the identified thalamo-insular subnetwork in interoception, decreased connectivity in AN patients in these nodes might reflect changes in the propagation of sensations that alert the organism to urgent homeostatic imbalances and pain-processes that are known to be severely disturbed in AN and might explain the striking discrepancy between patient's actual and perceived internal body state.
authors.affiliation: Department of Child and Adolescent Psychiatry, Eating Disorder Services and Research Center, Technische Universität Dresden, Faculty of Medicine, University Hospital C. G. Carus, Dresden, Germany; MGH/MIT/HMS Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts; Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Stefan
authors.initials: S
authors.lastname: Ehrlich
authors.forename: Anton R
authors.initials: AR
authors.lastname: Lord
authors.forename: Daniel
authors.initials: D
authors.lastname: Geisler
authors.forename: Viola
authors.initials: V
authors.lastname: Borchardt
authors.forename: Ilka
authors.initials: I
authors.lastname: Boehm
authors.forename: Maria
authors.initials: M
authors.lastname: Seidel
authors.forename: Franziska
authors.initials: F
authors.lastname: Ritschel
authors.forename: Anne
authors.initials: A
authors.lastname: Schulze
authors.forename: Joseph A
authors.initials: JA
authors.lastname: King
authors.forename: Kerstin
authors.initials: K
authors.lastname: Weidner
authors.forename: Veit
authors.initials: V
authors.lastname: Roessner
authors.forename: Martin
authors.initials: M
authors.lastname: Walter
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000856:Anorexia Nervosa / Q000503:physiopathology*; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000503:physiopathology*; D002648:Child; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D015233:Models, Statistical; D009434:Neural Pathways / Q000503:physiopathology; D012815:Signal Processing, Computer-Assisted; D013788:Thalamus / Q000503:physiopathology*; D055815:Young Adult
keywords: connectivity; fMRI; network; posterior insula; thalamus