title: A systematic review of resting-state functional-MRI studies in anorexia nervosa: Evidence for functional connectivity impairment in cognitive control and visuospatial and body-signal integration.
abstract: This paper systematically reviews the literature pertaining to the use of resting-state functional magnetic resonance imaging (rsfMRI) in anorexia nervosa (AN), classifying studies on the basis of different analysis approaches. We followed PRISMA guidelines. Fifteen papers were included, investigating a total of 294 participants with current or past AN and 285 controls. The studies used seed-based, whole-brain independent component analysis (ICA), network-of-interest ICA based and graph analysis approaches. The studies showed relatively consistent overlap in results, yet little overlap in their analytical approach and/or a-priori assumptions. Functional connectivity alterations were mainly found in the corticolimbic circuitry, involved in cognitive control and visual and homeostatic integration. Some overlapping findings were found in brain areas putatively important in AN, such as the insula. These results suggest altered functional connectivity in networks/areas linked to the main symptom domains of AN, such as impaired cognitive control and body image disturbances. These preliminary evidences suggest that more targeted treatments need to be developed that focus on these two symptom domains. Further studies with multi-approach analyses and longitudinal designs are needed to better understand the complexity of AN.
authors.affiliation: Department of Neuroscience, Functional Pharmacology, Uppsala University, BMC, Box 593, Husargatan 3, 751 24, Uppsala, Sweden; Centre for Integrated Research (CIR), Area of Diagnostic Imaging, Universita "Campus Bio-Medico di Roma", via Alvaro del Portillo, 200 - 00133 - Rome, Italy. Electronic address: santino.gaudio@gmail.com.
authors.forename: Santino
authors.initials: S
authors.lastname: Gaudio
authors.affiliation: Department of Neuroscience, Functional Pharmacology, Uppsala University, BMC, Box 593, Husargatan 3, 751 24, Uppsala, Sweden.
authors.forename: Lyle
authors.initials: L
authors.lastname: Wiemerslage
authors.affiliation: Department of Neuroscience, Functional Pharmacology, Uppsala University, BMC, Box 593, Husargatan 3, 751 24, Uppsala, Sweden; Psychiatry Neuroimaging Group (PNG), University of Cape Town, Department of Psychiatry and Mental Health, Old Groote Schuur Hospital, Anzio Road, Observatory, Cape Town, 7925, South Africa.
authors.forename: Samantha J
authors.initials: SJ
authors.lastname: Brooks
authors.affiliation: Department of Neuroscience, Functional Pharmacology, Uppsala University, BMC, Box 593, Husargatan 3, 751 24, Uppsala, Sweden.
authors.forename: Helgi B
authors.initials: HB
authors.lastname: Schiöth
mesh_terms: D000856:Anorexia Nervosa; D001921:Brain; D001931:Brain Mapping; D003071:Cognition; D006801:Humans; D008279:Magnetic Resonance Imaging
keywords: Anorexia nervosa; Body image disturbances; Cognitive control; Default mode network; Eating disorders; Insula; Neuroimaging; Resting-state