J Psychiatry Neurosci 2016;41(6):377-385
Ilka Boehm, MSc; Daniel Geisler, MSc; Friederike Tam, MD; Joseph A. King, MSc; Franziska Ritschel, MSc; Maria Seidel, MSc; Fabio Bernardoni, PhD; Julia Murr, MD; Thomas Goschke, PhD; Vince D. Calhoun, PhD; Veit Roessner, MD; Stefan Ehrlich, MD
Background: We have previously shown increased resting-state functional connectivity (rsFC) in the frontoparietal network (FPN) and the default mode network (DMN) in patients with acute anorexia nervosa. Based on these findings we investigated within-network rsFC in patients recovered from anorexia nervosa to examine whether these abnormalities are a state or trait marker of the disease. To extend the understanding of functional connectivity in patients with anorexia nervosa, we also estimated rsFC between large-scale networks.
Methods: Girls and women recovered from anorexia nervosa and pair-wise, age- and sex-matched healthy controls underwent a resting- state fMRI scan. Using independent component analyses (ICA), we isolated the FPN, DMN and salience network. We used standard comparisons as well as a hypothesis-based approach to test the findings of our previous rsFC study in this recovered cohort. Temporal correlations between network time-course pairs were computed to investigate functional network connectivity (FNC).
Results: Thirty-one patients recovered from anorexia nervosa and 31 controls participated in our study. Standard group comparisons revealed reduced rsFC between the dorsolateral prefrontal cortex (dlPFC) and the FPN in the recovered group. Using a hypothesis-based approach we extended the previous finding of increased rsFC between the angular gyrus and the FPN in patients recovered from anorexia nervosa. No group differences in FNC were revealed.
Limitations: The study design did not allow us to conclude that the difference found in rsFC constitutes a scar effect of the disease.
Conclusion: This study suggests that some abnormal rsFC patterns found in patients recovered from anorexia nervosa normalize after long-term weight restoration, while distorted rsFC in the FPN, a network that has been associated with cognitive control, may constitute a trait marker of the disorder.
Submitted Nov. 27, 2015; Revised Nov. 27, 2015; Accepted Dec. 14, 2015; Early-released Apr. 5, 2016
Acknowledgments: This work was supported by Deutsche Forschungsgemeinschaft (367/5-1 & SFB 940) and Swiss Anorexia Nervosa Foundation grants to S. Ehrlich. The authors thank all members of the research team for their assistance and thank all participants for their cooperation.
Affiliations: From the Eating Disorder Services and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Boehm, Geisler, Tam, King, Ritschel, Seidel, Bernardoni, Roessner, Ehrlich); the MGH/MIT/HMS Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA (Ehrlich); the Harvard Medical School, Department of Psychiatry, Massachusetts General Hospital, Boston, MA (Ehrlich); the Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany (Murr); the Department of Psychology, Technische Universität Dresden, Dresden, Germany ( Goschke); the The Mind Research Network, Albuquerque, New Mexico (Calhoun); and the Department of ECE, the University of New Mexico, Albuquerque, New Mexico (Calhoun).
Competing interests: V. Roessner has received payment for consulting and writing activities from Lilly, Novartis and Shire Pharmaceuticals; lecture honoraria from Lilly, Novartis, Shire Pharmaceuticals and Medice Pharma; and support for research from Shire and Novartis. He has carried out (and is currently carrying out) clinical trials in cooperation with Novartis, Shire and Otsuka. No other competing interests declared.
Contributors: S. Ehrlich designed the study. I. Boehm, D. Geisler, F. Tam, J. King, F. Ritschel. M. Seidel. F. Bernardoni and J. Murr acquired the data, which I. Boehm, D. Geisler, T. Goschke, V. Calhoun, V. Roessner and S. Ehrlich analyzed. I. Boehm, J. King and S. Ehrlich wrote the article, which all authors reviewed and approved for publication.
Correspondence to: S. Ehrlich, Technische Universität Dresden, Faculty of Medicine, University Hospital CG Carus, Dresden, Department of Child and Adolescent Psychiatry, Translational Developmental Neuroscience Section, Fetscherstraße 74, 01307 Dresden; firstname.lastname@example.org