Evidence for Thalamocortical Circuit Abnormalities and Associated Cognitive Dysfunctions in Underweight Individuals with Anorexia Nervosa

Biezonski, Dominik; Cha, Jiook; Steinglass, Joanna E.; Posner, Jonathan

doi:10.1038/npp.2015.314

Cited by 52 publications

(49 citation statements)

References 56 publications

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“…AN and BN patients show reduced gray matter volume specifically in SN regions including the caudate nucleus, anterior cingulate cortex and insula, among other areas (Schäfer et al, 2010; Friederich et al, 2012; Frank et al, 2013; Coutinho et al, 2015). On DTI, AN patients show abnormal thalamic connectivity to the dlPFC and anterior PFC (Frieling et al, 2012; Hayes et al, 2015), and reduced fractional anisotrophy in the medial dorsal thalamic radiations (Biezonski et al, 2015; Hayes et al, 2015). Further, increased structural connectivity between the insula and striatum is observed in ED (Frank et al, 2016; Shott et al, 2016).…”

Section: Abnormalities Of Sn-cstc Loop Circuits In Psychiatric Illnessesmentioning

confidence: 99%

Cortico-Striatal-Thalamic Loop Circuits of the Salience Network: A Central Pathway in Psychiatric Disease and Treatment

Peters

Dunlop

Downar³

2016

Front. Syst. Neurosci.

462

298

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The salience network (SN) plays a central role in cognitive control by integrating sensory input to guide attention, attend to motivationally salient stimuli and recruit appropriate functional brain-behavior networks to modulate behavior. Mounting evidence suggests that disturbances in SN function underlie abnormalities in cognitive control and may be a common etiology underlying many psychiatric disorders. Such functional and anatomical abnormalities have been recently apparent in studies and meta-analyses of psychiatric illness using functional magnetic resonance imaging (fMRI) and voxel-based morphometry (VBM). Of particular importance, abnormal structure and function in major cortical nodes of the SN, the dorsal anterior cingulate cortex (dACC) and anterior insula (AI), have been observed as a common neurobiological substrate across a broad spectrum of psychiatric disorders. In addition to cortical nodes of the SN, the network’s associated subcortical structures, including the dorsal striatum, mediodorsal thalamus and dopaminergic brainstem nuclei, comprise a discrete regulatory loop circuit. The SN’s cortico-striato-thalamo-cortical loop increasingly appears to be central to mechanisms of cognitive control, as well as to a broad spectrum of psychiatric illnesses and their available treatments. Functional imbalances within the SN loop appear to impair cognitive control, and specifically may impair self-regulation of cognition, behavior and emotion, thereby leading to symptoms of psychiatric illness. Furthermore, treating such psychiatric illnesses using invasive or non-invasive brain stimulation techniques appears to modulate SN cortical-subcortical loop integrity, and these effects may be central to the therapeutic mechanisms of brain stimulation treatments in many psychiatric illnesses. Here, we review clinical and experimental evidence for abnormalities in SN cortico-striatal-thalamic loop circuits in major depression, substance use disorders (SUD), anxiety disorders, schizophrenia and eating disorders (ED). We also review emergent therapeutic evidence that novel invasive and non-invasive brain stimulation treatments may exert therapeutic effects by normalizing abnormalities in the SN loop, thereby restoring the capacity for cognitive control. Finally, we consider a series of promising directions for future investigations on the role of SN cortico-striatal-thalamic loop circuits in the pathophysiology and treatment of psychiatric disorders.

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Section: Abnormalities Of Sn-cstc Loop Circuits In Psychiatric Illnessesmentioning

confidence: 99%

Cortico-Striatal-Thalamic Loop Circuits of the Salience Network: A Central Pathway in Psychiatric Disease and Treatment

Peters

Dunlop

Downar³

2016

Front. Syst. Neurosci.

462

298

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“…It is used to investigate the functional architecture of the brain at rest (Lee, Smyser, & Shimony, ). In AN, a number of rs‐fcMRI studies have demonstrated evidence of disturbed functional connectivity in brain regions associated with cortico‐striato‐thalamo‐cortical (CSTC) circuitry which have also been implicated in OCD (Biezonski, Cha, Steinglass, & Posner, ; Cha et al, ; Ehrlich et al, ; Haynos et al, ). Using network‐based statistics (NBS), Ehrlich et al identified reduced functional connectivity in a thalamo‐insular subnetwork among underweight adolescents and young adults with AN relative to healthy control participants (HC) (Ehrlich et al, ).…”

Section: Introductionmentioning

confidence: 99%

“…Using network‐based statistics (NBS), Ehrlich et al identified reduced functional connectivity in a thalamo‐insular subnetwork among underweight adolescents and young adults with AN relative to healthy control participants (HC) (Ehrlich et al, ). Another study measuring thalamo‐frontal functional connectivity in acutely ill individuals with AN relative to HC found evidence of altered connectivity between the thalamus and both the dorsal and anterior prefrontal cortices which were associated with impairments in tasks measuring cognitive control and working memory, respectively (Biezonski et al, ). Haynos et al () used a seed‐based approach to investigate ventral and dorsal frontostriatal circuits and found evidence of reduced functional connectivity in both circuits among underweight individuals with restricting type AN relative to HC.…”

Section: Introductionmentioning

confidence: 99%

Resting‐state connectivity within and across neural circuits in anorexia nervosa

et al. 2018

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Introduction Obsessional thoughts and ritualized eating behaviors are characteristic of Anorexia Nervosa (AN), leading to the common suggestion that the illness shares neurobiology with obsessive–compulsive disorder (OCD). Resting‐state functional connectivity MRI (rs‐fcMRI) is a measure of functional neural architecture. This longitudinal study examined functional connectivity in AN within the limbic cortico‐striato‐thalamo‐cortical (CSTC) loop, as well as in the salience network, the default mode network, and the executive control network (components of the triple network model of psychopathology). Methods Resting‐state functional connectivity MRI scans were collected in unmedicated female inpatients with AN (n = 25) and healthy controls (HC; n = 24). Individuals with AN were scanned before and after weight restoration and followed for one month after hospital discharge. HC were scanned twice over the same timeframe. Results Using a seed‐based correlation approach, individuals with AN had increased connectivity within the limbic CSTC loop when underweight, only. There was no significant association between limbic CSTC connectivity and obsessive–compulsive symptoms or prognosis. Exploratory analyses of functional network connectivity within the triple network model showed reduced connectivity between the salience network and left executive control network among AN relative to HC. These abnormalities persisted following weight restoration. Conclusions The CSTC findings suggest that the neural underpinnings of obsessive–compulsive symptoms may differ from those of OCD. The inter‐network abnormalities warrant examination in relation to illness‐specific behaviors, namely abnormal eating behavior. This longitudinal study highlights the complexity of the neural underpinnings of AN.

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“…The IFG is part of the cognitive control system of the brain which governs response inhibition (27). Furthermore, alterations in connectivity between the thalamus and the prefrontal cortex have also been seen in AN, which may play a role in the cognitive dysfunction seen in this group (28). In a study using whole-brain ICA to examine RSNs in a population of adolescents with AN, decreased functional connectivity between the executive network and the anterior cingulate was reported, which might contribute to impaired cognitive flexibility in relation to the control of appetite and body image in AN (29).…”

Section: Introductionmentioning

confidence: 99%

Reduced Resting-State Functional Connectivity in Current and Recovered Restrictive Anorexia Nervosa

et al. 2017

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Functional connectivity studies based on resting-state functional magnetic resonance imaging (rs-fMRI) have shown alterations in brain networks associated with self-referential processing, cognitive control, and somatosensory processing in anorexia nervosa (AN). This study aimed to further investigate the functional connectivity of resting-state networks (RSNs) in homogenous subsamples of individuals with restrictive AN (current and recovered) and the relationship this has with core eating disorder psychopathology. rs-fMRI scans were obtained from 12 female individuals with restrictive AN, 14 females recovered from restrictive AN, and 16 female healthy controls. Independent components analysis revealed a set of functionally relevant RSNs, previously reported in the literature. Dual regression analysis showed decreased temporal coherence within the lateral visual and auditory RSNs in individuals with current AN and those recovered from AN compared to healthy individuals. This decreased connectivity was also found in regions associated with somatosensory processing, and is consistent with reduced interoceptive awareness and body image perception, characteristic of AN. Widespread gray matter (GM) reductions were also found in both the AN groups, and differences in functional connectivity were no longer significant when GM maps were added as a covariate in the dual regression analysis. This raises the possibility that deficits in somatosensory and interoceptive processing observed in AN may be in part underpinned or exacerbated by GM reductions.

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Evidence for Thalamocortical Circuit Abnormalities and Associated Cognitive Dysfunctions in Underweight Individuals with Anorexia Nervosa

Cited by 52 publications

References 56 publications

Cortico-Striatal-Thalamic Loop Circuits of the Salience Network: A Central Pathway in Psychiatric Disease and Treatment

Cortico-Striatal-Thalamic Loop Circuits of the Salience Network: A Central Pathway in Psychiatric Disease and Treatment

Resting‐state connectivity within and across neural circuits in anorexia nervosa

Reduced Resting-State Functional Connectivity in Current and Recovered Restrictive Anorexia Nervosa

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