Rewarding cognitive effort increases the intrinsic value of mental labor.

Current models of mental effort in psychology, behavioral economics, and cognitive neuroscience typically suggest that exerting cognitive effort is aversive, and people avoid it whenever possible. The aim of this research was to challenge this view and show that people can learn to value and seek effort intrinsically. Our experiments tested the hypothesis that effort-contingent reward in a working-memory task will induce a preference for more demanding math tasks in a transfer phase, even though participants were aware that they would no longer receive any reward for task performance. In laboratory Experiment 1 (n = 121), we made reward directly contingent on mobilized cognitive effort as assessed via cardiovascular measures (ß-adrenergic sympathetic activity) during the training task. Experiments 2a to 2e (n = 1,457) were conducted online to examine whether the effects of effort-contingent reward on subsequent demand seeking replicate and generalize to community samples. Taken together, the studies yielded reliable evidence that effort-contingent reward increased participants' demand seeking and preference for the exertion of cognitive effort on the transfer task. Our findings provide evidence that people can learn to assign positive value to mental effort. The results challenge currently dominant theories of mental effort and provide evidence and an explanation for the positive effects of environments appreciating effort and individual growth on people's evaluation of effort and their willingness to mobilize effort and approach challenging tasks.

The ReCoDe addiction research consortium: Losing and regaining control over drug intake-Findings and future perspectives.

Substance use disorders (SUDs) are seen as a continuum ranging from goal-directed and hedonic drug use to loss of control over drug intake with aversive consequences for mental and physical health and social functioning. The main goals of our interdisciplinary German collaborative research centre on Losing and Regaining Control over Drug Intake (ReCoDe) are (i) to study triggers (drug cues, stressors, drug priming) and modifying factors (age, gender, physical activity, cognitive functions, childhood adversity, social factors, such as loneliness and social contact/interaction) that longitudinally modulate the trajectories of losing and regaining control over drug consumption under real-life conditions. (ii) To study underlying behavioural, cognitive and neurobiological mechanisms of disease trajectories and drug-related behaviours and (iii) to provide non-invasive mechanism-based interventions. These goals are achieved by: (A) using innovative mHealth (mobile health) tools to longitudinally monitor the effects of triggers and modifying factors on drug consumption patterns in real life in a cohort of 900 patients with alcohol use disorder. This approach will be complemented by animal models of addiction with 24/7 automated behavioural monitoring across an entire disease trajectory; i.e. from a naïve state to a drug-taking state to an addiction or resilience-like state. (B) The identification and, if applicable, computational modelling of key molecular, neurobiological and psychological mechanisms (e.g., reduced cognitive flexibility) mediating the effects of such triggers and modifying factors on disease trajectories. (C) Developing and testing non-invasive interventions (e.g., Just-In-Time-Adaptive-Interventions (JITAIs), various non-invasive brain stimulations (NIBS), individualized physical activity) that specifically target the underlying mechanisms for regaining control over drug intake. Here, we will report on the most important results of the first funding period and outline our future research strategy.

Measuring self-regulation in everyday life: Reliability and validity of smartphone-based experiments in alcohol use disorder.

Self-regulation, the ability to guide behavior according to one's goals, plays an integral role in understanding loss of control over unwanted behaviors, for example in alcohol use disorder (AUD). Yet, experimental tasks that measure processes underlying self-regulation are not easy to deploy in contexts where such behaviors usually occur, namely outside the laboratory, and in clinical populations such as people with AUD. Moreover, lab-based tasks have been criticized for poor test-retest reliability and lack of construct validity. Smartphones can be used to deploy tasks in the field, but often require shorter versions of tasks, which may further decrease reliability. Here, we show that combining smartphone-based tasks with joint hierarchical modeling of longitudinal data can overcome at least some of these shortcomings. We test four short smartphone-based tasks outside the laboratory in a large sample (N = 488) of participants with AUD. Although task measures indeed have low reliability when data are analyzed traditionally by modeling each session separately, joint modeling of longitudinal data increases reliability to good and oftentimes excellent levels. We next test the measures' construct validity and show that extracted latent factors are indeed in line with theoretical accounts of cognitive control and decision-making. Finally, we demonstrate that a resulting cognitive control factor relates to a real-life measure of drinking behavior and yields stronger correlations than single measures based on traditional analyses. Our findings demonstrate how short, smartphone-based task measures, when analyzed with joint hierarchical modeling and latent factor analysis, can overcome frequently reported shortcomings of experimental tasks.

Meta-control of the exploration-exploitation dilemma emerges from probabilistic inference over a hierarchy of time scales.

Cognitive control is typically understood as a set of mechanisms that enable humans to reach goals that require integrating the consequences of actions over longer time scales. Importantly, using routine behaviour or making choices beneficial only at short time scales would prevent one from attaining these goals. During the past two decades, researchers have proposed various computational cognitive models that successfully account for behaviour related to cognitive control in a wide range of laboratory tasks. As humans operate in a dynamic and uncertain environment, making elaborate plans and integrating experience over multiple time scales is computationally expensive. Importantly, it remains poorly understood how uncertain consequences at different time scales are integrated into adaptive decisions. Here, we pursue the idea that cognitive control can be cast as active inference over a hierarchy of time scales, where inference, i.e., planning, at higher levels of the hierarchy controls inference at lower levels. We introduce the novel concept of meta-control states, which link higher-level beliefs with lower-level policy inference. Specifically, we conceptualize cognitive control as inference over these meta-control states, where solutions to cognitive control dilemmas emerge through surprisal minimisation at different hierarchy levels. We illustrate this concept using the exploration-exploitation dilemma based on a variant of a restless multi-armed bandit task. We demonstrate that beliefs about contexts and meta-control states at a higher level dynamically modulate the balance of exploration and exploitation at the lower level of a single action. Finally, we discuss the generalisation of this meta-control concept to other control dilemmas.

Meta-control: From psychology to computational neuroscience.

Research in the past decades shed light on the different mechanisms that underlie our capacity for cognitive control. However, the meta-level processes that regulate cognitive control itself remain poorly understood. Following the terminology from artificial intelligence, meta-control can be defined as a collection of mechanisms that (a) monitor the progress of controlled processing and (b) regulate the underlying control parameters in the service of current task goals and in response to internal or external constraints. From a psychological perspective, meta-control is an important concept because it may help explain and predict how and when human agents select different types of behavioral strategies. From a cognitive neuroscience viewpoint, meta-control is a useful concept for understanding the complex networks in the prefrontal cortex that guide higher-level behavior as well as their interactions with neuromodulatory systems (such as the dopamine or norepinephrine system). The purpose of the special issue is to integrate hitherto segregated strands of research across three different perspectives: 1) a psychological perspective that specifies meta-control processes on a functional level and aims to operationalize them in experimental tasks; 2) a computational perspective that builds on ideas from artificial intelligence to formalize normative solutions to meta-control problems; and 3) a cognitive neuroscience perspective that identifies neural correlates of and mechanisms underlying meta-control.

Real-Life Self-Control is Predicted by Parietal Activity During Preference Decision Making: A Brain Decoding Analysis.

Despite its relevance for health and education, the neurocognitive mechanism of real-life self-control is largely unknown. While recent research revealed a prominent role of the ventromedial prefrontal cortex in the computation of an integrative value signal, the contribution and relevance of other brain regions for real-life self-control remains unclear. To investigate neural correlates of decisions in line with long-term consequences and to assess the potential of brain decoding methods for the individual prediction of real-life self-control, we combined functional magnetic resonance imaging during preference decision making with ecological momentary assessment of daily self-control in a large community sample (N = 266). Decisions in line with long-term consequences were associated with increased activity in bilateral angular gyrus and precuneus, regions involved in different forms of perspective taking, such as imagining one's own future and the perspective of others. Applying multivariate pattern analysis to the same clusters revealed that individual patterns of activity predicted the probability of real-life self-control. Brain activations are discussed in relation to episodic future thinking and mentalizing as potential mechanisms mediating real-life self-control.

No relation of Need for Cognition to basic executive functions.

OBJECTIVE: Need for Cognition (NFC) refers to a personality trait describing the relatively stable intrinsic motivation of individuals to invest cognitive effort in cognitive endeavors. Higher NFC is associated with a more elaborated, central information processing style and increased recruitment of resources in cognitively demanding situations. To further clarify the association between cognitive resources and NFC, we examined in two studies how NFC relates to executive functions as basic cognitive abilities. METHOD: In Study 1, 189 healthy young adults completed an NFC scale and a battery of six commonly used inhibitory control tasks (Stroop, antisaccade, stop-signal, flanker, shape-matching, word-naming). In Study 2, 102 healthy young adults completed the NFC scale and two tasks for each of the three executive functions inhibitory control (go-nogo, stop-signal), shifting (number-letter, color-shape), and working memory updating (two-back, letter-memory). RESULTS: Using a Bayesian approach to correlation analysis, we found no conclusive evidence that NFC was related to any executive function measure. Instead, we obtained even moderate evidence for the null hypothesis. CONCLUSIONS: Both studies add to more recent findings that shape the understanding of NFC as a trait that is less characterized by increased cognitive control abilities but rather by increased willingness to invest effort and exert self-control via motivational processes.

Chronic stress, executive functioning, and real-life self-control: An experience sampling study.

OBJECTIVE: To test the hypothesis that chronic stress impairs the use of cognitive control for self-control, we examined how chronic stress affects the relation between individual differences in general executive functioning (GEF) and self-control in real-life situations. METHOD: About 338 young adults with varying degrees of chronic stress underwent experience sampling of real-life self-control for 7 days and completed a battery of nine executive function tasks from which a latent variable representing individual differences in GEF was derived. RESULTS: Structural equation models showed that higher levels of chronic stress were associated with stronger desires and a less negative relationship between GEF and desire strength. Chronic stress and GEF did not predict desire enactment in situations where effortful resistance was attempted. CONCLUSIONS: These findings suggest that chronic stress may impair self-control by reducing the use of cognitive control for "early" desire regulation strategies while leaving "late" resistance strategies unaffected. That relationships between executive functioning and real-life self-control can be moderated by third factors such as chronic stress may to some extent explain the common finding of weak or missing associations between laboratory measures of executive functioning and real-life self-control.

Self-control and interoception: Linking the neural substrates of craving regulation and the prediction of aversive interoceptive states induced by inspiratory breathing restriction.

Following the interoceptive inference framework, we set out to replicate our previously reported association of self-control and interoceptive prediction and strived to investigate the neural underpinnings subserving the relationship between self-control and aversive interoceptive predictive models. To this end, we used fMRI and a within-subject design including an inspiratory breathing-load task to examine the prediction of aversive interoceptive perturbation and a craving-regulation for palatable foods task to measure self-control. In this current study, we could successfully replicate previous effects with an independent sample (n â€‹= â€‹39) and observed that individuals who 'over-estimated' their upcoming interoceptive state with respect to experienced dyspnea (i.e., anticipated versus experienced) were more effective in the down-regulation of craving using negative future-thinking strategies. These individuals, again, obtained higher scores on a measure of trait self-control, i.e. self-regulation to achieve long-term goals. On a neural level, we found evidence that the anterior insula (AI) and the presupplementary motor area (preSMA), which were recruited in both tasks, partly accounted for these effects. Specifically, levels of AI activation during the anticipation of the aversive interoceptive state (breathing restriction) were associated with self-controlled behavior in the craving task, whereas levels of interoceptive prediction during the breathing task were conversely associated with activation in preSMA during the down-regulation of craving, whose anticipatory activity was correlated with self-control success. Moreover, during the self-control task, levels of interoceptive prediction were associated with connectivity in a spatially distributed network including among other areas the insula and regions of cognitive control, while during the interoceptive prediction task, levels of self-control were associated with connectivity in a spatially distributed network including among other regions the insula and preSMA. In sum, these findings consolidate the notion that self-control is directly linked to interoceptive inference and highlight the contribution of AI and preSMA as candidate regions underlying this relationship possibly creating processing advantages in self-control situations referring to the prediction of future internal states.

Predicting Real-Life Self-Control From Brain Activity Encoding the Value of Anticipated Future Outcomes.

Deficient self-control leads to shortsighted decisions and incurs severe personal and societal costs. Although neuroimaging has advanced our understanding of neural mechanisms underlying self-control, the ecological validity of laboratory tasks used to assess self-control remains largely unknown. To increase ecological validity and to test a specific hypothesis about the mechanisms underlying real-life self-control, we combined functional MRI during value-based decision-making with smartphone-based assessment of real-life self-control in a large community sample (N = 194). Results showed that an increased propensity to make shortsighted decisions and commit self-control failures, both in the laboratory task as well as during real-life conflicts, was associated with a reduced modulation of neural value signals in the ventromedial prefrontal cortex in response to anticipated long-term consequences. These results constitute the first evidence that neural mechanisms mediating anticipations of future consequences not only account for self-control in laboratory tasks but also predict real-life self-control, thereby bridging the gap between laboratory research and real-life behavior.

L-DOPA reduces model-free control of behavior by attenuating the transfer of value to action.

Dopamine is a key neurotransmitter in action control. However, influential theories of dopamine function make conflicting predictions about the effect of boosting dopamine neurotransmission. Here, we tested if increases in dopamine tone by administration of L-DOPA upregulate reward learning as predicted by reinforcement learning theories, and if increases are specific for deliberative "model-based" control or reflexive "model-free" control. Alternatively, L-DOPA may impair learning as suggested by "value" or "thrift" theories of dopamine. To this end, we employed a two-stage Markov decision-task to investigate the effect of L-DOPA (randomized cross-over) on behavioral control while brain activation was measured using fMRI. L-DOPA led to attenuated model-free control of behavior as indicated by the reduced impact of reward on choice. Increased model-based control was only observed in participants with high working memory capacity. Furthermore, L-DOPA facilitated exploratory behavior, particularly after a stream of wins in the task. Correspondingly, in the brain, L-DOPA decreased the effect of reward at the outcome stage and when the next decision had to be made. Critically, reward-learning rates and prediction error signals were unaffected by L-DOPA, indicating that differences in behavior and brain response to reward were not driven by differences in learning. Taken together, our results suggest that L-DOPA reduces model-free control of behavior by attenuating the transfer of value to action. These findings provide support for the value and thrift accounts of dopamine and call for a refined integration of valuation and action signals in reinforcement learning models.

Switch-Independent Task Representations in Frontal and Parietal Cortex.

Alternating between two tasks is effortful and impairs performance. Previous fMRI studies have found increased activity in frontoparietal cortex when task switching is required. One possibility is that the additional control demands for switch trials are met by strengthening task representations in the human brain. Alternatively, on switch trials, the residual representation of the previous task might impede the buildup of a neural task representation. This would predict weaker task representations on switch trials, thus also explaining the performance costs. To test this, male and female participants were cued to perform one of two similar tasks, with the task being repeated or switched between successive trials. Multivoxel pattern analysis was used to test which regions encode the tasks and whether this encoding differs between switch and repeat trials. As expected, we found information about task representations in frontal and parietal cortex, but there was no difference in the decoding accuracy of task-related information between switch and repeat trials. Using cross-classification, we found that the frontoparietal cortex encodes tasks using a generalizable spatial pattern in switch and repeat trials. Therefore, task representations in frontal and parietal cortex are largely switch independent. We found no evidence that neural information about task representations in these regions can explain behavioral costs usually associated with task switching.SIGNIFICANCE STATEMENT Alternating between two tasks is effortful and slows down performance. One possible explanation is that the representations in the human brain need time to build up and are thus weaker on switch trials, explaining performance costs. Alternatively, task representations might even be enhanced to overcome the previous task. Here, we used a combination of fMRI and a brain classifier to test whether the additional control demands under switching conditions lead to an increased or decreased strength of task representations in frontoparietal brain regions. We found that task representations are not modulated significantly by switching processes and generalize across switching conditions. Therefore, task representations in the human brain cannot account for the performance costs associated with alternating between tasks.

Habit strength is predicted by activity dynamics in goal-directed brain systems during training.

Previous neuroscientific research revealed insights into the brain networks supporting goal-directed and habitual behavior, respectively. However, it remains unclear how these contribute to inter-individual differences in habit strength which is relevant for understanding not only normal behavior but also more severe dysregulations between these types of action control, such as in addiction. In the present fMRI study, we trained subjects on approach and avoidance behavior for an extended period of time before testing the habit strength of the acquired stimulus-response associations. We found that stronger habits were associated with a stronger decrease in inferior parietal lobule activity for approach and avoidance behavior and weaker vmPFC activity at the end of training for avoidance behavior, areas associated with the anticipation of outcome identity and value. VmPFC in particular showed markedly different activity dynamics during the training of approach and avoidance behavior. Furthermore, while ongoing training was accompanied by increasing functional connectivity between posterior putamen and premotor cortex, consistent with previous assumptions about the neural basis of increasing habitualization, this was not predictive of later habit strength. Together, our findings suggest that inter-individual differences in habitual behavior are driven by differences in the persistent involvement of brain areas supporting goal-directed behavior during training.

Anticipating the good and the bad: A study on the neural correlates of bivalent emotion anticipation and their malleability via attentional deployment.

In everyday life, we often deliberate about affective outcomes of decisions which can be described as ambivalent; i.e. positive and negative at the same time. For example, when looking forward to meet a dear friend at her/his favorite concert although one dislikes the music that is being performed. Thus, anticipation of bivalent emotions and their volitional regulation is an important ingredient of everyday choices. However, previous studies investigating neural substrates involved in anticipating emotional events mostly focused on anticipating either negative emotions (punishment) or positive emotions (reward) in isolation, thus inducing either of them separately. Furthermore, these studies rather focused on the effortful down-regulation of affect (i.e. reducing negative or positive affect), whereas such conflict situations may also require us to deploy attention on and thereby upregulate anticipated emotions in order to resolve a decision conflict (e.g., by focusing on positive consequences while orienting away from negative consequences of that same situation). To address this gap, we performed a series of three fMRI-experiments using simple visual and auditory stimuli in order to (i) determine the neural correlates involved when anticipating a bivalent affective outcome that is both positive and negative at the same time - related to a conflict situation and (ii) investigate their malleability during anticipation via voluntary emotion regulation using attentional focusing. In these studies, we (i) demonstrate that brain areas involved in anticipating positive (ventral striatum) and negative (anterior insula) emotional events are co-activated when anticipating the occurrence of both punishment and reward at the same time and (ii) provide evidence that attention on either the positive or the negative correlates with a shift in activations of these co-activated neural networks and associated anticipated emotions towards either the positive (increased activity in ventral striatum, ventromedial prefrontal cortex, posterior cingulate cortex) or the negative (increased activity in insula) aspect of the upcoming bivalent outcome. In summary, we provide self-report and neural evidence for the assumption that affective brain systems associated with the processing of bivalent anticipated emotions can be voluntarily controlled by cognitive emotion regulation strategies.

Monitor yourself! Deficient error-related brain activity predicts real-life self-control failures.

Despite their immense relevance, the neurocognitive mechanisms underlying real-life self-control failures (SCFs) are insufficiently understood. Whereas previous studies have shown that SCFs were associated with decreased activity in the right inferior frontal gyrus (rIFG; a region involved in cognitive control), here we consider the possibility that the reduced implementation of cognitive control in individuals with low self-control may be due to impaired performance monitoring. Following a brain-as-predictor approach, we combined experience sampling of daily SCFs with functional magnetic resonance imaging (fMRI) in a Stroop task. In our sample of 118 participants, proneness to SCF was reliably predicted by low error-related activation of a performance-monitoring network (comprising anterior mid-cingulate cortex, presupplementary motor area, and anterior insula), low posterror rIFG activation, and reduced posterror slowing. Remarkably, these neural and behavioral measures predicted variability in SCFs beyond what was predicted by self-reported trait self-control. These results suggest that real-life SCFs may result from deficient performance monitoring, leading to reduced recruitment of cognitive control after responses that conflict with superordinate goals.

Low-level alcohol consumption during adolescence and its impact on cognitive control development.

Adolescence is a critical period for maturation of cognitive control and most adolescents start experimenting with alcohol around that time. On the one hand, recent studies indicate that low control abilities predict future problematic alcohol use. On the other hand, binge drinking during young adulthood can (further) impair cognitive control. However, so far no study examined the effects of low-level alcohol use during adolescence. In the present longitudinal fMRI study, we therefore investigated the development of cognitive control in a community-based sample of 92 adolescents at ages 14, 16 and 18. Two different cognitive control functions, i.e. inhibition of pre-potent responses (operationalized by incongruence effects) and switching between different task sets, were measured within one task. Alcohol use in our sample was low (mean: 54 g/week at age 18). The study revealed that neither behavioural nor neural measures of cognitive control function at age 14 predicted alcohol use at age 18 but confirmed established predictors such as gender and personality. As expected, from age 14 to 18, cognitive control abilities were improving (decreased reaction times and/or errors), and activation of cognitive control networks (dorsal anterior cingulate cortex and pre-supplementary motor area) during incongruent trials increased. Unexpectedly, higher alcohol consumption during adolescence was associated with a more pronounced increase in cognitive performance and a smaller increase of neural activation when incongruent trials afforded inhibitory control. We conclude that low-level alcohol use during adolescence does not severely impair ongoing maturation of cognitive control abilities and networks.

Acute stress shifts the balance between controlled and automatic processes in prospective memory.

In everyday life we frequently rely on our abilities to postpone intentions until later occasions (prospective memory; PM) and to deactivate completed intentions even in stressful situations. Yet, little is known about the effects of acute stress on these abilities. In the present work we investigated the impact of acute stress on PM functioning under high task demands. (1) Different from previous studies, in which intention deactivation required mostly low processing demands, we used salient focal PM cues to induce high processing demands during intention-deactivation phases. (2) We systematically manipulated PM-monitoring demands in a nonfocal PM task that required participants to monitor for either one or six specific syllables that could occur in ongoing-task words. Eighty participants underwent the Trier Social Stress Test, a standardized stress induction protocol, or a standardized control situation, before performing a computerized PM task. Our primary interests were whether PM performance, PM-monitoring costs, aftereffects of completed intentions and/or commission-error risk would differ between stressed and non-stressed individuals and whether these effects would differ under varying task demands. Results revealed that PM performance and aftereffects of completed intentions during subsequent performance were not affected by acute stress induction, replicating previous findings. Under high demands on intention deactivation (focal condition), however, acute stress produced a nominal increase in erroneous PM responses after intention completion (commission errors). Most importantly, under high demands on PM monitoring (nonfocal condition), acute stress led to a substantial reduction in PM-monitoring costs. These findings support ideas of selective and demand-dependent effects of acute stress on cognitive functioning. Under high task demands, acute stress might induce a shift in processing strategy towards resource-saving behavior, which seems to increase the efficiency of PM performance (reduced monitoring costs), but might increase initial susceptibility to automatic response activation after intention completion.

Intention deactivation: effects of prospective memory task similarity on aftereffects of completed intentions.

Recent prospective memory (PM) studies indicate that intentions are not always directly deactivated after completion, but that they entail aftereffects in terms of slower ongoing-task performance and/or commission errors on repeated (no-longer relevant) PM trials. In four experiments, we investigated whether aftereffects depend on the similarity between completed and currently performed PM-tasks. Aftereffects were reduced when PM-cues differed between the two PM-tasks (symbols vs. words) compared to when PM-cues belonged to the same category (symbols vs. symbols). This could be explained by the new dissimilar PM-task shifting spatial attention away from repeated PM-cues and, thus, attenuating processing of these cues. Moreover, a switch of the PM-response (to or within the manual modality) did not result in erroneous retrieval of the no-more-relevant PM-response (i.e., commission errors) but in erroneous retrieval of the currently relevant PM-response (i.e., false alarms). In addition, aftereffects vanished in conditions, in which participants did not perform a new PM-task. This finding indicates that forming a new PM-task set might be a prerequisite for aftereffects when the ongoing task changes between the two subsequent PM-tasks. Finally, we did not find evidence that forming a new, dissimilar PM-task representation led to overwriting of the completed intention representation, and thus to a change of the content or destabilization of its activation level.

Similar coding of freely chosen and externally cued intentions in a fronto-parietal network.

Intentional action is essential to human behavior, yet its neural basis remains poorly understood. In order to identify neural networks specifically involved in intentional action, freely chosen and externally cued intentions have previously been contrasted. This has led to the identification of a fronto-parietal network, which is involved in freely choosing one's intentions. However, it remains unclear whether this network encodes specific intentions, or whether it merely reflects general preparatory or control processes correlated with intentional action. Here, we used MVPA on fMRI data to identify brain regions encoding non-motor intentions that were either freely chosen or externally cued. We found that a fronto-parietal network, including the lateral prefrontal cortex, premotor, and parietal cortex, contained information about both freely chosen and externally cued intentions. Importantly, MVPA cross-classification indicated that this network represents the content of our intentions similarly, regardless of whether these intentions are freely chosen or externally cued. This finding suggests that the intention network has a general role in processing and representing intentions independent of their origin.

Partially restored resting-state functional connectivity in women recovered from anorexia nervosa.

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.