Dynamic Functional Connectivity Markers in Anorexia Nervosa and Their Association With Clinical Symptoms: A Cross-Sectional Study

The human brain possesses a unique ability to switch between patterns of functional connectivity, known as brain states, which are crucial for regulating biological, cognitive, and emotional processes. These states are linked to numerous neurological and neuropsychiatric conditions, however, their relationship to clinical symptoms of anorexia nervosa (AN) is not well understood. In this exploratory study, we aimed to identify whole-brain dynamic functional alterations in AN and their association with AN symptoms. To this end, we recruited 19 women diagnosed with AN and 22 healthy controls (HCs) who underwent resting-state functional magnetic resonance imaging. By implementing a sliding-window approach, we found that AN patients had limited flexibility to transit between different brain configurations compared to HCs. Moreover, AN patients spent a significant amount of time in a functional configuration characterised by strong coupling between the ventral attentional network and the somatomotor network. Changes in these networks play a crucial role in body image disturbances, interoceptive awareness, and body image-body schema interaction. Interestingly, the time spent in this specific brain state showed a negative relationship with body mass index, along with a positive correlation with eating disorder indices. Our study highlights the potential of dynamic functional connectivity as a prognostic and therapeutic means to spotlight maladaptive functional brain configurations in AN.