ORIGINAL RESEARCH article
Front. Hum. Neurosci.
Sec. Cognitive Neuroscience
Volume 19 - 2025 | doi: 10.3389/fnhum.2025.1624489
This article is part of the Research TopicNew Insights into the Management of Chronic Idiopathic Constipation: From Physiopathology to Novel Therapeutic StrategiesView all 5 articles
Abnormal connection between the posterior insula and the gastric network among patients with functional constipation title:
Provisionally accepted
- First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
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Abstract Background: Functional constipation (FCon) is frequently accompanied by psychological disorders, implicating the interaction between the gastrointestinal symptom and brain dysfunction in FCon. Recent studies combining electrogastrogram and resting-state functional magnetic resonance imaging (fMRI) have reported a novel gastric network. Besides, the fMRI activity of the gastric network was also coupled with the insular fMRI signal. However, little is known about the connection between the gastric network and the insula in FCon. Methods: Based on rs-fMRI, functional connectivity (FC) using a large sample of 652 healthy subjects identified the insular cortex as the most closely linked to the gastric network. Then, seed-based FC and dynamic functional connectivity of the gastric network and the gastric-related insular cortex were calculated and compared in 35 patients with FCon and 36 healthy controls. Constipation symptoms were measured using the Patient Assessment of Constipation Symptom Scale (PAC-SYM) and the Wexner Constipation Scale. Their relationships with alterations in the gastric network-insula subregion were investigated. Results: The posterior insular cortex presented a strong connection with the gastric network with large-scale resting-state fMRI data sets of healthy participants. FCon patients had significantly decreased FC (t = -2.19, P = 0.032) in the left posterior insula and gastric network compared to healthy controls and were significantly negatively correlated with PAC-SYM (r = -0.407, P =0.015) and Wexner Constipation Scale (r = -0.483, P = 0.003) scores. Conclusions: The abnormality of the connection between the posterior insula and the gastric network may be the prominent neuroimaging feature on FCon, which sheds light on a new perspective on the pathophysiology of FCon.
Keywords: Functional constipation, resting-state functional magnetic resonance imaging, insula, Gastric network, Radiology
Received: 07 May 2025; Accepted: 06 Oct 2025.
Copyright: © 2025 Zha, Chen, Yang, Zhang, Tao, Wang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wei Wang, 358004798@qq.com
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