Altered habenula to locus coeruleus functional connectivity in past anorexia nervosa suggests correlation with suicidali
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BRIEF REPORT
Altered habenula to locus coeruleus functional connectivity in past anorexia nervosa suggests correlation with suicidality: a pilot study Kristin E. Wills1,2 · Savannah N. Gosnell1,3 · Kaylah N. Curtis1,3 · Kenia Velasquez1,3 · J. Christopher Fowler1,4 · Ramiro Salas1,3,4,5 Received: 26 March 2019 / Accepted: 3 July 2019 © This is a U.S. government work and its text is not subject to copyright protection in the United States; however, its text may be subject to foreign copyright protection 2019
Abstract Purpose Despite anorexia nervosa having the highest mortality rate of mental illnesses, little is known regarding the brain mechanisms involved. Given that lack of interest for food in anorexic patients is related to alterations in the reward system, we tested the hypothesis that patients with past anorexia nervosa (pAN) have altered resting state functional connectivity (RSFC) between the habenula (a major component of the reward system) and its targets. Methods RSFC between the habenula and major targets (locus coeruleus, median and dorsal raphe nuclei, substantia nigra, and ventral tegmental area) was studied in 14 psychiatric inpatients with pAN and 14 psychiatric inpatient controls (PC, never-anorexic patients in same clinic, matched for comorbidities). Next, we tested possible correlations between RSFC and suicidal ideation, depression, and anxiety as determined by self-report questionnaires. Results Left habenula/locus coeruleus RSFC was lower in pAN patients compared to PC. The left habenula/locus coeruleus RSFC was positively correlated with suicidal ideation (past 2 months) in pAN patients, but not in controls. Conclusions pAN patients showed long lasting alterations in habenular connectivity. This may have clinical implications, possibly including future evaluation of the habenula as a therapeutic target and the need to carefully monitor suicidality in pAN patients. No level of evidence Basic science. Keywords Habenula · Resting state functional connectivity · Anorexia nervosa · Suicide · Reward circuitry
Introduction
Kristin E. Wills and Savannah N. Gosnell have equal contributions. * Ramiro Salas [email protected] 1
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
2
Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
3
Michael E DeBakey VA Medical Center, 2002 Holcombe Blvd, Bldg 110, #219, Houston, TX 77030, USA
4
The Menninger Clinic, Houston, TX, USA
5
Department of Neuroscience, Baylor College of Medicine, Houston, TX, USA
Anorexia nervosa (AN) affects 0.9% of American women and 0.3% of American men in their lifetimes has the highest mortality rate of all mental illnesses, and 20% of AN deaths are suicides [1]. These patients also have a high incidence of comorbid mental illnesses: 33–50% with mood disorders and ~ 50% with anxiety spectrum disorders [2]. The neural correlates of the disorder have been an active field of study for several years. The general current view
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