{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T15:21:09Z","timestamp":1780413669009,"version":"3.54.1"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002947","name":"Anhui Medical University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002947","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002729","name":"Anhui University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002729","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Hum. Neurosci."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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\u202f=\u202f\u22122.19, <jats:italic>p<\/jats:italic>\u202f=\u202f0.032) in the left posterior insula and gastric network compared to healthy controls and were significantly negatively correlated with PAC-SYM (r\u202f=\u202f\u22120.407, <jats:italic>p<\/jats:italic>\u202f=\u202f0.015) and Wexner Constipation Scale (r\u202f=\u202f\u22120.483, <jats:italic>p<\/jats:italic>\u202f=\u202f0.003) scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnhum.2025.1624489","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T05:30:39Z","timestamp":1760679039000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Abnormal connection between the posterior insula and the gastric network among patients with functional constipation"],"prefix":"10.3389","volume":"19","author":[{"given":"Dehua","family":"Zha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiajing","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyan","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaohua","family":"Tao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1297","DOI":"10.1093\/scan\/nsaa008","article-title":"Common variant of CNTNAP2 gene modulate the social performances and functional connectivity of posterior right temporoparietal junction","volume":"14","author":"Bai","year":"2019","journal-title":"Soc. Cogn. Affect. Neurosci."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2696","DOI":"10.1016\/j.cgh.2019.03.046","article-title":"Chronic diarrhea and constipation are more common in depressed individuals","volume":"17","author":"Ballou","year":"2019","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"3440","DOI":"10.1111\/ene.15607","article-title":"Intestinal histomorphological and molecular alterations in patients with Parkinson\u2019s disease","volume":"30","author":"Bellini","year":"2023","journal-title":"Eur. J. Neurol."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2091","DOI":"10.1002\/mds.29937","article-title":"Prokineticin-2 is highly expressed in colonic mucosa of early Parkinson\u2019s disease patients","volume":"39","author":"Bellini","year":"2024","journal-title":"Mov. Disord."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1212\/WNL.0000000000008525","article-title":"Insular cortex: functional complexity and clinical correlations","volume":"93","author":"Benarroch","year":"2019","journal-title":"Neurology"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1093\/cercor\/bhad403","article-title":"Regional homogeneity alterations in patients with functional constipation and their associations with gene expression profiles","volume":"34","author":"Cai","year":"2024","journal-title":"Cereb. Cortex"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1016\/j.neuroimage.2012.04.012","article-title":"Meta-analytic clustering of the insular cortex: characterizing the meta-analytic connectivity of the insula when involved in active tasks","volume":"62","author":"Cauda","year":"2012","journal-title":"NeuroImage"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"13","DOI":"10.3389\/fnsys.2010.00013","article-title":"DPARSF: a MATLAB toolbox for \u201cpipeline\u201d data analysis of resting-state fMRI","volume":"4","author":"Chao-Gan","year":"2010","journal-title":"Front. Syst. Neurosci."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1038\/nrn894","article-title":"How do you feel? Interoception: the sense of the physiological condition of the body","volume":"3","author":"Craig","year":"2002","journal-title":"Nat. Rev. Neurosci."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"2237","DOI":"10.1056\/NEJMra1706158","article-title":"Mapping symptoms to brain networks with the human connectome","volume":"379","author":"Fox","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref11","first-page":"159","article-title":"Psychological disorders in patients with chronic constipation","volume":"4","author":"Hosseinzadeh","year":"2011","journal-title":"Gastroenterol Hepatol Bed Bench"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1899","DOI":"10.1007\/s11682-019-00133-4","article-title":"Cortical morphometry alterations in brain regions involved in emotional, motor-control and self-referential processing in patients with functional constipation","volume":"14","author":"Hu","year":"2020","journal-title":"Brain Imaging Behav."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1741","DOI":"10.1007\/s11682-022-00648-3","article-title":"Brain structural changes in regions within the salience network in patients with functional constipation","volume":"16","author":"Jia","year":"2022","journal-title":"Brain Imaging Behav."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e13566","DOI":"10.1111\/nmo.13566","article-title":"Sex-related differences in resting-state brain activity and connectivity in the orbital frontal cortex and insula in patients with functional constipation","volume":"31","author":"Jin","year":"2019","journal-title":"Neurogastroenterol. Motil."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"4956","DOI":"10.1002\/hbm.26436","article-title":"Reliability and validity of brain-gastric phase synchronization","volume":"44","author":"Levakov","year":"2023","journal-title":"Hum. Brain Mapp."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1007\/s11682-020-00273-y","article-title":"Abnormalities in the thalamo-cortical network in patients with functional constipation","volume":"15","author":"Liu","year":"2021","journal-title":"Brain Imaging Behav."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1038\/nrn3071","article-title":"Gut feelings: the emerging biology of gut-brain communication","volume":"12","author":"Mayer","year":"2011","journal-title":"Nat. Rev. Neurosci."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1146\/annurev-med-042320-014032","article-title":"The gut-brain Axis","volume":"73","author":"Mayer","year":"2022","journal-title":"Annu. Rev. Med."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"2205","DOI":"10.1523\/JNEUROSCI.1285-21.2021","article-title":"The sensory and motor components of the cortical hierarchy are coupled to the rhythm of the stomach during rest","volume":"42","author":"Rebollo","year":"2022","journal-title":"J. Neurosci."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"7","DOI":"10.7554\/eLife.33321","article-title":"Stomach-brain synchrony reveals a novel, delayed-connectivity resting-state network in humans","volume":"22","author":"Rebollo","year":"2018","journal-title":"eLife"},{"key":"ref21","first-page":"346","article-title":"Insula sub-regions across the psychosis spectrum: morphology and clinical correlates","author":"Sheffield","year":"2021"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"2944","DOI":"10.1002\/hbm.22113","article-title":"Keeping the body in mind: insula functional organization and functional connectivity integrate interoceptive, exteroceptive, and emotional awareness","volume":"34","author":"Simmons","year":"2013","journal-title":"Hum. Brain Mapp."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1007\/s11894-017-0554-0","article-title":"Update on Rome IV criteria for colorectal disorders: implications for clinical practice","volume":"19","author":"Simren","year":"2017","journal-title":"Curr. Gastroenterol. Rep."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1007\/s00429-010-0296-3","article-title":"Functional neuroanatomy of the insular lobe","volume":"216","author":"Stephani","year":"2011","journal-title":"Brain Struct. Funct."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1162\/jocn_a_00462","article-title":"Beyond the tripartite cognition-emotion-interoception model of the human insular cortex","volume":"26","author":"Uddin","year":"2014","journal-title":"J. Cogn. Neurosci."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1097\/WNP.0000000000000377","article-title":"Structure and function of the human insula","volume":"34","author":"Uddin","year":"2017","journal-title":"J. Clin. Neurophysiol. Off. Pub. Am. Electroencephalographic Soc."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1186\/s12876-024-03124-y","article-title":"Symptom effects and central mechanism of acupuncture in patients with functional gastrointestinal disorders: a systematic review based on fMRI studies","volume":"24","author":"Wang","year":"2024","journal-title":"BMC Gastroenterol."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"5985","DOI":"10.1002\/hbm.25663","article-title":"Aberrant functional brain network dynamics in patients with functional constipation","volume":"42","author":"Yin","year":"2021","journal-title":"Hum. Brain Mapp."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"957620","DOI":"10.3389\/fnins.2022.957620","article-title":"Intra and inter: alterations in functional brain resting-state networks in patients with functional constipation","volume":"16","author":"Zhang","year":"2022","journal-title":"Front. Neurosci."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/j.neulet.2016.08.042","article-title":"Distinct resting-state brain activity in patients with functional constipation","volume":"632","author":"Zhu","year":"2016","journal-title":"Neurosci. 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