{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T21:59:12Z","timestamp":1792706352567,"version":"4.5.0"},"reference-count":92,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82001429, 82090034"],"award-info":[{"award-number":["82001429, 82090034"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2021YFC3300500, 2021YFC3300504"],"award-info":[{"award-number":["2021YFC3300500, 2021YFC3300504"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Gastrointestinal (GI) symptoms are a common and burdensome dimension of major depressive disorder (MDD), yet their neurobiological underpinnings are poorly understood. It is unclear how the brain\u2019s processing of visceral signals relates to the subjective experience of GI distress in depression. We aimed to identify a neural substrate for GI symptoms by examining functional connectivity (FC) between the insula and a network defined by gastric rhythms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We first identified a gastric-related seed in the posterior insula (GD-pINS) using a large normative dataset of 652 healthy adults. Subsequently, 100 MDD patients\u2014stratified into groups with (GD; n=58) and without (NGD; n=42) GI symptoms\u2014and 80 healthy controls (HCs) were recruited. Using resting-state fMRI, we analyzed FC between the GD-pINS and the gastric network (GN). Group differences, clinical correlations, and the utility of FC features for patient classification via a support vector machine (SVM) were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared to HCs, MDD patients as a whole showed reduced GD-pINS to GN connectivity. Paradoxically, GD patients exhibited relatively stronger connectivity than NGD patients. This symptom-specific enhancement was driven by pathways connecting the posterior insula to the secondary somatosensory cortex (SII). The strength of this insula-SII connection was positively correlated with GI symptom severity. An SVM classifier using these connectivity features distinguished between GD and NGD patients with high accuracy (AUC\u00a0=\u00a00.82).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings reveal a distinct neural signature for GI distress in depression, characterized by aberrant connectivity within an insula-somatosensory circuit. This circuit, which shows relative enhancement in symptomatic patients against a backdrop of globally reduced connectivity, may reflect a mechanism of somatosensory amplification. It represents a potential biomarker for patient stratification and a novel target for therapeutic intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2025.1672148","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T16:29:06Z","timestamp":1763569746000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["A neural signature for gastrointestinal symptoms in depression: insula-gastric connectivity predicts symptom severity"],"prefix":"10.3389","volume":"16","author":[{"given":"Li","family":"Qi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaomin","family":"Pan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhishun","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjia","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Ying","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tongjian","family":"Bai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianqian","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2005.07.022","article-title":"Propagation of major depressive disorder: relationship between first episode symptoms and recurrence","volume":"141","author":"Pettit","year":"2006","journal-title":"Psychiatry Res"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v9.i31.9350","article-title":"Major depressive disorder: Validated treatments and future challenges","volume":"9","author":"Karrouri","year":"2021","journal-title":"World J Clin cases"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1176\/appi.focus.20200008","article-title":"Consequences of recurrence of major depressive disorder: is stopping effective antidepressant medications ever safe","volume":"18","author":"Severe","year":"2020","journal-title":"Focus (Am Psychiatr Publ)"},{"key":"B4","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1038\/s41392-024-01738-y","article-title":"Major depressive disorder: hypothesis, mechanism, prevention and treatment","volume":"9","author":"Cui","year":"2024","journal-title":"Signal Transduct Target Ther"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02143-7","article-title":"Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic","volume":"398","year":"2021","journal-title":"Lancet"},{"key":"B6","unstructured":"\u201cDepression in Adults with A Chronic Physical Health Problem.,\u201d Depression in Adults with a Chronic Physical Health Problem: Treatment and Management\n          \n          \n          UK\n          British Psychological Society\n          \n          2010"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5545.64586","article-title":"A tale of two comorbidities: Understanding the neurobiology of depression and pain","volume":"52","author":"Narasimhan","year":"2010","journal-title":"Indian J Psychiatry"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41575-023-00794-z","article-title":"Irritable bowel syndrome and mental health comorbidity \u2014 approach to multidisciplinary management","author":"Staudacher","year":"2023","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1037\/a0038101","article-title":"Interoceptive dysfunction: toward an integrated framework for understanding somatic and affective disturbance in depression","volume":"141","author":"Harshaw","year":"2015","journal-title":"psychol Bull"},{"key":"B10","article-title":"The link between depression and physical symptoms. Prim care companion","volume":"6","author":"Trivedi","year":"2004","journal-title":"J Clin Psychiatry"},{"key":"B11","article-title":"Somatic symptoms and depression: diagnostic confusion and clinical neglect","volume":"55","author":"Dowrick","year":"2005","journal-title":"Br J Gen Pract"},{"key":"B12","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1016\/j.apnu.2022.01.004","article-title":"Experiences and coping strategies of somatic symptoms in patients with depressive disorder: A qualitative study","volume":"38","author":"Chen","year":"2022","journal-title":"Arch Psychiatr Nurs"},{"key":"B13","first-page":"41","article-title":"The reliability of psychiatric diagnosis revisited","volume":"3","author":"Aboraya","year":"2006","journal-title":"Psychiatry (Edgmont)"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2023.1144826","article-title":"Classifying mental disorders through clinicians\u2019 subjective approach based on three-way decisions","volume":"14","author":"Wang","year":"2023","journal-title":"Front Psychol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1002\/wps.21078","article-title":"Candidate biomarkers in psychiatric disorders: state of the field","volume":"22","author":"Abi-Dargham","year":"2023","journal-title":"World Psychiatry"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1093\/ijnp\/pyv042","article-title":"Biomarkers for psychiatry: the journey from fantasy to fact, a report of the 2013 CINP think tank","volume":"18","author":"Scarr","year":"2015","journal-title":"Int J Neuropsychopharmacol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci9060131","article-title":"Major depressive disorder is associated with impaired interoceptive accuracy: A systematic review","volume":"9","author":"Eggart","year":"2019","journal-title":"Brain Sci"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2008.12.015","article-title":"Migraine: a missing link between somatic symptoms and major depressive disorder","volume":"117","author":"Hung","year":"2009","journal-title":"J Affect Disord"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci14070646","article-title":"Uncovering interoceptive human insular lobe function through intraoperative cortical stimulation-A review","volume":"14","author":"Zinn","year":"2024","journal-title":"Brain Sci"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.pneurobio.2025.102748","article-title":"Anatomo-functional organization of insular networks: From sensory integration to behavioral control","volume":"247","author":"Simone","year":"2025","journal-title":"Prog Neurobiol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1007\/s12264-024-01211-4","article-title":"The insular cortex: an interface between sensation, emotion and cognition","volume":"40","author":"Zhang","year":"2024","journal-title":"Neurosci Bull"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2023.1273439","article-title":"Insular dysfunction of interoception in major depressive disorder: from the perspective of neuroimaging","volume":"14","author":"Hu","year":"2023","journal-title":"Front Psychiatry"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3390\/ijms24065736","article-title":"The role of the insular cortex in pain","volume":"24","author":"Labrakakis","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1152\/jn.91100.2008","article-title":"Parsing pain perception between nociceptive representation and magnitude estimation","volume":"101","author":"Baliki","year":"2009","journal-title":"J Neurophysiol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2008.12.070","article-title":"Anterior insular cortex anticipates impending stimulus significance","volume":"45","author":"Lovero","year":"2009","journal-title":"Neuroimage"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2024.11.043","article-title":"Role of the insula in rTMS response for depression","volume":"370","author":"Wu","year":"2025","journal-title":"J Affect Disord"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1101\/2024.10.15.24315550","article-title":"Increased insular functional connectivity during repetitive negative thinking in major depression and healthy volunteers","volume":"2024","author":"Edwards","year":"2024","journal-title":"medRxiv"},{"key":"B28","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1016\/j.jpain.2014.04.007","article-title":"Altered resting state connectivity of the insular cortex in individuals with fibromyalgia","volume":"15","author":"Ichesco","year":"2014","journal-title":"J Pain"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1002\/art.27497","article-title":"Intrinsic brain connectivity in fibromyalgia is associated with chronic pain intensity","volume":"62","author":"Napadow","year":"2010","journal-title":"Arthritis Rheum"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2011.06.007","article-title":"Executive function in chronic pain patients and healthy controls: different cortical activation during response inhibition in fibromyalgia","volume":"12","author":"Glass","year":"2011","journal-title":"J Pain"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1089\/brain.2014.0274","article-title":"Fibromyalgia is associated with decreased connectivity between pain- and sensorimotor brain areas","volume":"4","author":"Flodin","year":"2014","journal-title":"Brain Connect"},{"key":"B32","doi-asserted-by":"publisher","first-page":"e33041","DOI":"10.1002\/ajmg.b.33041","article-title":"Transcriptional patterns of functional connectivity associated with somatic symptoms in major depressive disorder","author":"Wang","year":"2025","journal-title":"Am J Med Genet B Neuropsychiatr Genet"},{"key":"B33","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1186\/s12888-022-03795-5","article-title":"Aberrant functional connectivity in insular subregions in somatic depression: a resting-state fMRI study","volume":"22","author":"Yan","year":"2022","journal-title":"BMC Psychiatry"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1093\/cercor\/bhs065","article-title":"Decoding the role of the insula in human cognition: functional parcellation and large-scale reverse inference","volume":"23","author":"Chang","year":"2013","journal-title":"Cereb Cortex"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1176\/appi.neuropsych.260401","article-title":"Insular cortex: structural and functional neuroanatomy","volume":"26","author":"Shura","year":"2014","journal-title":"J Neuropsychiatry Clin Neurosci"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1016\/j.cub.2024.10.035","article-title":"Interoception and gut-brain communication","volume":"34","author":"Alhadeff","year":"2024","journal-title":"Curr Biol"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.3389\/fnbeh.2022.929332","article-title":"Gut signals and gut feelings: science at the interface of data and beliefs","volume":"16","author":"Holzer","year":"2022","journal-title":"Front Behav Neurosci"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1038\/nrn2201","article-title":"Spontaneous fluctuations in brain activity observed with functional magnetic resonance imaging","volume":"8","author":"Fox","year":"2007","journal-title":"Nat Rev Neurosci"},{"key":"B39","doi-asserted-by":"publisher","first-page":"e33321","DOI":"10.7554\/eLife.33321","article-title":"Stomach-brain synchrony reveals a novel, delayed-connectivity resting-state network in humans","volume":"7","author":"Rebollo","year":"2018","journal-title":"Elife"},{"key":"B40","doi-asserted-by":"publisher","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":"B41","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2022.119628","article-title":"The vagus nerve mediates the stomach-brain coherence in rats","volume":"263","author":"Cao","year":"2022","journal-title":"Neuroimage"},{"key":"B42","doi-asserted-by":"publisher","first-page":"e14735","DOI":"10.1111\/psyp.14735","article-title":"Investigating the modulation of gastric sensations and disposition toward food with taVNS","volume":"62","author":"Salaris","year":"2025","journal-title":"Psychophysiology"},{"key":"B43","doi-asserted-by":"publisher","first-page":"sbae003","DOI":"10.1093\/schbul\/sbae003","article-title":"Heterogeneous brain abnormalities in schizophrenia converge on a common network associated with symptom remission","author":"Wang","year":"2024","journal-title":"Schizophr Bull"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1155\/2024\/3827870","article-title":"Heterogeneous brain atrophy sites in anxiety disorders map to a common brain network","volume":"2024","author":"Yang","year":"2024","journal-title":"Depression Anxiety"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1097\/00006842-200203000-00008","article-title":"The PHQ-15: validity of a new measure for evaluating the severity of somatic symptoms","volume":"64","author":"Kroenke","year":"2002","journal-title":"Psychosom Med"},{"key":"B46","doi-asserted-by":"publisher","first-page":"e2446603","DOI":"10.1001\/jamanetworkopen.2024.46603","article-title":"Measurement properties of the patient health questionnaire-15 and somatic symptom scale-8: A systematic review and meta-analysis","volume":"7","author":"Hybelius","year":"2024","journal-title":"JAMA Netw Open"},{"key":"B47","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1186\/s12888-016-0798-5","article-title":"Validation of the Chinese version of the PHQ-15 in a tertiary hospital","volume":"16","author":"Zhang","year":"2016","journal-title":"BMC Psychiatry"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2019.09.077","article-title":"Latent structure and factor invariance of somatic symptoms in the patient health questionnaire (PHQ-15)","volume":"261","author":"Cano-Garc\u00eda","year":"2020","journal-title":"J Affect Disord"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2018.00240","article-title":"Comparison of the factor structure of the patient health questionnaire for somatic symptoms (PHQ-15) in Germany, the Netherlands, and China. A transcultural structural equation modeling (SEM) study","volume":"9","author":"Leonhart","year":"2018","journal-title":"Front Psychiatry"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1016\/j.scib.2019.05.008","article-title":"RESTplus: an improved toolkit for resting-state functional magnetic resonance imaging data processing","volume":"64","author":"Jia","year":"2019","journal-title":"Sci Bull (Beijing)"},{"key":"B51","first-page":"689","volume-title":"Statistical Parametric Mapping: The Analysis of Functional Brain Images","author":"Penny","year":"2011"},{"key":"B52","doi-asserted-by":"publisher","first-page":"940","DOI":"10.1016\/j.neuron.2018.01.032","article-title":"The basal forebrain regulates global resting-state fMRI fluctuations","volume":"97","author":"Turchi","year":"2018","journal-title":"Neuron"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2017.02.036","article-title":"The global signal in fMRI: Nuisance or Information","volume":"150","author":"Liu","year":"2017","journal-title":"Neuroimage"},{"key":"B54","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1145\/1961189.1961199","article-title":"LIBSVM: A library for support vector machines","volume":"2","author":"Chang","year":"2011","journal-title":"ACM Trans Intell Syst Technol"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.23235","article-title":"Reduced global functional connectivity of the medial prefrontal cortex in major depressive disorder","volume":"37","author":"Murrough","year":"2016","journal-title":"Hum Brain Mapp"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.1038\/s41386-020-0624-0","article-title":"Evaluating global brain connectivity as an imaging marker for depression: influence of preprocessing strategies and placebo-controlled ketamine treatment","volume":"45","author":"Kraus","year":"2020","journal-title":"Neuropsychopharmacology"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.1007\/s00429-010-0262-0","article-title":"Saliency, switching, attention and control: a network model of insula function","volume":"214","author":"Menon","year":"2010","journal-title":"Brain Struct Funct"},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2024.1386984","article-title":"Weakened effective connectivity between salience network and default mode network during resting state in adolescent depression","volume":"15","author":"Willinger","year":"2024","journal-title":"Front Psychiatry"},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2013.05.012","article-title":"Whole-brain functional connectivity during emotional word classification in medication-free Major Depressive Disorder: Abnormal salience circuitry and relations to positive emotionality","volume":"2","author":"Van Tol","year":"2013","journal-title":"NeuroImage Clin"},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.23682","article-title":"Insula-based networks in professional musicians: Evidence for increased functional connectivity during resting state fMRI","volume":"38","author":"Zamorano","year":"2017","journal-title":"Hum Brain Mapp"},{"key":"B61","doi-asserted-by":"publisher","first-page":"e2105730118","DOI":"10.1073\/pnas.2105730118","article-title":"Altered effective connectivity in sensorimotor cortices is a signature of severity and clinical course in depression","volume":"118","author":"Ray","year":"2021","journal-title":"Proc Natl Acad Sci U.S.A"},{"key":"B62","doi-asserted-by":"publisher","DOI":"10.1016\/j.pscychresns.2024.111880","article-title":"Investigating changes of functional brain networks in major depressive disorder by graph theoretical analysis of resting-state fMRI","volume":"344","author":"Agziyart","year":"2024","journal-title":"Psychiatry Res Neuroimaging"},{"key":"B63","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.bbi.2015.12.018","article-title":"Intrinsic functional connectivity of insular cortex and symptoms of sickness during acute experimental inflammation","volume":"56","author":"Lekander","year":"2016","journal-title":"Brain Behav Immun"},{"key":"B64","doi-asserted-by":"publisher","DOI":"10.1111\/jon.13117","article-title":"The role of the insula in chronic pain following spinal cord injury: A resting-state fMRI study","volume":"33","author":"Mandloi","year":"2023","journal-title":"J Neuroimaging"},{"key":"B65","doi-asserted-by":"publisher","DOI":"10.4103\/1673-5374.125341","article-title":"Resting-state connectivity in the default mode network and insula during experimental low back pain","volume":"9","author":"Zhang","year":"2014","journal-title":"Neural Regener Res"},{"key":"B66","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2014.07.009","article-title":"Differential structural and resting state connectivity between insular subdivisions and other pain-related brain regions","volume":"155","author":"Wiech","year":"2014","journal-title":"Pain"},{"key":"B67","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2024.120624","article-title":"Individual differences of white matter characteristic along the anterior insula-based fiber tract circuit for pain empathy in healthy women and women with primary dysmenorrhea","volume":"293","author":"Mu","year":"2024","journal-title":"Neuroimage"},{"key":"B68","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2024.1392351","article-title":"Somatosensory Amplification Scale-Chinese version: psychometric properties and its mediating role in the relationship between alexithymia and somatization","volume":"15","author":"Tan","year":"2024","journal-title":"Front Psychol"},{"key":"B69","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2021.04.005","article-title":"Secondary somatosensory cortex evoked responses and 6-year neurodevelopmental outcome in extremely preterm children","volume":"132","author":"L\u00f6nnberg","year":"2021","journal-title":"Clin Neurophysiol"},{"key":"B70","unstructured":"Neuroanatomy, somatosensory cortex\n          \n          \n            \n              Raju\n              H\n            \n            \n              Tadi\n              P\n            \n          \n          32310375\n          Treasure Island (FL\n          StatPearls Publishing\n          StatPearls\n          \n          2025"},{"key":"B71","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.02.068","article-title":"Brain response to visceral aversive conditioning: a functional magnetic resonance imaging study","volume":"128","author":"Y\u00e1g\u00fcez","year":"2005","journal-title":"Gastroenterology"},{"key":"B72","doi-asserted-by":"publisher","DOI":"10.1016\/s1388-2457(00)00420-x","article-title":"Somatosensory cortex responses to median nerve stimulation: fMRI effects of current amplitude and selective attention","volume":"111","author":"Backes","year":"2000","journal-title":"Clin Neurophysiol"},{"key":"B73","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001541","article-title":"Somatotopically-specific primary somatosensory connectivity to salience and default mode networks encodes clinical pain","volume":"160","author":"Kim","year":"2019","journal-title":"Pain"},{"key":"B74","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2021.110534","article-title":"Comparison of brain activity within the sensorimotor network between sports players and patients with somatic symptom disorder","volume":"147","author":"Kim","year":"2021","journal-title":"J Psychosom Res"},{"key":"B75","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-11-200","article-title":"So depression is an inflammatory disease, but where does the inflammation come from","volume":"11","author":"Berk","year":"2013","journal-title":"BMC Med"},{"key":"B76","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci13020353","article-title":"Exploring associations between C-reactive protein and self-reported interoception in major depressive disorder: A bayesian analysis","volume":"13","author":"Eggart","year":"2023","journal-title":"Brain Sci"},{"key":"B77","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2022.11.003","article-title":"Inflammation-related functional and structural dysconnectivity as a pathway to psychopathology","volume":"93","author":"Goldsmith","year":"2023","journal-title":"Biol Psychiatry"},{"key":"B78","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.027","article-title":"Biopsychosocial aspects of functional gastrointestinal disorders: how central and environmental processes contribute to the development and expression of functional gastrointestinal disorders","author":"Oudenhove","year":"2016","journal-title":"Gastroenterology"},{"key":"B79","doi-asserted-by":"publisher","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"},{"key":"B80","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsaa124","article-title":"Functional organization of the insula in men and women with obstructive sleep apnea during Valsalva","volume":"44","author":"Pal","year":"2021","journal-title":"Sleep"},{"key":"B81","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2024.120591","article-title":"Emotional processing impairments in patients with insula lesions following stroke","volume":"291","author":"M","year":"2024","journal-title":"NeuroImage"},{"key":"B82","doi-asserted-by":"publisher","DOI":"10.1007\/BF02281899","article-title":"Left-insular cortex lesions perturb cardiac autonomic tone in humans","volume":"6","author":"Oppenheimer","year":"1996","journal-title":"Clin Auton Res"},{"key":"B83","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/j.cnp.2021.03.003","article-title":"Is the left insular cortex associated with the exaggerated activity in the parasympathetic nervous system","volume":"6","author":"Nagai","year":"2021","journal-title":"Clin Neurophysiol Pract"},{"key":"B84","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2013.04.014","article-title":"Lateralization of affective processing in the insula","volume":"78","author":"Duerden","year":"2013","journal-title":"Neuroimage"},{"key":"B85","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.bbi.2024.11.023","article-title":"The vagus nerve: An old but new player in brain-body communication","volume":"124","author":"Ma","year":"2025","journal-title":"Brain Behav Immun"},{"key":"B86","doi-asserted-by":"publisher","DOI":"10.3390\/ijms26031160","article-title":"Interaction of the vagus nerve and serotonin in the gut\u2013brain axis","volume":"26","author":"Hwang","year":"2025","journal-title":"Int J Mol Sci"},{"key":"B87","doi-asserted-by":"publisher","DOI":"10.1111\/ejn.14305","article-title":"Insular resting state functional connectivity is associated with gut microbiota diversity","volume":"50","author":"Curtis","year":"2019","journal-title":"Eur J Neurosci"},{"key":"B88","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2022.862443","article-title":"Effects of sub-threshold transcutaneous auricular vagus nerve stimulation on cingulate cortex and insula resting-state functional connectivity","volume":"16","author":"Mao","year":"2022","journal-title":"Front Hum Neurosci"},{"key":"B89","doi-asserted-by":"publisher","DOI":"10.1038\/sj.npp.1300725","article-title":"Antidepressant effect on connectivity of the mood-regulating circuit: an FMRI study","volume":"30","author":"Anand","year":"2005","journal-title":"Neuropsychopharmacology"},{"key":"B90","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.771147","article-title":"Antidepressant treatment-induced state-dependent reconfiguration of emotion regulation networks in major depressive disorder","volume":"12","author":"Zhao","year":"2022","journal-title":"Front Psychiatry"},{"key":"B91","doi-asserted-by":"publisher","DOI":"10.1080\/19490976.2023.2297864","article-title":"Elucidating the role of diet in maintaining gut health to reduce the risk of obesity, cardiovascular and other age-related inflammatory diseases: recent challenges and future recommendations","volume":"16","author":"Aziz","year":"2024","journal-title":"Gut Microbes"},{"key":"B92","doi-asserted-by":"publisher","DOI":"10.3390\/nu12092693","article-title":"Diet and nutrients in gastrointestinal chronic diseases","volume":"12","author":"Corsello","year":"2020","journal-title":"Nutrients"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2025.1672148\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T16:29:09Z","timestamp":1763569749000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2025.1672148\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,19]]},"references-count":92,"alternative-id":["10.3389\/fpsyt.2025.1672148"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2025.1672148","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,19]]},"article-number":"1672148"}}