Alterations in functional connectivity and interactions in resting-state networks in female patients with functional constipation

Patients with functional constipation (FCon) have been reported with brain functional abnormalities. The associations between constipation symptoms and brain functional connectivity (FC) in these patients are not well understood. Here we used functional magnetic resonance imaging (MRI) to examine FC alterations between resting-state networks (RSNs) and their associations with constipation symptoms in patients with FCon. The investigation of these characteristics might help to reveal the underlying neural mechanisms. Functional MRI with independent component analysis was applied to investigate alterations in FC within and functional network connectivity (FNC) between RSNs including default mode- (DMN), basal ganglia- (BGN), salience- (SN), left and right control executive-network (LCEN/ RCEN) in 39 female patients with FCon and 36 female healthy controls (HC). Patient Assessment of Constipation Quality of Life Scale (PAC-QOL) and Patient Assessment of Constipation Symptom Scale (PAC-SYM) were used to assess the constipation symptoms. Results showed that FCon patients had changed regional FC between different networks contributed to the abnormal FNCs among RSNs compared with HC. Patients with greater stool syndromes had increased FNC of BGN-SN and DMN-LCEN, and patients with greater worries/concerns and PAC-QOL total score had reduced FNC of SN-RCEN. The greater strength changes of FC in prefrontal and in parietal cortices were associated with higher negative emotion scores and greater rectal symptoms respectively. Our functional MRI suggested that FCon patients had altered FC within and interaction between RSNs and the brain FC changes were associated with constipation symptoms and altered emotions.