Can't get it off my brain: Meta-analysis of neuroimaging studies on perseverative cognition

Elena Makovac, Sabrina Fagioli, Charlotte L. Rae, Hugo D. Critchley, Cristina Ottaviani

Research output: Contribution to journalReview articlepeer-review


Perseverative cognition (i.e. rumination and worry) describes intrusive, uncontrollable, repetitive thoughts. These negative affective experiences are accompanied by physiological arousal, as if the individual were facing an external stressor. Perseverative cognition is a transdiagnostic symptom, yet studies of neural mechanisms are largely restricted to specific clinical populations (e.g. patients with major depression). The present study applied activation likelihood estimation (ALE) meta-analyses to 43 functional neuroimaging studies of perseverative cognition to elucidate the neurobiological substrates across individuals with and without psychopathological conditions. Task-related and resting state functional connectivity studies were examined in separate meta-analyses. Across task-based studies, perseverative cognition engaged medial frontal gyrus, cingulate gyrus, insula, and posterior cingulate cortex. Resting state functional connectivity studies similarly implicated posterior cingulate cortex together with thalamus and anterior cingulate cortex (ACC), yet the involvement of ACC distinguished between perseverative cognition in healthy controls (HC) and clinical groups. Perseverative cognition is accompanied by the engagement of prefrontal, insula and cingulate regions, whose interaction may support the characteristic conjunction of self-referential and affective processing with (aberrant) cognitive control and embodied (autonomic) arousal. Within this context, ACC engagement appears critical for the pathological expression of rumination and worry.

Original languageEnglish
Article number111020
JournalPsychiatry Research - Neuroimaging
Publication statusE-pub ahead of print - Nov 21 2019


  • Activation likelihood estimation
  • fMRI
  • Rumination
  • Worry

ASJC Scopus subject areas

  • Neuroscience (miscellaneous)
  • Radiology Nuclear Medicine and imaging
  • Psychiatry and Mental health


Dive into the research topics of 'Can't get it off my brain: Meta-analysis of neuroimaging studies on perseverative cognition'. Together they form a unique fingerprint.

Cite this