Intrinsic functional connectivity of the anterior cingulate cortex is associated with tolerance to distress.

The ability to adapt under significant adversity, defined as psychological resilience, is instrumental in preventing stress-related disorders. An important aspect of resilience is the capacity to endure affective distress when in pursuit of goals, also known as distress tolerance. Evidence that links intrinsic baseline interactions within large-scale functional networks with performance under distress remains missing. We hypothesized that the anterior cingulate cortex (ACC) may engage in distress tolerance due to its involvement in attention and emotion regulation. Accordingly, we tested whether behavioral performance under distress is associated with baseline resting-state ACC functional connectivity (FC). Distress tolerance was measured in 97 participants using the behavioral indicator of resiliency to distress (BIRD) task. Analyses contrasted participants who quit the task before its designated termination (n=51) with those who persisted throughout it (n=46). Seed-based FC analysis indicated greater connectivity between the anterior cingulate cortex (ACC) and dorsolateral prefrontal cortex in subjects who persisted throughout the task, along with greater FC between the ACC and the precentral gyrus in those who quit before its termination. The results shed light on the mechanisms underlying interindividual differences in the ability to handle distress. Significance Statement The brain mechanisms underlying distress tolerance (DT), the process of withstanding adversity while pursuing a goal, are incompletely understood. Here, we tested whether the anterior cingulate cortex (ACC), a region that integrates sensory input and guides attention to salient stimuli is involved in DT. Our results reveal increased resting-state Functional connectivity (FC) between the ACC and the left dorsolateral prefrontal cortex in individuals with high level of DT, and reduced FC between the ACC and the insular and motor cortex in those with lower levels of DT. Altogether, these results reveal that through functional connections with other cortical regions, the ACC regulates DT in the healthy brain.