Altered structural covariance and functional connectivity of the insula in patients with Crohn’s disease

Abstract

Background: Crohn's disease (CD) is a clinically chronic inflammatory bowel disease, which has been shown to be closely related to the brain-gut axis dysfunction. Although traditionally considered to be a limbic region, the insula has also been commonly identified as an abnormal brain region in previous CD-related studies.Methods: Structural magnetic resonance imaging (MRI) and resting-state functional MRI images were acquired from 45 CD patients in remission and 40 healthy controls (HCs). Three neuroimaging analysis methods including voxel-based morphometry (VBM), structural covariance, and functional connectivity (FC) were applied to investigate structural and functional alterations of the insulae between the CD patients and HCs. Pearson correlation was then used to examine the relationships between neuroimaging findings and clinical symptoms.Results: Compared with the HCs, CD patients exhibited decreased gray matter volume (GMV) in the left dorsal anterior insula (dAI) and bilateral posterior insula (PI). Taking these three areas including the left dAI, right PI, and left PI as regions of interest (ROIs), differences were observed in the structural covariance and FC of the ROI with several regions between the two groups. After controlling for psychological factors, the differences of several regions involved in emotional processing in GMV in the left dAI, the FC of the dAI, and the right PI were not significant. The FC of the parahippocampus/hippocampus with dAI and PI were negatively correlated with the CD activity index (CDAI). Conclusions:We suggest that the insula-centered structural and/or functional changes may be associated with abnormal visceral sensory processing and related emotional responses in CD patients.

Differential Cortical Volume and Surface Morphometry in Youth With Chronic Health Conditions

“…The insula is associated with diverse physiological functions, including interoception, the innate sense of the physiological condition of one's body states (Craig, 2002), and may also play a role in the pathology of psychiatric disorders and cognitive deficits (Goodkind et al, 2015). While insula structure has been associated with childhood internalizing disorders and traumatic experiences (Klabunde et al, 2017), this is one of few studies of childhood-onset CHCs specifically implicating insula structure (Naegel et al, 2014;S. Zhang et al, 2022S.…”

Altered mean apparent propagator-based microstructure and the corresponding functional connectivity of the parahippocampus and thalamus in Crohn’s disease

“…CD, as a chronic IBD, primarily affects the gastrointestinal tract. Some recent studies have proposed that the microbiota-gut-brain axis may be a critical contributor in understanding the concomitant mental health issues in IBD and related disorders ( Lv et al, 2018 ; Gracie et al, 2019 ; Thomann et al, 2019 ; Zhang et al, 2022 ). Animal-model research showed that chronic gastrointestinal inflammation might induce anxiety-like behavior and alter biochemistry of the central nervous system in mice ( Mogilevski et al, 2019 ).…”

Inflammatory bowel disease cross‐sectional imaging: What's new?

“…Prior CD studies based on functional MRI have demonstrated abnormal neural activity and functional connectivity, regional homogeneity, and amplitude of low‐frequency fluctuations in various regions primarily associated with emotion, pain, and cognitive‐related functions, which would provide information to further understand the neural mechanisms of CD 73 . Moreover, multimodal MRI that combines functional and structural MRI can provide additional information 74 . Prior multimodal studies of voxel‐based morphometry and functional connectivity indicated that differences were observed in the insula, paracentral lobule, cingulate gyrus, and medial frontal gyrus, which are related to the mental state, pain, and quality of life of patients with CD.…”

“… 73 Moreover, multimodal MRI that combines functional and structural MRI can provide additional information. 74 Prior multimodal studies of voxel‐based morphometry and functional connectivity indicated that differences were observed in the insula, paracentral lobule, cingulate gyrus, and medial frontal gyrus, which are related to the mental state, pain, and quality of life of patients with CD. These neural correlations potentially serve as useful biomarkers for evaluating the treatment efficacy and differential points for diagnosing diseases.…”