Brain functional changes in patients with ulcerative colitis

Agostini, Alessandro; Filippini, Nicola; Cevolani, Daniela; Agati, R.; Leoni, Chiara; Tambasco, Rosy; Calabrese, Carlo; Rizzello, Fernando; Gionchetti, Paolo; Ercolani, Mauro; Leonardi, Marco; Campieri, Massimo

doi:10.1002/ibd.21549

Cited by 67 publications

(36 citation statements)

References 33 publications

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“…Our finding of a reduction of positive bias during emotional recognition in people with active compared to inactive IBD was robust and consistent with the previous small fMRI study of patients with ulcerative colitis. 53 Our finding that less positive biases in emotional recognition partially mediated the association between IBD activity and depression is new and starts to elucidate the mechanisms un-…”

Section: Discussionmentioning

confidence: 92%

Factors associated with depression in people with inflammatory bowel disease: The relationship between active disease and biases in neurocognitive processing

Wilkinson

Trick

Knight

et al. 2019

Neurogastroenterology Motil

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Background Depression is common among people with inflammatory bowel disease (IBD), though the causes remain unclear. We conducted a cross‐sectional study to investigate the role of emotional processing biases in contributing to depression among people with IBD. Materials and Methods One hundred and twenty outpatients with IBD were recruited and: (a) completed questionnaires to record: age, sex, social support, socioeconomic status, anxiety and depression (n = 104), (b) underwent assessments of biases in emotional recognition (n = 112), emotional memory and reinforcement learning (c) had recorded from clinical records: type of IBD, duration of IBD, IBD activity and (d) provided blood for high‐sensitivity C‐reactive protein levels (n = 99). Key Results Sixty‐eight participants had Crohn's disease and 49 had ulcerative colitis. Of these, 35 had active disease and 26 had depression. Those with depression were more likely to be female, lack social support, have active disease, be taking corticosteroids but not TNF‐alpha inhibitors and exhibit less positive emotional recognition bias. On multivariable regression analysis, depression was associated independently with lack of social support (unstandardized regression coefficient (B) = −1.40, P = 0.02) and increased disease activity (B = 1.29, P = 0.03). Causal steps analysis was consistent with less positive emotional recognition bias partially mediating the effects of disease activity on depression. Conclusions and inferences This is the first study to demonstrate links between disease activity and less positive biases in emotional recognition that could explain higher rates of depression among people with active IBD. Future prospective studies are required to confirm the effects of emotional processing biases in depression and allow stronger causal inferences to be drawn.

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Section: Discussionmentioning

confidence: 92%

Factors associated with depression in people with inflammatory bowel disease: The relationship between active disease and biases in neurocognitive processing

Wilkinson

Trick

Knight

et al. 2019

Neurogastroenterology Motil

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“…Many recent studies of pain-related diseases, such as irritable bowel syndrome (IBS) [19, 28], migraine [44], and complex regional pain syndrome [10], have adopted rs-fMRI to detect pathophysiological changes in certain brain regions that are related to the recognition and processing of pain signals. In recent years, there has been growing interest in the use of MRI to detect the correlation between brain activities and inflammatory visceral pain in inflammatory bowel diseases (IBD) [1-3, 6, 20, 47]. Previous studies show alternations in gray matter (GM) structures including GM volumes and cortical thickness in multiple brain regions of CD patients, which in certain brain regions are correlated with disease duration [1, 6].…”

Section: Introductionmentioning

confidence: 99%

Differences in regional homogeneity between patients with Crohn's disease with and without abdominal pain revealed by resting-state functional magnetic resonance imaging

Bao

Liu

et al. 2016

Pain

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Abnormal pain processing in the central nervous system may be related to abdominal pain in patients with Crohn's disease (CD). The purpose of this study was to investigate changes in resting-state brain activity in CD patients in remission and its relationship with the presence of abdominal pain. Twenty-five CD patients with abdominal pain, 25 CD patients without abdominal pain, and 32 healthy subjects were scanned using a 3.0 T functional magnetic resonance imaging (fMRI) scanner. Regional homogeneity (ReHo) was used to assess resting-state brain activity. Daily pain scores were collected 1 week before fMRI scanning. We found that patients with abdominal pain exhibited lower ReHo values in the insula, middle cingulate cortex (MCC), and supplementary motor area, and higher ReHo values in the temporal pole. In contrast, patients without abdominal pain exhibited lower ReHo values in the hippocampal/parahippocampal cortex and higher ReHo values in the dorsomedial prefrontal cortex (all P<0.05, corrected). The ReHo values of the insula and MCC were significantly negatively correlated with daily pain scores for patients with abdominal pain (r=−0.53, P=0.008, and r=−0.61, P=0.002, respectively). These findings suggest that resting-state brain activities are different between remissive CD patients with and without abdominal pain, and that abnormal activities in insula and MCC are closely related to the severity of abdominal pain.

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“…IBD are associated with stress [ 1 , 2 ], emotional disturbances [ 3 - 5 ], psychological disorders, and impaired cognitive functioning [ 6 ]. The plausible neural substrate for these comorbidities have been investigated in recent research focused on the brain involvement in IBD patients [ 2 , 5 , 7 ]. In patients with CD, both functional and morphological neuroimaging studies have been conducted.…”

Section: Introductionmentioning

confidence: 99%

“…In patients with UC, despite an fMRI study that has shown dysfunction in the emotional processing characterized by abnormalities in the activity of the amygdala, thalamic and cerebellar regions [ 5 ], brain morphological studies still have not been conducted.…”

Section: Introductionmentioning

confidence: 99%

Absence of change in the gray matter volume of patients with ulcerative colitis in remission: a voxel based morphometry study

Agostini

Campieri

Bertani

et al. 2015

BioPsychoSocial Med

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BackgroundRecent neuroimaging studies have investigated the brain involvement in patients with Crohn's disease (CD) and Ulcerative Colitis (UC). Functional studies found abnormalities in cognitive and emotional functions in CD and UC, while a voxel based morphometry (VBM) study found morphological changes in CD. We conducted a VBM study to compare the gray matter (GM) volume of UC patients and controls.MethodsEighteen UC patients in remission and eighteen healthy controls underwent structural MRI. VBM is a fully automated technique allowing identification of regional differences in the amount of GM, which enables an objective analysis of the whole brain. VBM was used for comparisons between patients and controls.ResultsUC patients were all in remission and had a mild clinical course. There were no differences between patients and controls in GM volume.ConclusionThe brain morphology of patients with UC in remission is similar to controls. The lack of GM abnormalities in UC patients might reflect the mild clinical course of the inflammatory bowel disorder. Further research involving patients with different degrees of disease severity or during flares could shed more light on potential brain structural changes in UC.

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Brain functional changes in patients with ulcerative colitis

Cited by 67 publications

References 33 publications

Factors associated with depression in people with inflammatory bowel disease: The relationship between active disease and biases in neurocognitive processing

Factors associated with depression in people with inflammatory bowel disease: The relationship between active disease and biases in neurocognitive processing

Differences in regional homogeneity between patients with Crohn's disease with and without abdominal pain revealed by resting-state functional magnetic resonance imaging

Absence of change in the gray matter volume of patients with ulcerative colitis in remission: a voxel based morphometry study

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