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

Abstract

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.

Brain Resting-State Network Alterations Associated With Crohn's Disease

“…Within the DMN, MPFC is decreased reciprocally with the left LP cortex. Altered pre-frontal cortex FC is consistent with previous studies of CD including differences in amplitude of low-frequency fluctuations (29), in regional homogeneity for CD patients without pain (28), and in relation to effective treatment (30). The altered FC between anterior (MPFC) and posterior (LP) nodes within the DMN is also consistent with previous work (29).…”

“…Studies of brain structure in CD may be in agreement on one result, altered gray matter (GM) of the superior frontal gyrus, although laterality and direction of alteration are inconsistent (22)(23)(24). Studies of brain function in CD have reported numerous FC alterations with very little overlap (25)(26)(27)(28)(29)(30)(31)(32) aside from some agreement on changes in brain networks or regions involved in executive function and/or default mode (26,30,32). Our study aimed to identify brain structural and functional changes in CD as compared to HC.…”

Absence of dentate nucleus resting‐state functional connectivity changes in nonneurological patients with gadolinium‐related hyperintensity on T1‐weighted images

“…Patients with symptoms of Crohn's disease routinely undergo MR enterography and/or MR of the pelvis and, in most cases, receive intravenous injections of GBCAs. In these patients fMRI has shown sensitivity to detect brain functional changes related to stress and pain …”

“…In these patients fMRI has shown sensitivity to detect brain functional changes related to stress 27 and pain. 28 The purpose of this study was to test whether the gadolinium-associated hyperintensity on T 1 -weighted images of the DN of nonneurological adult patients is related to modifications of resting-state functional connectivity (RSFC) of the cerebellum and DN.…”

<p>Central Sensitization-Related Changes in Brain Function Activity in a Rat Endometriosis-Associated Pain Model</p>

“…signals may provide a clue that is likely associated with a noncompensatory reaction or unbalanced local functionality of the entire brain network. Bao et al 40 found that ReHo signals were reduced in the insula, middle cingulate cortex, and supplementary motor area in patients with abdominal pain. Using fMRI, Sawsan 41 also found that the signal of brain functional activity in the insula and medial prefrontal cortex was enhanced in patients with endometriosis-related pain, and the excitatory neurotransmitter in this area was significantly increased.…”