Magnetic resonance imaging analysis of brain function in patients with irritable bowel syndrome

Abstract

BackgroundIrritable bowel syndrome (IBS) is a common functional disease of the gastrointestinal tract. The current study aimed to examine the association between visceral hypersensitivity in IBS and cortical activation using functional magnetic resonance imaging (fMRI), and to elucidate the role of psychological factors in the pathogenesis of IBS.MethodsThe present study included 31 patients with IBS and 20 healthy controls. Cerebral function was assessed using fMRI. During imaging, a Sengstaken-Blakemore tube was placed within the rectum approximately 10 cm from the anus, following which gas was rapidly injected into the airbag using a 150-ml syringe. Images were obtained at 40 ml, 80 ml, and 120 ml of expansion. Psychological status was evaluated using the Hospital Anxiety and Depression Scale (HADS).ResultsAnxiety and depression scores were higher among patients with IBSthan among controls (both P < 0.05), although scores in both groups were below the level of clinical diagnosis. Brain activation in regions of interest (parietal areas, prefrontal cortex, cerebellum, anterior cingulate cortex, insular cortex, and thalamus) increased along with increases in rectal balloon dilation, except in women with IBS and patients with disease duration less than 5 years. Furthermore, region of interest (ROI) activation (such as the parietal region, prefrontal cortex, cerebellum, anterior cingulate cortex, insular cortex, and thalamus) differed significantly between the 40-ml and 120-ml conditions, and between the 80-ml and 120-ml conditions (P < 0.05), among patients with IBS with anxiety or depression scores less than 9 points.ConclusionsOverall, our findings indicate that changes in brain activation due to changes in rectal balloon distension can be objectively and accurately measured using fMRI. Although our results indicated that visceral hypersensitivity during IBS is associated with changes in cortical activation, further studies utilizing larger sample sizes are required to more fully elucidate the association between psychological factors and visceral hypersensitivity in IBS.

Electroacupuncture Improves IBS Visceral Hypersensitivity by Inhibiting the Activation of Astrocytes in the Medial Thalamus and Anterior Cingulate Cortex

“…e MT is an important relay station that receives visceral pain information from the spinal cord and then transmits this information to the cortex through the myelothalamic tract for integration and regulation. Clinical studies have found that activation of the thalamus is increased in patients with IBS depending on the level of rectal expansion, and electroacupuncture was shown to regulate MT activation and participate in the ascending pain transmission pathway of IBS through fMRI technology [6,28,29]. Astrocytes are widely distributed in brain regions, communicating with neurons and participating in the transmission of synaptic signals.…”

Brain Functional Interaction of Acupuncture Effects in Diarrhea-Dominant Irritable Bowel Syndrome

“…In existing studies, various functional mechanisms and biopsychosocial models (Tanaka et al, 2011) related to clinical types have been put forward to detect the pathogenesis of IBS. Recent studies have shown that gastrointestinal dysfunction caused by IBS is associated with the dysregulation of the brain's central and peripheral nervous system (Omalley, 2016;Wang et al, 2017) and may be altered by psychological factors such as stress, anxiety, and depression (Ke et al, 2015). Few of these studies make the effort to utilize functional interaction and segregation to investigate the brain dysfunction mechanism of IBS and those modulated by related treatments such as acupuncture stimulation.…”

Changes in the anterior cingulate cortex in Crohn’s disease: A neuroimaging perspective

“…Extraintestinal symptoms in the brain, such as cerebral thrombosis and multiple sclerosis in white matter, have been detected (Benjilali et al., 2011; Stovicek et al., 2014), suggesting that the GI tract might have peculiar effects on the brain, despite the remote distance. Furthermore, ulcerative colitis (a subtype of inflammatory bowel disease) (Fan et al., 2019) and other brain–gut axis‐related diseases, such as irritable bowel disease (Wang et al., 2017) and functional constipation (Liu et al., 2020), show anomalies in the ACC. Thus, we hypothesize that the ACC plays an important role in the pathophysiology of CD.…”