Resilience is decreased in irritable bowel syndrome and associated with symptoms and cortisol response

Park, S. H.; Naliboff, Bruce D.; Shih, Wendy; Presson, Angela P.; Videlock, Elizabeth J.; Ju, Tiffany; Kilpatrick, Lisa A.; Gupta, Abha R.; Mayer, Emeran A.; Chang, Lin

doi:10.1111/nmo.13155

Cited by 46 publications

(50 citation statements)

References 34 publications

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“…All subjects completed a BRS questionnaire (Park et al, 2018). The BRS consists of six questions and is used to characterize the ability of an individual to recover from stressful events (Smith et al, 2008).…”

Section: Methodsmentioning

confidence: 99%

Cortical Excitability Dynamics During Fear Processing

et al. 2019

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Background: Little is known about the modulation of cortical excitability in the prefrontal cortex during fear processing in humans. Here, we aimed to transiently modulate and test the cortical excitability during fear processing using transcranial magnetic stimulation (TMS) and brain oscillations in theta and alpha frequency bands with electroencephalography (EEG). Methods: We conducted two separate experiments (no-TMS and TMS). In the no-TMS experiment, EEG recordings were performed during the instructed fear paradigm in which a visual cue (CS+) was paired with an aversive unconditioned stimulus (electric shock), while the other visual cue was unpaired (CS-). In the TMS experiment, in addition the TMS was applied on the right dorsomedial prefrontal cortex (dmPFC). The participants also underwent structural MRI (magnetic resonance imaging) scanning and were assigned pseudo-randomly to both experiments, such that age and gender were matched. The cortical excitability was evaluated by time-frequency analysis and functional connectivity with weighted phase lag index (WPLI). We further linked the excitability patterns with markers of stress coping capability. Results: After visual cue onset, we found increased theta power in the frontal lobe and decreased alpha power in the occipital lobe during CS+ relative to CS- trials. TMS of dmPFC increased theta power in the frontal lobe and reduced alpha power in the occipital lobe during CS+. The TMS pulse increased the information flow from the sensorimotor region to the prefrontal and occipital regions in the theta and alpha bands, respectively during CS+ compared to CS-. Pre-stimulation frontal theta power (0.75–1 s) predicted the magnitude of frontal theta power changes after stimulation (1–1.25 s). Finally, the increased frontal theta power during CS+ compared to CS- was positively correlated with stress coping behavior. Conclusion: Our results show that TMS over dmPFC transiently modulated the regional cortical excitability and the fronto-occipital information flows during fear processing, while the pre-stimulation frontal theta power determined the strength of achieved effects. The frontal theta power may serve as a biomarker for fear processing and stress-coping responses in individuals and could be clinically tested in mental disorders.

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Section: Methodsmentioning

confidence: 99%

Cortical Excitability Dynamics During Fear Processing

et al. 2019

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“…In all cases, however, it is likely that the “three-hit concept” of vulnerability and resilience persists: a genetic predisposition and early life adverse events are necessary so that a later-in-life stressor can exhibit negative health outcomes, and one or more missing may result in higher resilience 65 . It is of importance to note that resilience has not yet been thoroughly investigated in relation to GI functions in animals (and humans) under stress; it is, however, known that patients with IBS lack resilience, and low resilience was associated with worse IBS severity, lower quality of life, more early life stressful events, and stress hyper-responsiveness 66 . Similarly, in patients with IBD, the role of (maladaptive) coping is only beginning to be unraveled (for example, 67 – 69 ), calling for translational research on individual risk and resilience in patients with GI conditions.…”

Section: Current Animal Stress Research In the Gastrointestinal Tractmentioning

confidence: 99%

The stress concept in gastroenterology: from Selye to today

Elsenbruch

Enck²

2017

F1000Res

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More than eighty years after Hans Selye (1907–1982) first developed a concept describing how different types of environmental stressors affect physiological functions and promote disease development (called the “general adaptation syndrome”) in 1936, we herein review advances in theoretical, mechanistic, and clinical knowledge in stress research, especially in the area of gastroenterology, and summarize progress and future perspectives arising from an interdisciplinary psychoneurobiological framework in which genetics, epigenetics, and other advanced ( omics) technologies in the last decade continue to refine knowledge about how stress affects the brain-gut axis in health and gastrointestinal disease. We demonstrate that neurobiological stress research continues to be a driving force for scientific progress in gastroenterology and related clinical areas, inspiring translational research from animal models to clinical applications, while highlighting some areas that remain incompletely understood, such as the roles of sex/gender and gut microbiota in health and disease. Future directions of research should include not only the genetics of the stress response and resilience but also epigenetic contributions.

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“…However, the evidence for gut microbial alterations in IBS is currently limited [ 8 , 9 , 10 ]. Alterations in psychobiological stress reactivity are also clearly implicated in IBS [ 11 , 12 , 13 ]. Data from our own and other research groups have shown associations between psychological stress and microbial factors [ 14 , 15 , 16 ], and animal models suggest a connection between stress-induced shifts in gut microbiota, visceral pain and altered brain-gut communication [ 17 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Intestinal Microbiome in Irritable Bowel Syndrome before and after Gut-Directed Hypnotherapy

Peter

Fournier

Keip

et al. 2018

IJMS

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Irritable bowel syndrome (IBS) is a disorder with brain-gut-microbiome alterations. Gut-directed hypnotherapy (GHT) has been shown to improve quality of life and symptoms in IBS. This therapy targets psychological coping, central nervous processing and brain-gut interaction. Studies have also demonstrated effects of hypnosis on intestinal transit and the mucosal immune system. So far, no study has examined the effect of GHT on the intestinal microbiome. This study aimed at examining microbial composition, IBS symptoms, and psychological distress before and after GHT. Methods: Fecal samples were collected from 38 IBS patients (Rome-III criteria, mean age 44 years, 27 female, 11 male, 22 diarrhea-dominant, 12 alternating-type and 4 constipation-dominant IBS) before and after 10 weekly group sessions of GHT. Assessments in psychological (perceived stress, PSQ; psychological distress, HADS-D; quality of life, visual analogue scales) and IBS symptom-related variables (IBS severity, IBS-SSS; single symptoms, visual analogue scales) were performed with validated questionnaires. Fecal samples underwent microbial 16S rRNA analyses (regions V1–2). Results: Microbial alpha diversity was stable before and after GHT (chao1 2591 ± 548 vs. 2581 ± 539, p = 0.92). No significant differences were found in relative bacterial abundances but trends of reduced abundance of Lachnospiraceae 32.18 (4.14–39.89) Median (Q1–Q3) vs. 28.11 (22.85; 35.55) and Firmicutes: Bacteroidetes ratio after GHT were observable. Significant reductions in symptom severity (323 (266–371) vs. 264 (191–331), p = 0.001) and psychological distress 17.0 (12.6–21.8) vs. 12.0 (8.3–18.0), p = 0.001, and increased well-being were found after GHT. Adequate relief after therapy was reported by 32 (84%) patients. Conclusion: Reductions in IBS symptoms and psychological burden were observed after gut-directed hypnotherapy, but only small changes were found in intestinal microbiota composition. The findings suggest that hypnosis may act by central nervous impact and other factors largely independent from microbiota composition modulating the brain-gut axis, possibly alterations in vagus nerve functioning and microbiota metabolism.

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Resilience is decreased in irritable bowel syndrome and associated with symptoms and cortisol response

Abstract: Background: Irritable bowel syndrome (IBS) is a stress-sensitive disorder associated

Cited by 46 publications

References 34 publications

Cortical Excitability Dynamics During Fear Processing

Cortical Excitability Dynamics During Fear Processing

The stress concept in gastroenterology: from Selye to today

Intestinal Microbiome in Irritable Bowel Syndrome before and after Gut-Directed Hypnotherapy

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