Stress and brain functional changes in patients with Crohn's disease: A functional magnetic resonance imaging study

Abstract

The MCC integrate "high" emotional processes with afferent sensory information ascending from the gut. In light of these integrative functions, the stress-evoked MCC hyperactivity in CD patients might represent a plausible neural substrate for the association between stress and symptomatic disease. The MCC dysfunction might be involved in mechanisms of central disinhibition of nociceptive inputs leading to amplify the visceral sensitivity. Finally, the stress-evoked MCC hyperactivity might affect the regulation of intestinal motility resulting in exacerbation of disease symptoms and the autonomic and neuroendocrine regulation of inflammation resulting in enhanced inflammatory activity.

The stress concept in gastroenterology: from Selye to today

“…Such anticipatory responses—mainly in brain areas linked to attention, threat detection, and emotion regulation—reflect pain-related fear resulting from associative learning processes 37 , 93 , which influence the processing of visceral stimuli even in healthy humans 94 . In patients with IBD, brain imaging studies have only recently begun to emerge 95 , 96 , including studies addressing effects of acute stress 97 , 98 , laying the foundation for much-needed research on putative similarities and differences in structure-function relationships along the brain-gut axis in IBD and IBS.…”

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

“…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 …”

“…26 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 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.…”