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Yeske B, Hou J, Chu DY, Adluru N, Nair VA, Beniwal-Patel P, Saha S, Prabhakaran V. Structural brain morphometry differences and similarities between young patients with Crohn's disease in remission and healthy young and old controls. Front Neurosci 2024; 18:1210939. [PMID: 38356645 PMCID: PMC10864509 DOI: 10.3389/fnins.2024.1210939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 01/10/2024] [Indexed: 02/16/2024] Open
Abstract
Introduction Crohn's disease (CD), one of the main phenotypes of inflammatory bowel disease (IBD), can affect any part of the gastrointestinal tract. It can impact the function of gastrointestinal secretions, as well as increasing the intestinal permeability leading to an aberrant immunological response and subsequent intestinal inflammation. Studies have reported anatomical and functional brain changes in Crohn's Disease patients (CDs), possibly due to increased inflammatory markers and microglial cells that play key roles in communicating between the brain, gut, and systemic immune system. To date, no studies have demonstrated similarities between morphological brain changes seen in IBD and brain morphometry observed in older healthy controls.. Methods For the present study, twelve young CDs in remission (M = 26.08 years, SD = 4.9 years, 7 male) were recruited from an IBD Clinic. Data from 12 young age-matched healthy controls (HCs) (24.5 years, SD = 3.6 years, 8 male) and 12 older HCs (59 years, SD = 8 years, 8 male), previously collected for a different study under a similar MR protocol, were analyzed as controls. T1 weighted images and structural image processing techniques were used to extract surface-based brain measures, to test our hypothesis that young CDs have different brain surface morphometry than their age-matched young HCs and furthermore, appear more similar to older HCs. The phonemic verbal fluency (VF) task (the Controlled Oral Word Association Test, COWAT) (Benton, 1976) was administered to test verbal cognitive ability and executive control. Results/Discussion On the whole, CDs had more brain regions with differences in brain morphometry measures when compared to the young HCs as compared to the old HCs, suggesting that CD has an effect on the brain that makes it appear more similar to old HCs. Additionally, our study demonstrates this atypical brain morphometry is associated with function on a cognitive task. These results suggest that even younger CDs may be showing some evidence of structural brain changes that demonstrate increased resemblance to older HC brains rather than their similarly aged healthy counterparts.
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Affiliation(s)
- Benjamin Yeske
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Jiancheng Hou
- Center for Cross-Straits Cultural Development, Fujian Normal University, Fuzhou City, Fujian, China
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Daniel Y. Chu
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, United States
| | - Nagesh Adluru
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- The Waisman Center, University of Wisconsin-Madison, Madison, WI, United States
| | - Veena A. Nair
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Poonam Beniwal-Patel
- Gastroenterology and Hepatology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Sumona Saha
- Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin- Madison, Madison, WI, United States
| | - Vivek Prabhakaran
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, United States
- Department of Psychology and Psychiatry, University of Wisconsin-Madison, Madison, WI, United States
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2
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Hall CV, Radford-Smith G, Savage E, Robinson C, Cocchi L, Moran RJ. Brain signatures of chronic gut inflammation. Front Psychiatry 2023; 14:1250268. [PMID: 38025434 PMCID: PMC10661239 DOI: 10.3389/fpsyt.2023.1250268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Gut inflammation is thought to modify brain activity and behaviour via modulation of the gut-brain axis. However, how relapsing and remitting exposure to peripheral inflammation over the natural history of inflammatory bowel disease (IBD) contributes to altered brain dynamics is poorly understood. Here, we used electroencephalography (EEG) to characterise changes in spontaneous spatiotemporal brain states in Crohn's Disease (CD) (n = 40) and Ulcerative Colitis (UC) (n = 30), compared to healthy individuals (n = 28). We first provide evidence of a significantly perturbed and heterogeneous microbial profile in CD, consistent with previous work showing enduring and long-standing dysbiosis in clinical remission. Results from our brain state assessment show that CD and UC exhibit alterations in the temporal properties of states implicating default-mode network, parietal, and visual regions, reflecting a shift in the predominance from externally to internally-oriented attentional modes. We investigated these dynamics at a finer sub-network resolution, showing a CD-specific and highly selective enhancement of connectivity between the insula and medial prefrontal cortex (mPFC), regions implicated in cognitive-interoceptive appraisal mechanisms. Alongside overall higher anxiety scores in CD, we also provide preliminary support to suggest that the strength of chronic interoceptive hyper-signalling in the brain co-occurs with disease duration. Together, our results demonstrate that a long-standing diagnosis of CD is, in itself, a key factor in determining the risk of developing altered brain network signatures.
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Affiliation(s)
- Caitlin V. Hall
- Clinical Brain Networks Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Graham Radford-Smith
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Gut Health Research Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Department of Gastroenterology, Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia
| | - Emma Savage
- Clinical Brain Networks Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Conor Robinson
- Clinical Brain Networks Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Luca Cocchi
- Clinical Brain Networks Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Rosalyn J. Moran
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom
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3
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Bao B, Zhu C, Shi J, Lu C. Causal association between inflammatory bowel disease and hidradenitis suppurativa: A two-sample bidirectional Mendelian randomization study. Front Immunol 2023; 14:1071616. [PMID: 36776852 PMCID: PMC9909343 DOI: 10.3389/fimmu.2023.1071616] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 01/16/2023] [Indexed: 01/28/2023] Open
Abstract
Background Epidemiological studies have revealed a link between inflammatory bowel disease (IBD) and hidradenitis suppurativa (HS). To determine whether IBD and HS are causally related, we used the Mendelian randomization (MR) approach. Methods A two-sample MR was performed using an analysis of 12,882 patients and 21,770 controls with IBD and its main subtypes, ulcerative colitis (UC) and Crohn's disease (CD). A total of 409 cases and 211,139 controls without hidradenitis suppurativa (HS) were included in the data for this condition from various GWAS investigations. Odds ratios (ORs) with 95% confidence intervals (CIs) are used to estimate causal effects. Results The study assessed the causal relationship between HS and IBD in both directions. The risk of HS was increased by IBD (IVW OR = 1.34, 95% CI = 1.20-1.49, p = 2.15E-07) and, in addition, HS was affected by UC (IVW OR = 1.27, 95% CI = 1.13-1.43, p = 8.97E-04) and CD (IVW OR = 1.18, 95% CI = 1.08-1.29, p = 4.15E-04). However, there was no evidence of a causal relationship between HS and IBD or its subtypes (IBD IVW OR = 1.00, 95% CI = 0.96-1.05, p = 0.85; UC IVW OR = 0.99, 95% CI = 0.95-1.03, p = 0.65; CD IVW OR = 1.03, 95% CI = 0.98- 1.07, p = 0.28). Conclusion This study demonstrates that IBD and its subtypes have a causal effect on HS, whereas HS does not affect IBD. Gut-skin axis interactions may help to understand this association. Nevertheless, further studies are needed to clarify the pathophysiology of the causal relationship between IBD and HS.
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Affiliation(s)
- Bingzhou Bao
- Department of Anorectal, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Chao Zhu
- College of Traditional Chinese Medicine, Anhui University of Chinese Medicine, Hefei, China
| | - Jian Shi
- Department of Anorectal, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Canxing Lu
- Department of Anorectal, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
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Thapaliya G, Eldeghaidy S, Asghar M, McGing J, Radford S, Francis S, Moran GW. The relationship between Central Nervous System morphometry changes and key symptoms in Crohn’s disease. Brain Imaging Behav 2022; 17:149-160. [PMID: 36409402 PMCID: PMC10049962 DOI: 10.1007/s11682-022-00742-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2022] [Indexed: 11/22/2022]
Abstract
AbstractAlterations in grey matter volume (GMV) and cortical thickness (CT) in Crohn’s disease (CD) patients has been previously documented. However, the findings are inconsistent, and not a true representation of CD burden, as only CD patients in remission have been studied thus far. We investigate alterations in brain morphometry in patients with active CD and those in remission, and study relationships between brain structure and key symptoms of fatigue, abdominal pain, and extraintestinal manifestations (EIM). Magnetic Resonance Imaging brain scans were collected in 89 participants; 34 CD participants with active disease, 13 CD participants in remission and 42 healthy controls (HCs); Voxel based morphometry (VBM) assessed GMV and white matter volume (WMV), and surface-based analysis assessed cortical thickness (CT). We show a significant reduction in global cerebrospinal fluid (CSF) volume in CD participants compared with HCs, as well as, a reduction in regional GMV, WMV and CT in the left precentral gyrus (motor cortex), and an increase in GMV in the frontal brain regions in CD compared with HCs. Atrophy of the supplementary motor area (SMA) was associated with greater fatigue in CD. We also show alterations in brain structure in multiple regions in CD associated with abdominal pain and extraintestinal inflammations (EIMs). These brain structural alterations likely reflect neuroplasticity to a chronic systemic inflammatory response, abdominal pain, EIMs and fatigue. These findings will aid our understanding of the cross-linking between chronic inflammation, brain structural changes and key unexplained CD symptomatology like fatigue.
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Affiliation(s)
- Gita Thapaliya
- Division of Child & Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
| | - Sally Eldeghaidy
- NIHR Nottingham Biomedical Research Centre, The University of Nottingham, Nottingham University Hospitals NHS Trust and School of Medicine, Nottingham, UK
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, The University of Nottingham, Nottingham, UK
- School of Biosciences and Future Food Beacon, The University of Nottingham, Nottingham, UK
| | - Michael Asghar
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, The University of Nottingham, Nottingham, UK
| | - Jordan McGing
- NIHR Nottingham Biomedical Research Centre, The University of Nottingham, Nottingham University Hospitals NHS Trust and School of Medicine, Nottingham, UK
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, The University of Nottingham, Nottingham, UK
| | - Shellie Radford
- NIHR Nottingham Biomedical Research Centre, The University of Nottingham, Nottingham University Hospitals NHS Trust and School of Medicine, Nottingham, UK
| | - Susan Francis
- NIHR Nottingham Biomedical Research Centre, The University of Nottingham, Nottingham University Hospitals NHS Trust and School of Medicine, Nottingham, UK
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, The University of Nottingham, Nottingham, UK
| | - Gordon William Moran
- NIHR Nottingham Biomedical Research Centre, The University of Nottingham, Nottingham University Hospitals NHS Trust and School of Medicine, Nottingham, UK.
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, The University of Nottingham, Nottingham, UK.
- Translational Medical Sciences Unit, University of Nottingham, Nottingham, UK.
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5
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Mickael ME, Bhaumik S, Chakraborti A, Umfress AA, van Groen T, Macaluso M, Totenhagen J, Sorace AG, Bibb JA, Standaert DG, Basu R. RORγt-Expressing Pathogenic CD4 + T Cells Cause Brain Inflammation during Chronic Colitis. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2022; 208:2054-2066. [PMID: 35379749 PMCID: PMC10103644 DOI: 10.4049/jimmunol.2100869] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 02/11/2022] [Indexed: 01/09/2023]
Abstract
Neurobehavioral disorders and brain abnormalities have been extensively reported in both Crohn's disease and ulcerative colitis patients. However, the mechanism causing neuropathological disorders in inflammatory bowel disease patients remains unknown. Studies have linked the Th17 subset of CD4+ T cells to brain diseases associated with neuroinflammation and cognitive impairment, including multiple sclerosis, ischemic brain injury, and Alzheimer's disease. To better understand how CD4+ T lymphocytes contribute to brain pathology in chronic intestinal inflammation, we investigated the development of brain inflammation in the T cell transfer model of chronic colitis. Our findings demonstrate that CD4+ T cells infiltrate the brain of colitic Rag1 -/- mice in proportional levels to colitis severity. Colitic mice developed hypothalamic astrogliosis that correlated with neurobehavioral disorders. Moreover, the brain-infiltrating CD4+ T cells expressed Th17 cell transcription factor retinoic acid-related orphan receptor γt (RORγt) and displayed a pathogenic Th17 cellular phenotype similar to colonic Th17 cells. Adoptive transfer of RORγt-deficient naive CD4+ T cells failed to cause brain inflammation and neurobehavioral disorders in Rag1 -/- recipients, with significantly less brain infiltration of CD4+ T cells. The finding is mirrored in chronic dextran sulfate sodium-induced colitis in Rorcfl/fl Cd4-Cre mice that showed lower frequency of brain-infiltrating CD4+ T cells and astrogliosis despite onset of significantly more severe colitis compared with wild-type mice. These findings suggest that pathogenic RORγt+CD4+ T cells that aggravate colitis migrate preferentially into the brain, contributing to brain inflammation and neurobehavioral disorders, thereby linking colitis severity to neuroinflammation.
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Affiliation(s)
| | - Suniti Bhaumik
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL
| | - Ayanabha Chakraborti
- Department of Surgery, Neuroscience, and Neurology, O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL
| | - Alan A Umfress
- Department of Surgery, Neuroscience, and Neurology, O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL
| | - Thomas van Groen
- Department of Cell, Developmental and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL
| | - Matthew Macaluso
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL
| | - John Totenhagen
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL
| | - Anna G Sorace
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL.,Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL; and
| | - James A Bibb
- Department of Surgery, Neuroscience, and Neurology, O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL.,Department of Neurology, University of Alabama at Birmingham, Birmingham, AL
| | - David G Standaert
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL
| | - Rajatava Basu
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL;
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6
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Yeske B, Hou J, Adluru N, Nair VA, Prabhakaran V. Differences in Diffusion Tensor Imaging White Matter Integrity Related to Verbal Fluency Between Young and Old Adults. Front Aging Neurosci 2021; 13:750621. [PMID: 34880746 PMCID: PMC8647802 DOI: 10.3389/fnagi.2021.750621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/14/2021] [Indexed: 12/14/2022] Open
Abstract
Throughout adulthood, the brain undergoes an array of structural and functional changes during the typical aging process. These changes involve decreased brain volume, reduced synaptic density, and alterations in white matter (WM). Although there have been some previous neuroimaging studies that have measured the ability of adult language production and its correlations to brain function, structural gray matter volume, and functional differences between young and old adults, the structural role of WM in adult language production in individuals across the life span remains to be thoroughly elucidated. This study selected 38 young adults and 35 old adults for diffusion tensor imaging (DTI) and performed the Controlled Oral Word Association Test to assess verbal fluency (VF). Tract-Based Spatial Statistics were employed to evaluate the voxel-based group differences of diffusion metrics for the values of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), and local diffusion homogeneity (LDH) in 12 WM regions of interest associated with language production. To investigate group differences on each DTI metric, an analysis of covariance (ANCOVA) controlling for sex and education level was performed, and the statistical threshold was considered at p < 0.00083 (0.05/60 labels) after Bonferroni correction for multiple comparisons. Significant differences in DTI metrics identified in the ANCOVA were used to perform correlation analyses with VF scores. Compared to the old adults, the young adults had significantly (1) increased FA values on the bilateral anterior corona radiata (ACR); (2) decreased MD values on the right ACR, but increased MD on the left uncinate fasciculus (UF); and (3) decreased RD on the bilateral ACR. There were no significant differences between the groups for AD or LDH. Moreover, the old adults had only a significant correlation between the VF score and the MD on the left UF. There were no significant correlations between VF score and DTI metrics in the young adults. This study adds to the growing body of research that WM areas involved in language production are sensitive to aging.
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Affiliation(s)
- Benjamin Yeske
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin–Madison, Madison, WI, United States
| | - Jiancheng Hou
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin–Madison, Madison, WI, United States
- Center for Cross-Strait Cultural Development, Fujian Normal University, Fuzhou, China
| | - Nagesh Adluru
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin–Madison, Madison, WI, United States
- Waisman Center, University of Wisconsin–Madison, Madison, WI, United States
| | - Veena A. Nair
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin–Madison, Madison, WI, United States
| | - Vivek Prabhakaran
- Department of Radiology, School of Medicine and Public Health, University of Wisconsin–Madison, Madison, WI, United States
- Department of Psychology, Department of Psychiatry, University of Wisconsin–Madison, Madison, WI, United States
- Neuroscience Training Program, University of Wisconsin–Madison, Madison, WI, United States
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7
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Bakshi N, Hart AL, Lee MC, Williams ACDC, Lackner JM, Norton C, Croft P. Chronic pain in patients with inflammatory bowel disease. Pain 2021; 162:2466-2471. [PMID: 34534174 PMCID: PMC8442739 DOI: 10.1097/j.pain.0000000000002304] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 03/19/2021] [Accepted: 03/31/2021] [Indexed: 12/19/2022]
Affiliation(s)
- Nikul Bakshi
- Research Department, Crohn's and Colitis UK, Hatfield, United Kingdom
| | | | - Michael C. Lee
- Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Amanda C de C. Williams
- Research Department of Clinical, Educational and Health Psychology, University College London, and Pain Management Centre, University College Hospitals NHS Foundation Trust, London, United Kingdom
| | - Jeffrey M. Lackner
- Division of Behavioral Medicine, Department of Medicine, University at Buffalo, SUNY, Buffalo, NY, United States
| | - Christine Norton
- Division of Care for Long-Term Conditions, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College, London, United Kingdom
| | - Peter Croft
- Primary Care Centre Versus Arthritis and Centre for Prognosis Research, Keele University, Keele, United Kingdom
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8
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Song CR, Kang NO, Bang M, Park CI, Choi TK, Lee SH. Initial white matter connectivity differences between remitters and non-remitters of patients with panic disorder after 6 months of pharmacotherapy. Neurosci Lett 2021; 751:135826. [PMID: 33727131 DOI: 10.1016/j.neulet.2021.135826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 12/28/2022]
Abstract
Panic disorder (PD) is a harmful mental condition that causes relapsed and persistent impairment. In the treatment of PD, the prognosis for PD should be considered. However, the relationship between pharmacotherapy and biomarkers, for predicting a better response through neuroimaging, is a little known. The purpose of the present study was to examine whether there would be the initial white matter (WM) regions associated with the remission in 6 months. A total of 104 patients with PD were investigated in the study. After six months, there were 17 remission patients with PD and 81 non-remission patients. The Panic Disorder Severity Scale, Albany Panic and Phobia Questionnaire, Anxiety Sensitivity Inventory-Revised, Beck Anxiety Inventory, and Beck Depression Inventory were assessed for all patients at baseline. We compared the diffusion indices between remission and non-remission group at 6 months using Tract-Based Spatial Statistics. The results showed that the fractional anisotropy (FA) values were significantly higher in the non-remitter group compared with those in the remitter group in the WM regions, such as the posterior corona radiata and superior longitudinal fasciculus, at the 6 month evaluation. The logistic regression analysis with clinical symptom severity and FA values of the WM regions as covariates showed that FA values in those regions and the Beck Depression Inventory-II predicted poor remission. This study suggests that posterior corona radiata and superior longitudinal fasciculus are related to potential predictive factors of 6-month remission in patients with PD. WM regions associated with the long-term remission should be verified with further investigations.
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Affiliation(s)
- Chae Rim Song
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea; Clinical Counseling Psychology Graduate School, CHA University, Seongnam, Republic of Korea
| | - Na-Ok Kang
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Minji Bang
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Chun Il Park
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Tae-Kiu Choi
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea; Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.
| | - Sang-Hyuk Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea; Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.
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9
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Thomann AK, Mak JWY, Zhang JW, Wuestenberg T, Ebert MP, Sung JJY, Bernstein ÇN, Reindl W, Ng SC. Review article: bugs, inflammation and mood-a microbiota-based approach to psychiatric symptoms in inflammatory bowel diseases. Aliment Pharmacol Ther 2020; 52:247-266. [PMID: 32525605 DOI: 10.1111/apt.15787] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 01/13/2020] [Accepted: 04/21/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Psychiatric co-morbidities including depression and anxiety are common in inflammatory bowel diseases (IBD). Emerging evidence suggests that interactions between the gut microbiota and brain may play a role in the pathogenesis of psychiatric symptoms in IBD. AIM To review the literature on microbiota-brain-gut interactions in gut inflammation, psychosocial stress and mental disorders and to discuss the putative mediating role of gut microbiota in the development of psychiatric symptoms or co-morbidities in IBD. METHODS A literature search was conducted on Ovid and Pubmed to select relevant animal and human studies reporting an association between IBD, mental disorders and gut microbiota. RESULTS Gut microbial alterations are frequently reported in subjects with IBD and with mental disorders. Both have been associated with reduced faecal bacterial diversity, decreased taxa within the phylum Firmicutes and increased Gammaproteobacteria. In animal studies, microbial perturbations induce behavioural changes and modulate inflammation in mice. Anxiety- and depression-like behaviours in animals can be transferred via faecal microbiota. In humans, modulation of the gut microbiota with probiotics is associated with behavioural and mood changes. Recent data show correlations in changes of faecal and mucosal microbiota and psychological distress in patients with IBD independent of disease activity. CONCLUSION Both IBD and mental disorders are associated with gut microbial alterations. Preclinical and preliminary human studies have shown a mediating role of the gut microbiota in intestinal inflammation and anxiety, depression and stress. Targeting the gut microbiota may represent a useful therapeutic approach for the treatment of psychiatric co-morbidities in IBD.
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Affiliation(s)
- Anne K Thomann
- Department of Medicine II, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Joyce W Y Mak
- Department of Medicine and Therapeutics, Institute of Digestive Disease, LKS Institute of Health Science, The Chinese University of Hong Kong, Hong Kong
| | - Jing Wan Zhang
- Department of Medicine and Therapeutics, Institute of Digestive Disease, LKS Institute of Health Science, The Chinese University of Hong Kong, Hong Kong
| | - Torsten Wuestenberg
- Department of Medicine II, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Department of Psychiatry and Psychotherapy, Charite, Berlin, Germany
| | - Matthias P Ebert
- Department of Medicine II, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Joseph J Y Sung
- Department of Medicine and Therapeutics, Institute of Digestive Disease, LKS Institute of Health Science, The Chinese University of Hong Kong, Hong Kong
| | | | - Wolfgang Reindl
- Department of Medicine II, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Siew C Ng
- Department of Medicine and Therapeutics, Institute of Digestive Disease, LKS Institute of Health Science, The Chinese University of Hong Kong, Hong Kong.,Center for Gut Microbiota Research, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
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10
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Clarke G, Kennedy PJ, Groeger JA, Quigley EM, Shanahan F, Cryan JF, Dinan TG. Impaired cognitive function in Crohn's disease: Relationship to disease activity. Brain Behav Immun Health 2020; 5:100093. [PMID: 34589862 PMCID: PMC8474502 DOI: 10.1016/j.bbih.2020.100093] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 06/03/2020] [Indexed: 01/04/2023] Open
Abstract
Background & aims Impaired attention and response inhibition have been reported in patients with Crohn’s disease (CD) in clinical remission. Prospective studies are needed to determine whether this is a stable feature of CD and whether a similar impairment is evident in ulcerative colitis (UC). Thus, our aims were to examine whether patients with CD and UC exhibited a persistent impairment in attentional performance, and if this impairment was related to key biological indices of relevance to cognition. Methods A prospective observational study was conducted on fifteen patients with CD and 7 with UC in clinical remission recruited from a specialty clinic and 30 healthy matched control participants. A neuropsychological assessment was carried out at baseline (visit 1) and at a 6 month follow-up (visit 2). Plasma proinflammatory cytokines, the plasma kynurenine:tryptophan (Kyn:Trp) ratio and the salivary cortisol awakening response (CAR) were also determined at each visit. Results Across visits, patients with CD exhibited impaired attentional performance (p = 0.023). Plasma IL-6 (P = 0.001) and the Kyn:Trp ratio (P = 0.03) were consistently elevated and the CAR significantly blunted (P < 0.05) in patients with CD. No significant relationships were identified between any biochemical parameter and altered cognitive performance. Conclusions Impaired cognitive function is a stable feature of patients with CD. These data suggest that even where remission has been achieved, the functional impact of an organic gastrointestinal disorder on cognition is still evident. However, it is unclear at present if physiological changes due to disease activity play a role in cognitive impairment in CD. Crohn’s disease (CD) patients previously associated with impaired cognition. CD patients consistently exhibited impaired attentional performance at multiple visits. Functional impact of organic gastrointestinal disorder on cognition still evident in remission. Increased IL-6, kynurenine pathway activation and blunted cortisol awakening response in CD. Biochemical parameters not associated with altered cognitive performance.
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Key Words
- ACC, anterior cingulate cortex
- BMI, body mass index
- CANTAB®, Cambridge Neuropsychological Test Automated Battery
- CAR, cortisol awakening response
- CD, Crohn’s disease
- Cognition
- Crohn’s disease
- EM, Expectation-maximization
- Gut-brain axis
- HBI, Harvey Bradshaw Index
- HSD, Honestly Significant Difference
- IBD, Inflammatory bowel disease
- IED, Intra-Extradimensional Set Shift
- Immune system
- Inflammatory bowel disease
- MCAR, missing completely at random
- MRT, mean response time
- PAL, Paired Associates Learning
- PFC, prefrontal cortex
- SCCAI, Short Clinical Colitis Activity Index
- SWM, Spatial Working Memory
- Tryptophan
- UC, ulcerative colitis
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Affiliation(s)
- Gerard Clarke
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Psychiatry and Neurobehavioural Science, University College Cork, Cork, Ireland
| | - Paul J Kennedy
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Psychiatry and Neurobehavioural Science, University College Cork, Cork, Ireland
| | - John A Groeger
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Eamonn Mm Quigley
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
| | - Fergus Shanahan
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
| | - John F Cryan
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Timothy G Dinan
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Psychiatry and Neurobehavioural Science, University College Cork, Cork, Ireland
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