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Chogle A, El-Chammas K, Santucci N, Grimm M, Dorfman L, Graham K, Kelly DR, Dranove JE, Rosen R, Nurko S, Croffie J, Balakrishnan K, Chiou EH, Zhang L, Simpson P, Karrento K. A multicenter registry study on percutaneous electrical nerve field stimulation for pediatric disorders of gut-brain interaction. J Pediatr Gastroenterol Nutr 2024; 78:817-826. [PMID: 38451058 DOI: 10.1002/jpn3.12174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 01/02/2024] [Accepted: 02/03/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVES Percutaneous electrical nerve field stimulation (PENFS) has demonstrated promise in single-center trials for pediatric abdominal pain-related disorders of gut-brain interaction (DGBI). Our aim was to explore efficacy of PENFS as standard therapy for DGBI in a registry involving multiple pediatric gastroenterology referral centers. METHODS This was a multicenter, prospective open-label registry of children (8-18 years) undergoing PENFS for DGBI at seven tertiary care gastroenterology clinics. DGBI subtypes were classified by Rome IV criteria. Parents and patients completed Abdominal Pain Index (API), Nausea Severity Scale (NSS), and Functional Disability Inventory (FDI) questionnaires before, during therapy and at follow-up visits up to 1 year later. RESULTS A total of 292 subjects were included. Majority (74%) were female with median (interquartile range [IQR]) age 16.3 (14.0, 17.7) years. Most (68%) met criteria for functional dyspepsia and 61% had failed ≥4 pharmacologic therapies. API, NSS, and FDI scores showed significant declines within 3 weeks of therapy, persisting long-term in a subset. Baseline (n = 288) median (IQR) child-reported API scores decreased from 2.68 (1.84, 3.58) to 1.99 (1.13, 3.27) at 3 weeks (p < 0.001) and 1.81 (0.85, 3.20) at 3 months (n = 75; p < 0.001). NSS scores similarly improved from baseline, persisting at three (n = 74; p < 0.001) and 6 months later (n = 55; p < 0.001). FDI scores displayed similar reductions at 3 months (n = 76; p = 0.01) but not beyond. Parent-reported scores were consistent with child reports. CONCLUSIONS This large, comprehensive, multicenter registry highlights efficacy of PENFS for gastrointestinal symptoms and functionality for pediatric DGBI.
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Affiliation(s)
- Ashish Chogle
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital of Orange County, Orange, California, USA
| | - Khalil El-Chammas
- Department of Pediatrics, Division of Pediatric Gastroenterology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Neha Santucci
- Department of Pediatrics, Division of Pediatric Gastroenterology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Monica Grimm
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition & Division of Quantitative Health Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Lev Dorfman
- Department of Pediatrics, Division of Pediatric Gastroenterology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Kahleb Graham
- Department of Pediatrics, Division of Pediatric Gastroenterology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Daniel R Kelly
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Atrium Health Levine Children's Hospital, Charlotte, North Carolina, USA
| | - Jason E Dranove
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Atrium Health Levine Children's Hospital, Charlotte, North Carolina, USA
| | - Rachel Rosen
- Center for Motility and Functional Gastrointestinal Disorders, Division of Gastroenterology, Children's Hospital Boston, Boston, Massachusetts, USA
| | - Samuel Nurko
- Center for Motility and Functional Gastrointestinal Disorders, Division of Gastroenterology, Children's Hospital Boston, Boston, Massachusetts, USA
| | - Joseph Croffie
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology & Nutrition, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Keshawadhana Balakrishnan
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA
| | - Eric H Chiou
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA
| | - Liyun Zhang
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition & Division of Quantitative Health Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Pippa Simpson
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition & Division of Quantitative Health Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Katja Karrento
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition & Division of Quantitative Health Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Xueyan H, Qi A, Chunming S, Yu Z, Wencai W. Abnormalities of white matter network properties in middle-aged and elderly patients with functional constipation. Front Neurol 2024; 15:1357274. [PMID: 38601332 PMCID: PMC11004343 DOI: 10.3389/fneur.2024.1357274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 03/14/2024] [Indexed: 04/12/2024] Open
Abstract
Purpose To explore white matter network topological properties changes in middle-aged and elderly patients with functional constipation (Functional Constipation, FC) by diffusion tensor imaging (DTI), and to evaluate the correlation between the abnormal changes and clinical data. Methods 29 FC patients and 31 age- and sex-matched healthy controls (HC) were recruited. Magnetic resonance imaging and clinical data were collected. The white matter network changes in FC patients were analyzed using deterministic fiber tracking methods, graph theory algorithms, and partial correlation analysis with clinical data. Results The nodal clustering coefficient and nodal local efficiency of FC patients in the right orbital inferior frontal gyrus, right medial superior frontal gyrus, right rectus muscle, right hippocampus, left paracentral lobule and left temporal pole, and the nodal clustering coefficient in right orbital superior frontal gyrus, left cuneus lobe and right superior occipital gyrus, the nodal local efficiency in the right medial and paracingulate gyrus, right precuneus and right dorsolateral superior frontal gyrus of FC patients are lower than that of HC. The nodal local efficiency and clustering coefficient of FC patients in left hippocampus, left amygdala, right parietal inferior limbic angular gyrus and right angular gyrus, the nodal local efficiency in the right fusiform gyrus, left supplementary motor cortex and the nodal efficiency in the left lateral temporal gyrus and right orbital middle frontal gyrus (ORBmid.R) of FC patients are higher than that of HC. The nodal efficiency of ORBmid.R in FC was positively correlated with the Patient Assessment of Constipation quality of life questionnaire (PAC-QoL). Conclusion Middle-aged and elderly FC patients have differences in the nodal level properties in the limbic system, supplementary motor cortex, and default mode network brain regions, and the nodal efficiency of ORBmid.R was positively correlated with the PAC-QoL score, revealing that FC may be related to the abnormal processing of visceral sensorimotor in ORBmid.R and providing potential imaging diagnostic markers and therapeutic targets for middle-aged and elderly FC patients.
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Affiliation(s)
- Hou Xueyan
- Department of Radiology, Xinhua Hospital Affiliated to Dalian University, Dalian, Liaoning, China
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Ai Qi
- Department of Radiology, Xinhua Hospital Affiliated to Dalian University, Dalian, Liaoning, China
- Graduated School, Tianjin Medical University, Tianjin, China
| | - Song Chunming
- Department of Radiology, Xinhua Hospital Affiliated to Dalian University, Dalian, Liaoning, China
| | - Zhi Yu
- Pelvic Floor Center, Xinhua Hospital Affiliated to Dalian University, Dalian, Liaoning, China
| | - Weng Wencai
- Department of Radiology, Xinhua Hospital Affiliated to Dalian University, Dalian, Liaoning, China
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Cai W, Tian H, Sun P, Hua T, Gong J, Zhang R, Wan L, Gu G, Zhang H, Tang G, Chen Q, Zhang L. Regional homogeneity alterations in patients with functional constipation and their associations with gene expression profiles. Cereb Cortex 2024; 34:bhad403. [PMID: 37981661 DOI: 10.1093/cercor/bhad403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/24/2023] [Accepted: 09/25/2023] [Indexed: 11/21/2023] Open
Abstract
Functional constipation, a highly prevalent functional gastrointestinal disorder, often accompanies by mental and psychological disorders. Previous neuroimaging studies have demonstrated brain functional and structural alterations in patients with functional constipation. However, little is known about whether and how regional homogeneity is altered in these patients. Moreover, the potential genetic mechanisms associated with these alterations remain largely unknown. The study included 73 patients with functional constipation and 68 healthy controls, and regional homogeneity comparison was conducted to identify the abnormal spontaneous brain activities in patients with functional constipation. Using Allen Human Brain Atlas, we further investigated gene expression profiles associated with regional homogeneity alterations in functional constipation patients with partial least squares regression analysis applied. Compared with healthy controls, functional constipation patients demonstrated significantly decreased regional homogeneity in both bilateral caudate nucleus, putamen, anterior insula, thalamus and right middle cingulate cortex, supplementary motor area, and increased regional homogeneity in the bilateral orbitofrontal cortex. Genes related to synaptic signaling, central nervous system development, fatty acid metabolism, and immunity were spatially correlated with abnormal regional homogeneity patterns. Our findings showed significant regional homogeneity alterations in functional constipation patients, and the changes may be caused by complex polygenetic and poly-pathway mechanisms, which provides a new perspective on functional constipation's pathophysiology.
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Affiliation(s)
- Wangli Cai
- Department of Radiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Hongliang Tian
- Department of Colorectal Disease, Intestinal Microenvironment Treatment Center, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Peiwen Sun
- Department of Radiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Ting Hua
- Department of Radiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Jian Gong
- Department of Radiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Ruiling Zhang
- Department of Radiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Lidi Wan
- Department of Radiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Guoqing Gu
- Department of Nursing, Wuliqiao Street Community Health Service Center, Shanghai 200023, China
| | - Haiying Zhang
- Department of Radiology, Chongming Branch of Shanghai Tenth People's Hospital, Shanghai 202157, China
| | - Guangyu Tang
- Department of Radiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Qiyi Chen
- Department of Colorectal Disease, Intestinal Microenvironment Treatment Center, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Lin Zhang
- Department of Radiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
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Yu X, Yu J, Li Y, Cong J, Wang C, Fan R, Wang W, Zhou L, Xu C, Li Y, Liu Y. Altered intrinsic functional brain architecture in patients with functional constipation: a surface-based network study. Front Neurosci 2023; 17:1241993. [PMID: 37811328 PMCID: PMC10551127 DOI: 10.3389/fnins.2023.1241993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 09/06/2023] [Indexed: 10/10/2023] Open
Abstract
Background Functional constipation (FCon) is a common functional gastrointestinal disorder (FGID). Studies have indicated a higher likelihood of psychiatric disorders, such as anxiety, depression, sleep disturbances, and impaired concentration, among patients with FCon. However, the underlying pathophysiological mechanisms responsible for these symptoms in FCon patients remain to be fully elucidated. The human brain is a complex network architecture with several fundamental organizational properties. Neurological interactions between gut symptoms and psychiatric issues may be closely associated with these complex networks. Methods In the present study, a total of 35 patients with FCon and 40 healthy controls (HC) were recruited for a series of clinical examinations and resting-state functional magnetic imaging (RS-fMRI). We employed the surface-based analysis (SBA) approach, utilizing the Schaefer cortical parcellation template and Tikhonov regularization. Graph theoretical analysis (GTA) and functional connectivity (FC) analysis of RS-fMRI were conducted to investigate the aberrant network alterations between the two groups. Additionally, correlation analyses were performed between the network indices and clinical variables in patients with FCon. Results At the global level, we found altered topological properties and networks in patients with FCon, mainly including the significantly increased clustering coefficient (CP), local efficiency (Eloc), and shortest path length (LP), whereas the decreased global efficiency (Eglob) compared to HC. At the regional level, patients with FCon exhibited increased nodal efficiency in the frontoparietal network (FPN). Furthermore, FC analysis demonstrated several functional alterations within and between the Yeo 7 networks, particularly including visual network (VN), limbic network (LN), default mode network (DMN), and somatosensory-motor network (SMN) in sub-network and large-scale network analysis. Correlation analysis revealed that there were no significant associations between the network metrics and clinical variables in the present study. Conclusion These results highlight the altered topological architecture of functional brain networks associated with visual perception abilities, emotion regulation, sensorimotor processing, and attentional control, which may contribute to effectively targeted treatment modalities for patients with FCon.
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Affiliation(s)
- Xiang Yu
- Department of Radiology, Tianjin Union Medical Center, Tianjin, China
| | - Jingjie Yu
- Department of Psychiatry and Psychology, Tianjin Union Medical Center, Tianjin, China
| | - Yuwei Li
- Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China
| | - Jiying Cong
- Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China
| | - Chao Wang
- Department of Radiology, Tianjin Union Medical Center, Tianjin, China
| | - Ran Fan
- Department of Radiology, Tianjin Union Medical Center, Tianjin, China
| | - Wanbing Wang
- Graduate School of Tianjin Nankai University, Tianjin, China
| | - Lige Zhou
- Graduate School of Tianjin Medical University, Tianjin, China
| | - Chen Xu
- Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China
| | - Yiming Li
- Department of Radiology, Tianjin Union Medical Center, Tianjin, China
| | - Yawu Liu
- Department of Neurology, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
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Sasso JM, Ammar RM, Tenchov R, Lemmel S, Kelber O, Grieswelle M, Zhou QA. Gut Microbiome-Brain Alliance: A Landscape View into Mental and Gastrointestinal Health and Disorders. ACS Chem Neurosci 2023; 14:1717-1763. [PMID: 37156006 DOI: 10.1021/acschemneuro.3c00127] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
Gut microbiota includes a vast collection of microorganisms residing within the gastrointestinal tract. It is broadly recognized that the gut and brain are in constant bidirectional communication, of which gut microbiota and its metabolic production are a major component, and form the so-called gut microbiome-brain axis. Disturbances of microbiota homeostasis caused by imbalance in their functional composition and metabolic activities, known as dysbiosis, cause dysregulation of these pathways and trigger changes in the blood-brain barrier permeability, thereby causing pathological malfunctions, including neurological and functional gastrointestinal disorders. In turn, the brain can affect the structure and function of gut microbiota through the autonomic nervous system by regulating gut motility, intestinal transit and secretion, and gut permeability. Here, we examine data from the CAS Content Collection, the largest collection of published scientific information, and analyze the publication landscape of recent research. We review the advances in knowledge related to the human gut microbiome, its complexity and functionality, its communication with the central nervous system, and the effect of the gut microbiome-brain axis on mental and gut health. We discuss correlations between gut microbiota composition and various diseases, specifically gastrointestinal and mental disorders. We also explore gut microbiota metabolites with regard to their impact on the brain and gut function and associated diseases. Finally, we assess clinical applications of gut-microbiota-related substances and metabolites with their development pipelines. We hope this review can serve as a useful resource in understanding the current knowledge on this emerging field in an effort to further solving of the remaining challenges and fulfilling its potential.
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Affiliation(s)
- Janet M Sasso
- CAS, a division of the American Chemical Society, 2540 Olentangy River Rd, Columbus, Ohio 43202, United States
| | - Ramy M Ammar
- Bayer Consumer Health, R&D Digestive Health, Darmstadt 64295, Germany
| | - Rumiana Tenchov
- CAS, a division of the American Chemical Society, 2540 Olentangy River Rd, Columbus, Ohio 43202, United States
| | - Steven Lemmel
- CAS, a division of the American Chemical Society, 2540 Olentangy River Rd, Columbus, Ohio 43202, United States
| | - Olaf Kelber
- Bayer Consumer Health, R&D Digestive Health, Darmstadt 64295, Germany
| | - Malte Grieswelle
- Bayer Consumer Health, R&D Digestive Health, Darmstadt 64295, Germany
| | - Qiongqiong Angela Zhou
- CAS, a division of the American Chemical Society, 2540 Olentangy River Rd, Columbus, Ohio 43202, United States
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Alexander S, Oelfke U, McNair H, Tree A. GI factors, potential to predict prostate motion during radiotherapy; a scoping review. Clin Transl Radiat Oncol 2023; 40:100604. [PMID: 36936470 PMCID: PMC10020110 DOI: 10.1016/j.ctro.2023.100604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/16/2023] [Accepted: 02/19/2023] [Indexed: 02/27/2023] Open
Abstract
Purpose A scoping literature review was conducted to identify gastrointestinal (GI) factors most likely to influence prostate motion during radiotherapy. We proffer that patient specific measurement of these GI factors could predict motion uncertainty during radiotherapy, facilitating personalised care by optimising treatment technique e.g., daily adaption or via bespoke patient pre-habilitation and preparation. Methods The scoping review was undertaken as per JBI guidelines. Searches were conducted across four databases: Ovid Medline®, EMBASE, CINAHL and EBSCO discovery. Articles written in English from 2010-present were included. Those pertaining to paediatrics, biological women exclusively, infectious and post-treatment GI morbidity and diet were excluded.Common GI factors impacting men were identified and related symptoms, incidence and measurement tools examined. Prevalence among persons with prostate cancer was explored and suitable assessment tools discussed. Results A preliminary search identified four prominent GI-factors: mental health, co-morbidity and medication, physical activity, and pelvic floor disorder. The scoping search found 3644 articles; 1646 were removed as duplicates. A further 1249 were excluded after title and abstract screening, 162 remained subsequent to full text review: 42 mental health, 53 co-morbidity and medication, 39 physical activity and 28 pelvic floor disorder.Six GI factors prevalent in the prostate cancer population and estimated most likely to influence prostate motion were identified: depression, anxiety, diabetes, obesity, low physical activity, and pelvic floor disorder. Reliable, quick, and easy to use tools are available to quantify these factors. Conclusion A comprehensive GI factor assessment package suitable to implement into the radiotherapy clinic has been created. Unveiling these GI factors upfront will guide improved personalisation of radiotherapy.
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Affiliation(s)
- S.E. Alexander
- The Royal Marsden NHS Foundation Trust, United Kingdom and The Institute of Cancer Research, United Kingdom
| | - U. Oelfke
- The Joint Department of Physics, The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, United Kingdom
| | - H.A. McNair
- The Royal Marsden NHS Foundation Trust, United Kingdom and The Institute of Cancer Research, United Kingdom
| | - A.C. Tree
- The Royal Marsden NHS Foundation Trust, United Kingdom and The Institute of Cancer Research, United Kingdom
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Yu X, Yu J, Li Y, Cong J, Wang C, Fan R, Wang W, Zhou L, Xu C, Li Y, Liu Y. Aberrant intrinsic functional brain networks in patients with functional constipation. Neuroradiology 2023; 65:337-348. [PMID: 36216896 DOI: 10.1007/s00234-022-03064-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 10/03/2022] [Indexed: 01/25/2023]
Abstract
PURPOSE Patients with functional constipation (FCon) often suffer from mental and psychological problems. To explore the possible neurological interaction, we used resting-state functional magnetic imaging (RS-fMRI) to compare the alterations in intrinsic brain functional networks at multiple levels between patients with FCon and healthy controls (HC). METHODS Twenty-eight patients with FCon and twenty-nine HC were recruited for a series of examinations and RS-fMRI. Both graph theory analysis and functional connectivity (FC) analysis were used to investigate brain functional alterations between the two groups. Correlation analyses were performed among neuropsychological scores, clinical indexes, and neuroimaging data. RESULTS Compared with the HC, the assortativity showed significantly increased in global level in patients with FCon. In regional level, we found obviously increased nodal degree and nodal efficiency in somatosensory network (SMN), decreased nodal degree, and increased nodal efficiency in default mode network (DMN) in the FCon group. Furthermore, FC analysis demonstrated several functional alterations within and between the networks, particularly including the SMN and visual network (VN) in sub-network and large-scale network analysis. Moreover, correlation analysis indicated that nodal metrics and aberrant FC among functional brain networks were associated with emotion and scores of constipation in patients with FCon. CONCLUSION All these findings reflect the differences in intrinsic brain functional networks between FCon and HC. Our study highlighted SMN, DMN, and VN as critical network and may be involved in the neurophysiology of FCon, which may contribute to improve personalized treatment in patients with FCon.
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Affiliation(s)
- Xiang Yu
- Department of Radiology, Tianjin Union Medical Center, No. 190, Jieyuan Road, Hongqiao District, Tianjin, 300121, China
| | - Jingjie Yu
- Department of Psychiatry and Psychology, Tianjin Union Medical Center, No. 190, Jieyuan Road, Hongqiao District, Tianjin, 300121, China
| | - Yuwei Li
- Department of Colorectal Surgery, Tianjin Union Medical Center, No. 190, Jieyuan Road, Hongqiao District, Tianjin, 300121, China
| | - Jiying Cong
- Department of Colorectal Surgery, Tianjin Union Medical Center, No. 190, Jieyuan Road, Hongqiao District, Tianjin, 300121, China
| | - Chao Wang
- Department of Radiology, Tianjin Union Medical Center, No. 190, Jieyuan Road, Hongqiao District, Tianjin, 300121, China
| | - Ran Fan
- Department of Radiology, Tianjin Union Medical Center, No. 190, Jieyuan Road, Hongqiao District, Tianjin, 300121, China
| | - Wanbing Wang
- Graduate School of Tianjin Nankai University, Tianjin, China
| | - Lige Zhou
- Graduate School of Tianjin Medical University, Tianjin, China
| | - Chen Xu
- Department of Colorectal Surgery, Tianjin Union Medical Center, No. 190, Jieyuan Road, Hongqiao District, Tianjin, 300121, China.
| | - Yiming Li
- Department of Radiology, Tianjin Union Medical Center, No. 190, Jieyuan Road, Hongqiao District, Tianjin, 300121, China.
| | - Yawu Liu
- Department of Neurology, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
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Neshatian L, Karmonik C, Khavari R, Shi Z, Elias S, Boone T, Quigley EMM. Alterations in brain activation patterns in women with functional defecatory disorder: A novel fMRI rectal balloon expulsion study. Neurogastroenterol Motil 2022; 34:e14389. [PMID: 35478218 DOI: 10.1111/nmo.14389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/09/2022] [Accepted: 04/11/2022] [Indexed: 12/07/2022]
Abstract
BACKGROUND Functional defecatory disorders (FDD) are common among women. Despite the extensive research on peripheral mechanisms involved in FDD, the central-neural contribution to its pathophysiology remains poorly understood. We aimed to delineate specific supra-spinal regions involved in defecation and examine whether their activity, as measured by blood-oxygen-level-dependent (BOLD) signals, is different in FDD. METHODS We performed functional MRI (fMRI) with concurrent rectal manometry in 15 controls and 18 females with ROME III diagnosis of FDD. A block design was used and brain activation maps based on BOLD effect employing the generalized linear model were calculated for each subject. Statistical significance between groups was assessed by a Student t-test with cluster-based multiple comparisons correction (corrected p < 0.01). KEY RESULTS Simulated defecation was associated with activation of regions of primary and supplementary motor (SMA) and somatosensory cortices, homeostatic afferent (thalamus, mid-cingulate cortex, and insula), and emotional arousal networks (hippocampus and prefrontal cortex), occipital and cerebellum along with deactivation of right anterior cingulate cortex (ACC) in controls. Women with FDD had fewer regions engaged in defecation and BOLD activation was much decreased is areas related to executive-cognitive function (insula, parietal, and prefrontal cortices). Patients unlike controls showed activation in right ACC and otherwise had similar brain activation patterns during anal squeeze. CONCLUSIONS & INFERENCES Our results provide evidence that distinct differences exist in supra-spinal control of defecation in key regions of motivational-affective regulation and executive-cognitive function, in patients with FDD as compared to controls.
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Affiliation(s)
- Leila Neshatian
- Lynda K and David M Underwood Center for Digestive Disorders, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas, USA
| | - Christof Karmonik
- Translational Imaging Center, Houston Methodist Research Institute, Houston, Texas, USA
| | - Rose Khavari
- Department of Urology, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas, USA
| | - Zhaoyue Shi
- Translational Imaging Center, Houston Methodist Research Institute, Houston, Texas, USA
| | - Saba Elias
- Translational Imaging Center, Houston Methodist Research Institute, Houston, Texas, USA
| | - Timothy Boone
- Department of Urology, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas, USA
| | - Eamonn M M Quigley
- Lynda K and David M Underwood Center for Digestive Disorders, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas, USA
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Alterations in functional connectivity and interactions in resting-state networks in female patients with functional constipation. Neurol Sci 2022; 43:6495-6504. [DOI: 10.1007/s10072-022-06275-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/09/2022] [Indexed: 10/17/2022]
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10
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Hu Y, Jia Z, Zhang L, Zhang Z, Li H, Tan Z, Lv S, von Deneen KM, Duan S, Cui G, Nie Y, Zhang Y. White-matter microstructural alterations in patients with functional constipation: A tract-based spatial statistics study. Neurogastroenterol Motil 2022; 34:e14338. [PMID: 35195324 DOI: 10.1111/nmo.14338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/23/2022] [Accepted: 01/30/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Highly prevalent functional constipation (FC) belongs to the category of functional gastrointestinal disorders. Neuroimaging studies have demonstrated brain functional and morphometric changes in patients with FC. However, whether FC is associated with white-matter (WM) microstructural alterations remains unclear. METHODS Diffusion tensor imaging (DTI) and tract-based spatial statistics (TBSS) were introduced to investigate WM microstructural changes as calculated by fractional anisotropy (FA), mean (MD), axial (AD), and radial diffusivity (RD) in 26 FC patients and 31 healthy controls. KEY RESULTS Patients with FC relative to healthy controls had significantly decreased FA with increased MD/RD in the genu (GCC) and body (BCC) of the corpus callosum, right cingulum (Cing), bilateral anterior corona radiata (ACR), bilateral superior corona radiata (SCR), and left posterior corona radiata (PCR) (pFWE < 0.05). Between-group difference was only in the left SCR and PCR when regressing out anxiety and depression as covariates. CONCLUSIONS AND INFERENCES These WM tracts are mainly responsible for sensory and emotional information communication and corresponding functional integration; thus, our findings indicate an association between FC and WM microstructural abnormalities in regions involved with visceral afferent and emotional-arousal processing. Alterations in WM microstructures including the CC, cingulum, and ACR are more related to psychological symptoms than constipation, which might have greater impact on brain structures.
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Affiliation(s)
- Yang Hu
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Zhenzhen Jia
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Lei Zhang
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Zhida Zhang
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Hao Li
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Zongxin Tan
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Shuai Lv
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Karen M von Deneen
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Shijun Duan
- Department of Radiology, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Guangbin Cui
- Department of Radiology, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Yongzhan Nie
- State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Air Force Medical University, Xi'an, China
| | - Yi Zhang
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, China
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11
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Long H, Fan M, Li Q, Yang X, Huang Y, Xu X, Ma J, Xiao J, Jiang T. Structural and functional biomarkers of the insula subregions predict sex differences in aggression subscales. Hum Brain Mapp 2022; 43:2923-2935. [PMID: 35289969 PMCID: PMC9120556 DOI: 10.1002/hbm.25826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/22/2022] [Accepted: 02/23/2022] [Indexed: 01/01/2023] Open
Abstract
Aggression is a common and complex social behavior that is associated with violence and mental diseases. Although sex differences were observed in aggression, the neural mechanism for the effect of sex on aggression behaviors remains unclear, especially in specific subscales of aggression. In this study, we investigated the effects of sex on aggression subscales, gray matter volume (GMV), and functional connectivity (FC) of each insula subregion as well as the correlation of aggression subscales with GMV and FC. This study found that sex significantly influenced (a) physical aggression, anger, and hostility; (b) the GMV of all insula subregions; and (c) the FC of the dorsal agranular insula (dIa), dorsal dysgranular insula (dId), and ventral dysgranular and granular insula (vId_vIg). Additionally, mediation analysis revealed that the GMV of bilateral dIa mediates the association between sex and physical aggression, and left dId–left medial orbital superior frontal gyrus FC mediates the relationship between sex and anger. These findings revealed the neural mechanism underlying the sex differences in aggression subscales and the important role of the insula in aggression differences between males and females. This finding could potentially explain sexual dimorphism in neuropsychiatric disorders and improve dysregulated aggressive behavior.
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Affiliation(s)
- Haixia Long
- College of Computer Science and Technology, Zhejiang University of Technology, Hangzhou, China
| | - Ming Fan
- Institute of Biomedical Engineering and Instrumentation, Hangzhou Dianzi University, Hangzhou, China
| | - Qiaojun Li
- School of Information Engineering, Tianjin University of Commerce, Tianjin, China
| | - Xuhua Yang
- College of Computer Science and Technology, Zhejiang University of Technology, Hangzhou, China
| | - Yujiao Huang
- Zhijiang College, Zhejiang University of Technology, Hangzhou, China
| | - Xinli Xu
- College of Computer Science and Technology, Zhejiang University of Technology, Hangzhou, China
| | - Ji Ma
- College of Computer Science and Technology, Zhejiang University of Technology, Hangzhou, China
| | - Jie Xiao
- College of Computer Science and Technology, Zhejiang University of Technology, Hangzhou, China
| | - Tianzi Jiang
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China.,CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China.,The Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
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12
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Brain structural changes in regions within the salience network in patients with functional constipation. Brain Imaging Behav 2022; 16:1741-1748. [DOI: 10.1007/s11682-022-00648-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2022] [Indexed: 11/02/2022]
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13
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Cai W, Zhou Y, Wan L, Zhang R, Hua T, Gong J, Yang B, Tang G. Transcriptomic Signatures Associated With Gray Matter Volume Changes in Patients With Functional Constipation. Front Neurosci 2022; 15:791831. [PMID: 35069104 PMCID: PMC8766403 DOI: 10.3389/fnins.2021.791831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 11/23/2021] [Indexed: 11/13/2022] Open
Abstract
Functional constipation, which belongs to the functional gastrointestinal disorder (FGID), is a common disease and significantly impacts daily life. FGID patients have been progressively proven with functional and structural alterations in various brain regions, but whether and how functional constipation affects the brain gray matter volume (GMV) remains unclear; besides, which genes are associated with the GMV changes in functional constipation is largely unknown. On account of the structural MRI image from the 30 functional constipation patients and 30 healthy controls (HCs), GMV analysis showed that functional constipation patients had significantly decreased GMV in the right orbital prefrontal cortex (OFC), left precentral gyrus (PreG), and bilateral thalamus (THA). Correlation analysis showed that the self-rating depressive scale, patient assessment of constipation quality of life (PAC-QOL), and Wexner constipation scores were negatively correlated with GMV of the OFC and negative correlations between PAC-QOL score and GMV of the bilateral THA. Based on the Allen Human Brain Atlas, a cross-sample spatial correlation was conducted and found that 18 genes’ expression values showed robust correlations with GMV changes in functional constipation patients. These outcomes highlight our recognition of the transcriptional features related to GMV changes in functional constipation and could be regarded as candidates to detect biological mechanisms of abnormality in functional constipation patients.
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Affiliation(s)
- Wangli Cai
- Department of Radiology, Shanghai Tenth People’s Hospital, School of Clinical Medicine of Nanjing Medical University, Shanghai, China
| | - Yujing Zhou
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Lidi Wan
- Department of Radiology, Shanghai Tenth People’s Hospital, School of Clinical Medicine of Nanjing Medical University, Shanghai, China
| | - Ruiling Zhang
- Department of Radiology, Shanghai Tenth People’s Hospital, School of Clinical Medicine of Nanjing Medical University, Shanghai, China
| | - Ting Hua
- Department of Radiology, Shanghai Tenth People’s Hospital, School of Clinical Medicine of Nanjing Medical University, Shanghai, China
| | - Jian Gong
- Department of Radiology, Shanghai Tenth People’s Hospital, School of Clinical Medicine of Nanjing Medical University, Shanghai, China
| | - Bo Yang
- Department of Colorectal and Anal Surgery, Shanghai Tenth People’s Hospital, School of Clinical Medicine of Nanjing Medical University, Shanghai, China
| | - Guangyu Tang
- Department of Radiology, Shanghai Tenth People’s Hospital, School of Clinical Medicine of Nanjing Medical University, Shanghai, China
- *Correspondence: Guangyu Tang,
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14
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Yin T, He Z, Ma P, Sun R, Xie K, Liu T, Chen L, Chen J, Hou L, Teng Y, Guo Y, Tian Z, Xiong J, Wang F, Li S, Yang S, Zeng F. Aberrant functional brain network dynamics in patients with functional constipation. Hum Brain Mapp 2021; 42:5985-5999. [PMID: 34533251 PMCID: PMC8596972 DOI: 10.1002/hbm.25663] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 08/25/2021] [Accepted: 09/06/2021] [Indexed: 12/17/2022] Open
Abstract
The aberrant static functional connectivity of brain network has been widely investigated in patients with functional constipation (FCon). However, the dynamics of brain functional connectivity in FCon patients remained unknown. This study aimed to detect the brain dynamics of functional connectivity states and network topological organizations of FCon patients and investigate the correlations of the aberrant brain dynamics with symptom severity. Eighty-three FCon patients and 80 healthy subjects (HS) were included in data analysis. The spatial group independent component analysis, sliding-window approach, k-means clustering, and graph-theoretic analysis were applied to investigate the dynamic temporal properties and coupling patterns of functional connectivity states, as well as the time-variation of network topological organizations in FCon patients. Four reoccurring functional connectivity states were identified in k-means clustering analysis. Compared to HS, FCon patients manifested the lower occurrence rate and mean dwell time in the state with a complex connection between default mode network and cognitive control network, as well as the aberrant anterior insula-cortical coupling patterns in this state, which were significantly correlated with the symptom severity. The graph-theoretic analysis demonstrated that FCon patients had higher sample entropy at the nodal efficiency of anterior insula than HS. The current findings provided dynamic perspectives for understanding the brain connectome of FCon and laid the foundation for the potential treatment of FCon based on brain connectomics.
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Affiliation(s)
- Tao Yin
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Zhaoxuan He
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Key Laboratory of Sichuan Province for Acupuncture and ChronobiologyChengduSichuanChina
| | - Peihong Ma
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Ruirui Sun
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Kunnan Xie
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Tianyu Liu
- School of SportChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Li Chen
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Jingwen Chen
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Likai Hou
- Sichuan Bayi Rehabilitation CenterChengduSichuanChina
| | - Yuke Teng
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Yuyi Guo
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Zilei Tian
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Jing Xiong
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Fumin Wang
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Shenghong Li
- State Key Laboratory of Southwestern Chinese Medicine Resources/Innovative Institute of Chinese Medicine and PharmacyChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Sha Yang
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Key Laboratory of Sichuan Province for Acupuncture and ChronobiologyChengduSichuanChina
| | - Fang Zeng
- Acupuncture and Tuina School/The 3rd Teaching HospitalChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture and Brain Science Research CenterChengdu University of Traditional Chinese MedicineChengduSichuanChina
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15
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Zhang Z, Hu Y, Lv G, Wang J, He Y, Zhang L, Li H, von Deneen KM, Wang H, Duan S, Zhang J, Hou Q, Pan Y, Zhao Y, Mao K, Wang F, Zhang Y, Cui G, Nie Y. Functional constipation is associated with alterations in thalamo-limbic/parietal structural connectivity. Neurogastroenterol Motil 2021; 33:e13992. [PMID: 33073892 DOI: 10.1111/nmo.13992] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 07/27/2020] [Accepted: 08/25/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Functional constipation (FCon) is a common functional gastrointestinal disorder (FGID) with a high prevalence in clinical practice. Previous studies have identified that FCon is associated with functional and structural alterations in the primary brain regions involved in emotional arousal processing, sensory processing, somatic/motor-control, and self-referential processing. However, whether FCon is associated with abnormal structural connectivity (SC) among these brain regions remains unclear. METHODS We selected the brain regions with functional and structural abnormalities as seed regions and employed diffusion tensor imaging (DTI) with probabilistic tractography to investigate SC changes in 29 patients with FCon and 31 healthy controls (HC). KEY RESULTS Results showed lower fractional anisotropy (FA) in the fibers connecting the thalamus, a region involved in sensory processing, with the amygdala (AMY), hippocampal gyrus (HIPP), precentral (PreCen) and postcentral gyrus (PostCen), supplementary motor area (SMA) and precuneus in patients with FCon compared with HC. FCon had higher mean diffusivity (MD) and radial diffusivity (RD) in the thalamus connected to the AMY and HIPP. In addition, FCon had significantly increased RD of the thalamus-SMA tract. Sensation of incomplete evacuation was negatively correlated with FA of the thalamus-PostCen and thalamus-HIPP tracts, and there was a negative correlation between difficulty of defecation and FA of the thalamus-SMA tract. CONCLUSIONS AND INFERENCES These findings reflected that FCon is associated with alterations in SC between the thalamus and limbic/parietal cortex, highlighting the integrative role of the thalamus in brain structural network.
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Affiliation(s)
- Zhida Zhang
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Yang Hu
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Ganggang Lv
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Jia Wang
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Yang He
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Lei Zhang
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Hao Li
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Karen M von Deneen
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Huaning Wang
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Shijun Duan
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Junwang Zhang
- State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Qiuqiu Hou
- College of Life Sciences, Northwest University, Xi'an, China
| | - Yanan Pan
- College of Life Sciences, Northwest University, Xi'an, China
| | - Yu Zhao
- College of Life Sciences, Northwest University, Xi'an, China
| | - Kuanrong Mao
- Xi'an Mayinglong Anorectal Hospital, Xi'an, Shaanxi, China
| | - Fan Wang
- Xi'an Mayinglong Anorectal Hospital, Xi'an, Shaanxi, China
| | - Yi Zhang
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Guangbin Cui
- Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yongzhan Nie
- State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, Shaanxi, China
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16
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Li G, Zhang W, Hu Y, Wang J, Li J, Jia Z, Zhang L, Sun L, von Deneen KM, Duan S, Wang H, Wu K, Fan D, Cui G, Zhang Y, Nie Y. Distinct Basal Brain Functional Activity and Connectivity in the Emotional-Arousal Network and Thalamus in Patients With Functional Constipation Associated With Anxiety and/or Depressive Disorders. Psychosom Med 2021; 83:707-714. [PMID: 34117157 DOI: 10.1097/psy.0000000000000958] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Functional constipation (FC) is a common gastrointestinal disorder. Anxiety and/or depressive disorders are common in patients with FC (FCAD). Brain dysfunction may play a role in FC, but the contribution of comorbid anxiety and/or depression in patients with FC is poorly understood. METHODS Sixty-five FC patients and 42 healthy controls (HCs) were recruited, and a hierarchical clustering algorithm was used to classify FC patients into FCAD and patients without anxiety/depressive status (FCNAD) based on neuropsychological assessment. Resting-state functional magnetic resonance imaging measures including fractional amplitude of low-frequency fluctuation (fALFF) and functional connectivity were used to investigate brain functional differences. RESULTS Thirty-seven patients were classified as FCAD, and 28 patients were classified as FCNAD; as compared with HC, both groups showed decreased activity (fALFF) in the perigenual anterior cingulate cortex (pACC), dorsomedial prefrontal cortex (DMPFC), and precuneus; enhanced precentral gyrus-thalamus connectivity and attenuated precuneus-thalamus connectivity in FCAD/FCNAD highlighted the thalamus as a critical connectivity node in the brain network (pFWE < .05). In comparison with FCNAD/HC, the FCAD group also had decreased fALFF in the orbitofrontal cortex (OFC) and thalamus, and increased OFC-hippocampus connectivity. In the FCNAD group, brain activities (pACC/DMPFC) and connection (precuneus-thalamus) had correlations only with symptoms; in the FCAD group, brain activities (OFC, pACC/DMPFC) and connectivities (OFC-hippocampus/precentral gyrus-thalamus) showed correlations with both constipation symptoms and anxiety/depressive status ratings. Mediation analysis indicated that the relationship between abdominal distension and OFC activity was completely mediated by anxiety in FCAD. CONCLUSIONS These findings provide evidence of differences in brain activity and functional connectivity between FCAD and FCNAD, potentially providing important clues for improving treatment strategies.
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Affiliation(s)
- Guanya Li
- From the Center for Brain Imaging, School of Life Science and Technology (G. Li, W. Zhang, Hu, J. Wang, J. Li, Jia, L. Zhang, Deneen, Y. Zhang), Xidian University; and State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases (Sun, Wu, Fan, Nie), Department of Radiology, Tangdu Hospital (Duan, Cui), and Department of Psychiatry, Xijing Hospital (H. Wang), the Fourth Military Medical University, Xi'an, Shaanxi, China. G.L. and W.Z. contributed equally to this work
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17
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Abnormalities in the thalamo-cortical network in patients with functional constipation. Brain Imaging Behav 2021; 15:630-642. [PMID: 32314199 DOI: 10.1007/s11682-020-00273-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Functional constipation (FCon) is a common functional gastrointestinal disorder (FGID); neuroimaging studies have shown brain functional abnormalities in thalamo-cortical regions in patients with FGID. However, association between FCon and topological characteristics of brain networks remains largely unknown. We employed resting-state functional magnetic resonance imaging (RS-fMRI) and graph theory approach to investigate functional brain topological organization in 42 patients with FCon and 41 healthy controls (HC) from perspectives of global, regional and modular levels. Results showed patients with FCon had a significantly lower normalized clustering coefficient and small-worldness, implying decreased brain functional connectivity. Regions showed altered nodal degree and efficiency mainly located in the thalamus, rostral anterior cingulate cortex (rACC), and supplementary motor area (SMA), which are involved in somatic/sensory, emotional processing and motor-control. For the modular analysis, thalamus, rACC and SMA had an aberrant within-module nodal degree and nodal efficiency, and thalamus-related network exhibited abnormal interaction with the limbic network (amygdala and hippocampal gyrus). Nodal degree in the thalamus was negatively correlated with difficulty of defecation, and nodal degree in the rACC was negatively correlated with sensation of incomplete evacuation. These findings indicated that FCon was associated with abnormalities in the thalamo-cortical network.
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18
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Peihong M, Tao Y, Zhaoxuan H, Sha Y, Li C, Kunnan X, Jingwen C, Likai H, Yuke T, Yuyi G, Fumin W, Zilei T, Ruirui S, Fang Z. Alterations of White Matter Network Properties in Patients With Functional Constipation. Front Neurol 2021; 12:627130. [PMID: 33841301 PMCID: PMC8024587 DOI: 10.3389/fneur.2021.627130] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/05/2021] [Indexed: 12/21/2022] Open
Abstract
Background: The abnormalities in brain function and structure of patients with functional constipation (FC) have been identified using multiple neuroimaging studies and have confirmed the abnormal processing of visceral sensation at the level of the central nervous system (CNS) as an important reason for FC. As an important basis for central information transfer, the role of the white matter (WM) networks in the pathophysiology of FC has not been investigated. This study aimed to explore the topological organization of WM networks in patients with FC and its correlation with clinical variables. Methods and Analysis: In this study, 70 patients with FC and 45 age- and gender-matched healthy subjects (HS) were recruited. Diffusion tensor imaging (DTI) data and clinical variables were acquired from each participant. WM networks were constructed using the deterministic fiber tracking approach, and the global and nodal properties of the WM networks were compared using graph theory analysis between patients with FC and HS. The relationship between the representative nodal characteristics-nodal betweenness and clinical parameters was assessed using partial correlation analysis. Results: Patients with FC showed increased nodal characteristics in the left superior frontal gyrus (orbital part), right middle frontal gyrus (orbital part), and right anterior cingulate and paracingulate (P < 0.05, corrected for false discovery rate) and decreased nodal characteristics in the left caudate and left thalamus (P < 0.05, corrected for false discovery rate) compared with HS. The duration of FC was negatively correlated with the nodal betweenness of the left thalamus (r = -0.354, P = 0.04, corrected for false discovery rate). Conclusion: The results indicated the alternations in WM networks of patients with FC and suggested the abnormal visceral sensation processing in the CNS from the perspective of large-scale brain WM network.
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Affiliation(s)
- Ma Peihong
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yin Tao
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - He Zhaoxuan
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yang Sha
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chen Li
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xie Kunnan
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chen Jingwen
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hou Likai
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Teng Yuke
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Guo Yuyi
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wang Fumin
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tian Zilei
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Sun Ruirui
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zeng Fang
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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19
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Duan S, Liu L, Li G, Wang J, Hu Y, Zhang W, Tan Z, Jia Z, Zhang L, von Deneen KM, Zhang Y, Nie Y, Cui G. Altered Functional Connectivity Within and Between Salience and Sensorimotor Networks in Patients With Functional Constipation. Front Neurosci 2021; 15:628880. [PMID: 33776637 PMCID: PMC7991789 DOI: 10.3389/fnins.2021.628880] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 02/01/2021] [Indexed: 12/12/2022] Open
Abstract
Functional constipation (FCon) is a common functional gastrointestinal disorder. A considerable portion of patients with FCon is associated with anxiety/depressive status (FCAD). Previous neuroimaging studies mainly focused on patients with FCon without distinguishing FCAD from FCon patients without anxiety/depressive status (FCNAD). Differences in brain functions between these two subtypes remain unclear. Thus, we employed resting-state functional magnetic resonance imaging (RS-fMRI) and graph theory method to investigate differences in brain network connectivity and topology in 41 FCAD, 42 FCNAD, and 43 age- and gender-matched healthy controls (HCs). FCAD/FCNAD showed significantly lower normalized clustering coefficient and small-world-ness. Both groups showed altered nodal degree/efficiency mainly in the rostral anterior cingulate cortex (rACC), precentral gyrus (PreCen), supplementary motor area (SMA), and thalamus. In the FCAD group, nodal degree in the SMA was negatively correlated with difficulty of defecation, and abdominal pain was positively correlated with nodal degree/efficiency in the rACC, which had a lower within-module nodal degree. The salience network (SN) exhibited higher functional connectivity (FC) with the sensorimotor network (SMN) in FCAD/FCNAD, and FC between these two networks was negatively correlated with anxiety ratings in FCAD group. Additionally, FC of anterior insula (aINS)-rACC was only correlated with constipation symptom (i.e., abdominal pain) in the FCNAD group. In the FCAD group, FCs of dorsomedial prefrontal cortex-rACC, PreCen-aINS showed correlations with both constipation symptom (i.e., difficulty of defecation) and depressive status. These findings indicate the differences in FC of the SN-SMN between FCAD and FCNAD and provide neuroimaging evidence based on brain function, which portrays important clues for improving new treatment strategies.
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Affiliation(s)
- Shijun Duan
- Department of Radiology, Tangdu Hospital, Air Force Medical University, Xi’an, China
| | - Lei Liu
- Center for Brain Imaging, School of Life Sciences and Technology, Xidian University, Xi’an, China
| | - Guanya Li
- Center for Brain Imaging, School of Life Sciences and Technology, Xidian University, Xi’an, China
| | - Jia Wang
- Center for Brain Imaging, School of Life Sciences and Technology, Xidian University, Xi’an, China
| | - Yang Hu
- Center for Brain Imaging, School of Life Sciences and Technology, Xidian University, Xi’an, China
| | - Wenchao Zhang
- Center for Brain Imaging, School of Life Sciences and Technology, Xidian University, Xi’an, China
| | - Zongxin Tan
- Center for Brain Imaging, School of Life Sciences and Technology, Xidian University, Xi’an, China
| | - Zhenzhen Jia
- Center for Brain Imaging, School of Life Sciences and Technology, Xidian University, Xi’an, China
| | - Lei Zhang
- Center for Brain Imaging, School of Life Sciences and Technology, Xidian University, Xi’an, China
| | - Karen M. von Deneen
- Center for Brain Imaging, School of Life Sciences and Technology, Xidian University, Xi’an, China
| | - Yi Zhang
- Center for Brain Imaging, School of Life Sciences and Technology, Xidian University, Xi’an, China
| | - Yongzhan Nie
- State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, Air Force Medical University, Xi’an, China
| | - Guangbin Cui
- Department of Radiology, Tangdu Hospital, Air Force Medical University, Xi’an, China
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20
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Berentsen B, Nagaraja BH, Teige EP, Lied GA, Lundervold AJ, Lundervold K, Steinsvik EK, Hillestad ER, Valeur J, Brønstad I, Gilja OH, Osnes B, Hatlebakk JG, Haász J, Labus J, Gupta A, Mayer EA, Benitez-Páez A, Sanz Y, Lundervold A, Hausken T. Study protocol of the Bergen brain-gut-microbiota-axis study: A prospective case-report characterization and dietary intervention study to evaluate the effects of microbiota alterations on cognition and anatomical and functional brain connectivity in patients with irritable bowel syndrome. Medicine (Baltimore) 2020; 99:e21950. [PMID: 32925728 PMCID: PMC7489588 DOI: 10.1097/md.0000000000021950] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Irritable bowel syndrome (IBS) is a common clinical label for medically unexplained gastrointestinal (GI) symptoms, recently described as a disturbance of the brain-gut-microbiota (BGM) axis. To gain a better understanding of the mechanisms underlying the poorly understood etiology of IBS, we have designed a multifaceted study that aim to stratify the complex interaction and dysfunction between the brain, the gut, and the microbiota in patients with IBS. METHODS Deep phenotyping data from patients with IBS (n = 100) and healthy age- (between 18 and 65) and gender-matched controls (n = 40) will be collected between May 2019 and December 2021. Psychometric tests, questionnaires, human biological tissue/samples (blood, faeces, saliva, and GI biopsies from antrum, duodenum, and sigmoid colon), assessment of gastric accommodation and emptying using transabdominal ultrasound, vagal activity, and functional and structural magnetic resonance imaging (MRI) of the brain, are included in the investigation of each participant. A subgroup of 60 patients with IBS-D will be further included in a 12-week low FODMAP dietary intervention-study to determine short and long-term effects of diet on GI symptoms, microbiota composition and functions, molecular GI signatures, cognitive, emotional and social functions, and structural and functional brain signatures. Deep machine learning, prediction tools, and big data analyses will be used for multivariate analyses allowing disease stratification and diagnostic biomarker detection. DISCUSSION To our knowledge, this is the first study to employ unsupervised machine learning techniques and incorporate systems-based interactions between the central and the peripheral components of the brain-gut-microbiota axis at the levels of the multiomics, microbiota profiles, and brain connectome of a cohort of 100 patients with IBS and matched controls; study long-term safety and efficacy of the low-FODMAP diet on changes in nutritional status, gut microbiota composition, and metabolites; and to investigate changes in the brain and gut connectome after 12 weeks strict low-FODMAP-diet in patients with IBS. However, there are also limitations to the study. As a restrictive diet, the low-FODMAP diet carries risks of nutritional inadequacy and may foster disordered eating patterns. Strict FODMAP restriction induces a potentially unfavourable gut microbiota, although the health effects are unknown. TRIAL REGISTRATION NUMBER NCT04296552 (ClinicalTrials.gov).
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Affiliation(s)
- Birgitte Berentsen
- National Center for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, Norway
- Center for Nutrition, Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | | | - Erica Pearson Teige
- National Center for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, Norway
- Center for Nutrition, Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Gülen Arslan Lied
- National Center for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, Norway
- Center for Nutrition, Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Astri J. Lundervold
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Katarina Lundervold
- National Center for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, Norway
- National Center for Ultrasound in Gastroenterology, Medical Department, Haukeland University Hospital, Bergen, Norway
| | - Elisabeth Kjelsvik Steinsvik
- National Center for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, Norway
- National Center for Ultrasound in Gastroenterology, Medical Department, Haukeland University Hospital, Bergen, Norway
| | - Eline Randulff Hillestad
- National Center for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, Norway
| | - Jørgen Valeur
- Unger-Vetlesen Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Ingeborg Brønstad
- National Center for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, Norway
- National Center for Ultrasound in Gastroenterology, Medical Department, Haukeland University Hospital, Bergen, Norway
| | - Odd Helge Gilja
- National Center for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, Norway
- National Center for Ultrasound in Gastroenterology, Medical Department, Haukeland University Hospital, Bergen, Norway
| | - Berge Osnes
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Jan Gunnar Hatlebakk
- National Center for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, Norway
| | - Judit Haász
- Department of Radiology, Haukeland University Hospital, Bergen, Norway
| | - Jennifer Labus
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, and UCLA Microbiome Center, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Arpana Gupta
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, and UCLA Microbiome Center, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Emeran A. Mayer
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, and UCLA Microbiome Center, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Alfonso Benitez-Páez
- Microbial Ecology, Nutrition & Health Research Unit, Institute of Agrochemistry and Food Technology, National Research Council (IATA-CSIC), Valencia, Spain
| | - Yolanda Sanz
- Microbial Ecology, Nutrition & Health Research Unit, Institute of Agrochemistry and Food Technology, National Research Council (IATA-CSIC), Valencia, Spain
| | - Arvid Lundervold
- Mohn Medical Imaging and Visualization Center, Haukeland University Hospital, Bergen, Norway
| | - Trygve Hausken
- National Center for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, Norway
- Center for Nutrition, Department of Clinical Medicine, University of Bergen, Bergen, Norway
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21
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Pirwani AF, Fang Z, Li B, Smith A, Northoff G, Ismail N. The effects of gastrointestinal symptoms on structural grey matter volume in youth. Int J Dev Neurosci 2020; 80:477-488. [PMID: 32479685 DOI: 10.1002/jdn.10044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/22/2020] [Accepted: 05/25/2020] [Indexed: 12/17/2022] Open
Abstract
Previous neuroimaging studies have examined the association between changes in brain structure and gastrointestinal symptoms (GIS), seen in disorders such as Irritable Bowel Syndrome and Irritable Bowel Disease. Studies in adults have found changes in white and grey matter volume (GMV) in patients with various gastrointestinal disorders. However, it is unclear whether GIS-related structural changes in the brain are limited to adults or could be present throughout the lifespan. Given that gastrointestinal disorders are typically diagnosed between 4 and 18 years old, we investigated GIS-induced morphological changes in pre-adolescents (8-10), adolescents (12-16 years) and young adults (17-21 years). Using a voxel-based morphometry (VBM) analysis, we compared regional grey matter volume (GMV) between participants with GIS and controls, using structural brain images from the Philadelphia Neurodevelopmental Cohort (PNC) database. A total of 211 participants (107 participants with GISs and 104 control participants) who had undergone structural magnetic resonance imaging were analysed. VBM analysis was used to objectively analyse GMV across the whole brain and compare between participants with GIS and controls. Participants experiencing GIS showed smaller GMV in regions within the limbic system/basal ganglia (bilateral caudate, bilateral ventral hippocampus, bilateral amygdala and bilateral superior orbital frontal cortex), and larger GMV in regions within the pain-matrix (thalamus, bilateral putamen, right mid-frontal gyrus) compared to controls. These differences were most prominent in the adolescent and young adult groups compared to pre-adolescents. In conclusion, the structural differences found in participants with GIS support the need for further research into the neurophysiological impact of these symptoms.
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Affiliation(s)
- Atiqa F Pirwani
- Neuroimmunology, Stress and Endocrinology (NISE) Lab, Faculty of Social Science, School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Zhuo Fang
- University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada.,Brain Imaging Group (BIG) Lab, Faculty of Social Science, School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Bo Li
- Advanced Research Institute of Multidisciplinary Science, Beijing Institute of Technology, Beijing, China.,Beijing Key Laboratory for Separation and Analysis in Biomedicine and Pharmaceuticals, School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Andra Smith
- Brain Imaging Group (BIG) Lab, Faculty of Social Science, School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Georg Northoff
- University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Nafissa Ismail
- Neuroimmunology, Stress and Endocrinology (NISE) Lab, Faculty of Social Science, School of Psychology, University of Ottawa, Ottawa, ON, Canada.,University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada
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22
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Li J, Yuan B, Li G, Lu X, Guo Y, Yang Y, Liang M, Ding J, Zhou Q. Convergent syndromic atrophy of pain and emotional systems in patients with irritable bowel syndrome and depressive symptoms. Neurosci Lett 2020; 723:134865. [PMID: 32109554 DOI: 10.1016/j.neulet.2020.134865] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 02/22/2020] [Accepted: 02/24/2020] [Indexed: 12/19/2022]
Abstract
Irritable bowel syndrome (IBS) is a brain-gut disorder that is often accompanied by psychiatric comorbidities, particularly depression. However, the neuroanatomical substrates of IBS with depressive symptoms (DEP-IBS) and how depressive symptoms and brain morphology modulate IBS symptoms remain unknown. In this study, structural MRI data were processed using a voxel-based morphometry technique and one-way analysis of covariance (ANCOVA) and post-hoc t-tests were performed to compare gray matter volume (GMV) among 28 patients with DEP-IBS, 21 patients with IBS who lacked depressive symptoms (nDEP-IBS), and 36 healthy controls (HC). Correlation and mediation analyses were performed to evaluate the relationship between differing GMV in DEP-IBS and clinical variables. We found that GMV in the bilateral prefrontal, insular, and dorsal striatal areas, as well as the left temporal pole, were significantly lower in the DEP-IBS group than in the HC group. Moreover, compared with the nDEP-IBS group, the DEP-IBS group exhibited decreased GMV in the bilateral medial, dorsolateral prefrontal, and orbitofrontal cortices, bilateral dorsal striatum, and left insular cortices. Correlation analysis revealed that GMV in these atrophic brain areas of the DEP-IBS group was negatively correlated with depression, gastrointestinal symptoms, and disease duration. Our results further revealed that depressive symptoms served as a mediator between gastrointestinal symptoms and GMV in the left insula, right medial prefrontal cortex, and right middle frontal gyrus, while gastrointestinal symptoms served as a mediator between depression and GMV in these regions. Our results suggest convergent syndromic atrophy in the pain and emotional systems of patients with DEP-IBS.
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Affiliation(s)
- Jie Li
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China; Department of Radiology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Binke Yuan
- Center for Language and Brain, Shenzhen Institute of Neuroscience, Shenzhen, Guangdong, China
| | - Guoxiong Li
- Department of Gastroenterology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Xingqi Lu
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Yun Guo
- Department of Gastroenterology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Ying Yang
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Minjie Liang
- Department of Radiology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Jianping Ding
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China.
| | - Quan Zhou
- Department of Radiology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China; Department of Radiology, Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics Guangdong Province), Guangzhou, Guangdong, China.
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