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Pastis I, Santos MG, Paruchuri A. Exploring the role of inflammation in major depressive disorder: beyond the monoamine hypothesis. Front Behav Neurosci 2024; 17:1282242. [PMID: 38299049 PMCID: PMC10829100 DOI: 10.3389/fnbeh.2023.1282242] [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: 08/23/2023] [Accepted: 12/04/2023] [Indexed: 02/02/2024] Open
Abstract
Major depressive disorder affects approximately 8.4% of the United States population. The World Health Organization estimates that 280 million adults worldwide are suffering from depression. They have estimated that by 2030 it will be the second most serious condition. Current treatment relies on the monoamine hypothesis, however, one-third of patients with MDD do not respond to monoamine-based antidepressants. For years, it was hypothesized that the primary pathway of MDD involved serotonin as the main neurotransmitter. The monoamine hypothesis, a widely accepted theory, sought to explain the biological basis of MDD as being caused by the depletion of monoamine neurotransmitters, namely norepinephrine and serotonin. This hypothesis regarding monoamines as the pathophysiological basis of MDD led to the design and widespread use of selective serotonin reuptake inhibitors. However, given that only one-third of patients improve with SSRI it is reasonable to infer that the pathway involved is more complex than once hypothesized and there are more neurotransmitters, receptors, and molecules involved. The monoamine hypothesis does not explain why there is a delay in the onset of effect and action of SSRIs. Several studies have demonstrated that chronic stress is a risk factor for the development of MDD. Thus the monoamine hypothesis alone is not enough to fully account for the pathophysiology of MDD highlighting the need for further research involving the pathways of MDD. In this paper, we review the role of inflammation and cytokines on MDD and discuss other pathways involved in the development and persistence of depressive symptoms.
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Affiliation(s)
- Irene Pastis
- Department of Psychiatry and Behavioral Medicine, East Carolina University, Greenville, NC, United States
| | - Melody G. Santos
- Internal Medicine and Psychiatry Combined Program, Department of Psychiatry and Behavioral Medicine, East Carolina University, Greenville, NC, United States
| | - Akshita Paruchuri
- East Carolina University Brody School of Medicine, Greenville, NC, United States
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2
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Nasiri-Dehsorkhi H, Vaziri S, Esmaillzadeh A, Adibi P. Psychological distress, perceived stress and nocebo effect (multifood adverse reaction) in irritable bowel syndrome patients. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:257. [PMID: 37727431 PMCID: PMC10506782 DOI: 10.4103/jehp.jehp_221_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 04/03/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Psychological distress and perceived stress may complicate the clinical presentation, course, and treatment of patients with functional gastrointestinal disorders. The correlation between psychological distress, perceived stress, and the nocebo effect (multifood adverse reaction) in patients with irritable bowel syndrome (IBS) was the main aim of the present study. MATERIALS AND METHODS In this cross-sectional correlation study, data on 4,763 Iranian adults, 748 of whom by purposive sampling were patients with IBS (65.1% female), working in 50 different health centers affiliated to the Isfahan University of Medical Sciences across Isfahan province were examined. For assessing dietary intake, a 106-item self-administered Dish-based Semi-Quantitative Food Frequency Questionnaire that was specifically designed and validated for Iranian adults was used. General Heath Questionnaire 12 and Stressful Life event Questionnaire were used to assess psychological distress and perceived stress. By using a modified Persian version of the Rome III questionnaire, IBS was assessed. Based on researcher-made definition of nocebo effect (multiitem food intolerance), 164 people had the nocebo phenomenon in IBS group. RESULTS Age, sex, education, marital status, antidepressant use, and specifically chronic underlying disease (odds ratio [OR]: 3.54, 95% confidence interval [CI]: 1.73-7.23) of general characteristics had a significant correlation (P <.05) with presenting nocebo responses in IBS patients. Psychological distress (OR: 1.415; 95% CI: 0.992-2.020; P = 0.056) had a significant correlation with nocebo effect and did not find significant correlation with perceived stress (OR: 0.999; 95% CI: 0.990-1.008; P = 0.865). Data were analyzed by Chi-square test, analysis of variance, and OR. CONCLUSION The present study showed that psychological distress with chronic underlying disease and antidepressant use are important elements in presenting multifood adverse reactions that we named here as the nocebo effect in IBS patients. Reducing psychological distress and managing chronic underlying diseases appear to be an effective factor in reducing the nocebo phenomenon in IBS patients. For managing the nocebo responses in IBS patients, these findings may help clinicians to improve their interventions. Further studies are required to confirm these findings.
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Affiliation(s)
- Hamid Nasiri-Dehsorkhi
- Department of Clinical Psychology, Roudehen Branch, Islamic Azad University, Roudehen, Iran
- Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahram Vaziri
- Department of Clinical Psychology, Roudehen Branch, Islamic Azad University, Roudehen, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Peyman Adibi
- Isfahan Gastroenterology and Hepatology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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3
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Gao J, Zhao L, Cheng Y, Lei W, Wang Y, Liu X, Zheng N, Shao L, Chen X, Sun Y, Ling Z, Xu W. Probiotics for the treatment of depression and its comorbidities: A systemic review. Front Cell Infect Microbiol 2023; 13:1167116. [PMID: 37139495 PMCID: PMC10149938 DOI: 10.3389/fcimb.2023.1167116] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 03/15/2023] [Indexed: 05/05/2023] Open
Abstract
Depression is one of the most common psychiatric conditions, characterized by significant and persistent depressed mood and diminished interest, and often coexists with various comorbidities. The underlying mechanism of depression remain elusive, evidenced by the lack of an appreciate therapy. Recent abundant clinical trials and animal studies support the new notion that the gut microbiota has emerged as a novel actor in the pathophysiology of depression, which partakes in bidirectional communication between the gut and the brain through the neuroendocrine, nervous, and immune signaling pathways, collectively known as the microbiota-gut-brain (MGB) axis. Alterations in the gut microbiota can trigger the changes in neurotransmitters, neuroinflammation, and behaviors. With the transition of human microbiome research from studying associations to investigating mechanistic causality, the MGB axis has emerged as a novel therapeutic target in depression and its comorbidities. These novel insights have fueled idea that targeting on the gut microbiota may open new windows for efficient treatment of depression and its comorbidities. Probiotics, live beneficial microorganisms, can be used to modulate gut dysbiosis into a new eubiosis and modify the occurrence and development of depression and its comorbidities. In present review, we summarize recent findings regarding the MGB axis in depression and discuss the potential therapeutic effects of probiotics on depression and its comorbidities.
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Affiliation(s)
- Jie Gao
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Longyou Zhao
- Department of Laboratory Medicine, Lishui Second People’s Hospital, Lishui, Zhejiang, China
| | - Yiwen Cheng
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, Shandong, China
| | - Wenhui Lei
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, Shandong, China
- Department of Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yu Wang
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xia Liu
- Department of Intensive Care Unit, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Nengneng Zheng
- Department of Obstetrics, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Li Shao
- School of Clinical Medicine, Institute of Hepatology and Metabolic Diseases, Hangzhou Normal University, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Xulei Chen
- Department of Psychiatry, Lishui Second People’s Hospital, Lishui, Zhejiang, China
| | - Yilai Sun
- Department of Psychiatry, Lishui Second People’s Hospital, Lishui, Zhejiang, China
| | - Zongxin Ling
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, Shandong, China
| | - Weijie Xu
- Department of Psychiatry, Lishui Second People’s Hospital, Lishui, Zhejiang, China
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4
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Monem SMA, Elbadrawy EG, Shalaby SM, Hendawy DM, Hassan SM, Almonem NA. The role of serum gastric peptide ghrelin hormone level in irritable bowel syndrome at Zagazig University Hospitals. J Med Life 2022; 15:1525-1531. [PMID: 36762339 PMCID: PMC9884357 DOI: 10.25122/jml-2022-0089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 09/15/2022] [Indexed: 02/11/2023] Open
Abstract
Generalized dysmotility of the gastrointestinal tract develops in individuals with irritable bowel syndrome (IBS). The ghrelin hormone appears to be critical in controlling gastrointestinal motility. We aimed to evaluate serum ghrelin levels in people with IBS and to demonstrate its role in IBS pathophysiology. This study included 32 individuals with IBS (16 with constipation and 16 with diarrhea) and 16 healthy individuals as controls. Blood specimens were collected from patients and controls following an overnight fast. Total ghrelin level was detected in plasma by commercially available ELISA Kit. There were significant differences in the serum levels of ghrelin between the control group and both types of IBS. The mean±SD of ghrelin level in the control group was 2.608±0.714 pg/ml, and that of both types of IBS was 5.782±2.450 pg/ml (P-value<0.001). There was a significant variation between the control and IBS-D groups (mean±SD: 7.838±1.687 pg/ml, p-value<0.001). Also, we indicated a considerable difference between the control and IBS-C groups (mean±SD: 3.726±0.740 pg/ml, P-value<0.001). In comparing the IBS-D group and IBS-C group, we found a highly considerable variation between the two groups (p-value<0.001). This means that serum ghrelin levels were significantly greater in IBS-D than in IBS-C and the control group. Our findings concluded that serum ghrelin level was higher among the IBS-D group than in the IBS-C and control groups. The ghrelin hormone may play a vital role in IBS pathophysiology.
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Affiliation(s)
| | | | - Sally Mahmoud Shalaby
- Medical Biochemistry & Molecular Biology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Doaa Mahmoud Hendawy
- Medical Biochemistry & Molecular Biology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Sherif Mahmoud Hassan
- Tropical Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt,Corresponding Author: Sherif Mahmoud Hassan, Tropical Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt. E-mail:
| | - Nagla Abd Almonem
- Tropical Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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5
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Alexandru BA, Rat LA, Moldovan AF, Mihancea P, Mariș L. An Open-Label Trial Study of Quality-of-Life Assessment in Irritable Bowel Syndrome and Their Treatment. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58060763. [PMID: 35744026 PMCID: PMC9230795 DOI: 10.3390/medicina58060763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/31/2022] [Accepted: 06/03/2022] [Indexed: 11/16/2022]
Abstract
Background and objectives: Irritable bowel syndrome (IBS) does not only have a complex pathophysiological evolution with central and peripheral mechanisms. This study aimed to monitor the neuropsychiatric part of IBS and its management, following the quality of life of patients with IBS. Materials and Methods: Participants numbering 145 were investigated in this study for 6 months and were divided into four groups, namely the control group with a symptomatic period of less than 6 months (n = 34), the group with irritable bowel syndrome (IBS; n = 58), IBS and neuropsychiatric treatment (n = 32), and IBS with probiotic treatment (n = 22). Clinical and paraclinical analyses as well as quality of life were monitored by domestic and international psychological questionnaires. Results: It was observed that, in patients with pro-longed symptoms, neuropsychiatric impairment occurred more frequently, and both clinical and paraclinical analyses improved significantly (p < 0.05) more so in those with complex allopathic treatment and in those with probiotic treatment. There were no significant differences between the two research groups. Conclusions: It has been shown that the neuropsychological component of IBS plays an important role in its treatment, and modern probation therapy can achieve similar results to those of neuropsychiatry. This also requires further studies to ensure the best combination in the approach to IBS.
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Affiliation(s)
- Bogdana Ariana Alexandru
- Faculty of Medicine and Pharmacy, Medicine Department, University of Oradea, 410068 Oradea, Romania; (B.A.A.); (A.F.M.)
| | - Lavinia Alina Rat
- Faculty of Medicine and Pharmacy, Doctoral School, University of Oradea, 1 December Square, 410068 Oradea, Romania; (L.A.R.); (P.M.)
| | - Andrada Florina Moldovan
- Faculty of Medicine and Pharmacy, Medicine Department, University of Oradea, 410068 Oradea, Romania; (B.A.A.); (A.F.M.)
| | - Petru Mihancea
- Faculty of Medicine and Pharmacy, Doctoral School, University of Oradea, 1 December Square, 410068 Oradea, Romania; (L.A.R.); (P.M.)
| | - Lavinia Mariș
- Faculty of Medicine and Pharmacy, Medicine Department, University of Oradea, 410068 Oradea, Romania; (B.A.A.); (A.F.M.)
- Correspondence: ; Tel.: +40-769627181
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6
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Doll JPK, Vázquez-Castellanos JF, Schaub AC, Schweinfurth N, Kettelhack C, Schneider E, Yamanbaeva G, Mählmann L, Brand S, Beglinger C, Borgwardt S, Raes J, Schmidt A, Lang UE. Fecal Microbiota Transplantation (FMT) as an Adjunctive Therapy for Depression-Case Report. Front Psychiatry 2022; 13:815422. [PMID: 35250668 PMCID: PMC8891755 DOI: 10.3389/fpsyt.2022.815422] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 01/25/2022] [Indexed: 12/20/2022] Open
Abstract
Depression is a debilitating disorder, and at least one third of patients do not respond to therapy. Associations between gut microbiota and depression have been observed in recent years, opening novel treatment avenues. Here, we present the first two patients with major depressive disorder ever treated with fecal microbiota transplantation as add-on therapy. Both improved their depressive symptoms 4 weeks after the transplantation. Effects lasted up to 8 weeks in one patient. Gastrointestinal symptoms, constipation in particular, were reflected in microbiome changes and improved in one patient. This report suggests further FMT studies in depression could be worth pursuing and adds to awareness as well as safety assurance, both crucial in determining the potential of FMT in depression treatment.
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Affiliation(s)
- Jessica P K Doll
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Jorge F Vázquez-Castellanos
- Department of Microbiology and Immunology, Rega Institute for Medical Research, KU Leuven-University of Leuven, Leuven, Belgium
| | | | - Nina Schweinfurth
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Cedric Kettelhack
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Else Schneider
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | | | - Laura Mählmann
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Serge Brand
- Center for Affective, Stress- and Sleep Disorders (ZASS), Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland.,Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Division of Sport Science and Psychosocial Health, Department of Sport, Exercise, and Health, University of Basel, Basel, Switzerland.,Department of Psychiatry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Stefan Borgwardt
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland.,Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Jeroen Raes
- Department of Microbiology and Immunology, Rega Institute for Medical Research, KU Leuven-University of Leuven, Leuven, Belgium
| | - André Schmidt
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Undine E Lang
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
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7
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The Role of the Gut Microbiota in the Development and Progression of Major Depressive and Bipolar Disorder. Nutrients 2021; 14:nu14010037. [PMID: 35010912 PMCID: PMC8746924 DOI: 10.3390/nu14010037] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/13/2021] [Accepted: 12/20/2021] [Indexed: 02/07/2023] Open
Abstract
A growing number of studies in rodents indicate a connection between the intestinal microbiota and the brain, but comprehensive human data is scarce. Here, we systematically reviewed human studies examining the connection between the intestinal microbiota and major depressive and bipolar disorder. In this review we discuss various changes in bacterial abundance, particularly on low taxonomic levels, in terms of a connection with the pathophysiology of major depressive and bipolar disorder, their use as a diagnostic and treatment response parameter, their health-promoting potential, as well as novel adjunctive treatment options. The diversity of the intestinal microbiota is mostly decreased in depressed subjects. A consistent elevation of phylum Actinobacteria, family Bifidobacteriaceae, and genus Bacteroides, and a reduction of family Ruminococcaceae, genus Faecalibacterium, and genus Roseburia was reported. Probiotics containing Bifidobacterium and/or Lactobacillus spp. seemed to improve depressive symptoms, and novel approaches with different probiotics and synbiotics showed promising results. Comparing twin studies, we report here that already with an elevated risk of developing depression, microbial changes towards a “depression-like” microbiota were found. Overall, these findings highlight the importance of the microbiota and the necessity for a better understanding of its changes contributing to depressive symptoms, potentially leading to new approaches to alleviate depressive symptoms via alterations of the gut microbiota.
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8
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Baughman J, Ambrogio J, Motevalli M. Irritable Bowel Syndrome and Depression: A Case Report. Integr Med (Encinitas) 2021; 20:38-43. [PMID: 34803539 PMCID: PMC8594971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
A 26-year-old Caucasian woman presented with a two-year history of depression concomitant with irritable bowel syndrome (IBS-C; constipation subtype, gas/bloating). Past evaluation resulted in a clinical diagnosis of IBS-C in August of 2015. Between August and November of 2015, the patient developed worsening bowel irregularities and persistent depression. The patient opted out of conventional treatment and was referred for nutritional care in November of 2017. Throughout one year of treatment with dietary interventions, Chinese herbal medicine, and targeted nutritional supplementation, the patient gradually reached full remission of all complaints.
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Affiliation(s)
- Joshuan Baughman
- Corresponding author: Joshuan Baughman, MS, RH (AHG) (C), CN E-mail address:
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9
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Chen XF, Guo Y, Lu XQ, Qi L, Xu KH, Chen Y, Li GX, Ding JP, Li J. Aberrant Intraregional Brain Activity and Functional Connectivity in Patients With Diarrhea-Predominant Irritable Bowel Syndrome. Front Neurosci 2021; 15:721822. [PMID: 34539337 PMCID: PMC8446353 DOI: 10.3389/fnins.2021.721822] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/09/2021] [Indexed: 12/12/2022] Open
Abstract
Background and Purpose The appearance and aggravation of diarrhea-predominant irritable bowel syndrome (IBS-D) have proven to be closely related to psychosocial factors. We aimed to measure altered spontaneous brain activity and functional connectivity (FC) in patients with IBS-D using resting-state functional magnetic resonance imaging (RS-fMRI) and to analyze the relationship between these parameters and emotional symptoms. Methods Thirty-six adult IBS-D patients and thirty-six demographic-matched healthy controls (HCs) underwent RS-fMRI scans. After processing RS-fMRI data, the values of the amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) of the two groups were compared. The abnormal regions were selected as the regions of interest to compare whole-brain seed-based FC between the groups. The relationships between RS-fMRI data and mood and gastrointestinal symptoms were analyzed using correlation and mediation analyses. Results Compared with HCs, IBS-D patients showed increased ALFF in the right cerebellum posterior lobe, the right lingual gyrus/calcarine, the right postcentral gyrus, the right superior frontal gyrus (SFG), and middle frontal gyrus (MFG), with decreased ALFF in the right inferior parietal lobule, the right striatum, the right anterior cingulated cortex, the right insula, the right hippocampus, the right thalamus, the right midbrain, and the left precuneus. IBS-D patients showed increased ReHo in the bilateral lingual gyrus/calcarine, the bilateral SFG, the right MFG, and the right postcentral gyrus, with decreased ReHo in the orbital part of the left inferior frontal gyrus and the right supplementary motor area. Patients showed enhanced FC between the left precuneus and the bilateral orbitofrontal cortex (OFC). There was a positive correlation between increased ALFF values in the right midbrain and anxiety-depression symptoms in IBS-D patients, and the mediating effect of gastrointestinal symptoms indirectly caused this correlation. Conclusion IBS-D patients had dysregulated spontaneous activity and FC in regions related to pain regulation and emotional arousal involved in prefrontal–limbic–midbrain circuit and somatosensory processing. The development of mood disorders in IBS-D patients may be partly related to the dysfunction of components in the dopamine pathway (especially the midbrain, OFC) due to visceral pain.
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Affiliation(s)
- Xiao-Fei Chen
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Yun Guo
- Department of Gastroenterology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Xing-Qi Lu
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Le Qi
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.,Medical College, Hangzhou Normal University, Hangzhou, China
| | - Kuang-Hui Xu
- Medical College, Hangzhou Normal University, Hangzhou, China
| | - Yong Chen
- Medical College, Hangzhou Normal University, Hangzhou, China
| | - Guo-Xiong Li
- Department of Gastroenterology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
| | - Jian-Ping Ding
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.,Medical College, Hangzhou Normal University, Hangzhou, China
| | - Jie Li
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China
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10
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Selim A, Saad Salem S, Albasher N, Bakrmom G, Alanzi S, Jradi H. Irritable Bowel Syndrome and Coping Strategies: A Cross-sectional Study for Identifying Psychological Alarms and Factors Related to Coping in Riyadh, Saudi Arabia. Clin Nurs Res 2021; 31:144-154. [PMID: 34056933 DOI: 10.1177/10547738211020437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Psychological alarms including severity of pain, functional impairment, depression, and impaired coping strategies have been correlated with (IBS); however, these attributes, particularly coping strategies, have not been well studied. The aim of this study was to assess psychological alarms, life stressors, and coping strategies of adults diagnosed with IBS. A total of 806 participants completed a self-administered survey consisting of socio-demographic data and life stressors, the Rome IV criteria to diagnose IBS, the Psychological Alarm Questionnaire, and the Coping Strategies Questionnaire (CSQ 24). IBS diagnosis was established among 372 (46.15%) participants. Anxiety (OR = 1.81; 95% CI: 1.35-2.45), severe pain (OR = 1.92; 95% CI: 1.42-2.63), financial life stressors (OR = 1.98; 95% CI: 1.33-2.40), and coping strategies such as reinterpretation (OR = 1.92; 95% CI: 1.39-2.68) and diversion (OR = 2.01; 95% CI: 1.05-3.89) were all significantly and independently associated with IBS diagnosis. Giving the chronic nature of IBS, future research should focus on coping as a potential treatment goal for IBS patients.
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Affiliation(s)
- Abeer Selim
- Faculty of Nursing, Psychiatric and Mental Health Nursing Department, Mansoura University, Mansoura, Egypt
- College of Nursing, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi
| | - Samah Saad Salem
- College of Nursing, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi
- Faculty of Nursing, Medical-Surgical Nursing Department, Cairo University, Egypt
| | - Noura Albasher
- King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - Ghadah Bakrmom
- King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - Samar Alanzi
- Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Hoda Jradi
- College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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11
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Li J, He P, Lu X, Guo Y, Liu M, Li G, Ding J. A Resting-state Functional Magnetic Resonance Imaging Study of Whole-brain Functional Connectivity of Voxel Levels in Patients With Irritable Bowel Syndrome With Depressive Symptoms. J Neurogastroenterol Motil 2021; 27:248-256. [PMID: 33795543 PMCID: PMC8026363 DOI: 10.5056/jnm20209] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/11/2020] [Accepted: 12/02/2020] [Indexed: 12/13/2022] Open
Abstract
Background/Aims Depressive symptom is one of the most common symptoms in patients with irritable bowel syndrome (IBS), but its pathogenetic mechanisms remain unclear. As a voxel-level graph theory analysis method, degree centrality (DC) can provide a new perspective for exploring the abnormalities of whole-brain functional network of IBS with depressive symptoms (DEP-IBS). Methods DC, voxel-wise image and clinical symptoms correlation and seed-based functional connectivity (FC) analyses were performed in 28 DEP-IBS patients, 21 IBS without depressive symptoms (nDEP-IBS) patients and 36 matched healthy controls (HC) to reveal the abnormalities of whole brain FC in DEP-IBS. Results Compared to nDEP-IBS patients and HC, DEP-IBS patients showed significant decrease of DC in the left insula and increase of DC in the left precentral gyrus. The DC's z-scores of the left insula negatively correlated with depression severity in DEP-IBS patients. Compared to nDEP-IBS patients, DEP-IBS patients showed increased left insula-related FC in the left inferior parietal lobule and right inferior occipital gyrus, and decreased left insula-related FC in the left precentral gyrus, right supplementary motor area (SMA), and postcentral gyrus. In DEP-IBS patients, abstracted clusters' mean FC in the right SMA negatively correlated with depressive symptoms. Conclusions DEP-IBS patients have abnormal FC in brain regions associated with the fronto-limbic and sensorimotor networks, especially insula and SMA, which explains the vicious circle between negative emotion and gastrointestinal symptoms in IBS. Identification of such alterations may facilitate earlier and more accurate diagnosis of depression in IBS, and development of effective treatment strategies.
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Affiliation(s)
- Jie Li
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Ping He
- Department of Orthodontics, Hangzhou Stomatological Hospital, 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
| | - Min Liu
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Guoxiong Li
- Department of Gastroenterology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Jianping Ding
- Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
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12
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Söderquist F, Syk M, Just D, Kurbalija Novicic Z, Rasmusson AJ, Hellström PM, Ramklint M, Cunningham JL. A cross-sectional study of gastrointestinal symptoms, depressive symptoms and trait anxiety in young adults. BMC Psychiatry 2020; 20:535. [PMID: 33176747 PMCID: PMC7661167 DOI: 10.1186/s12888-020-02940-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 10/28/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND >Patients with functional gastrointestinal disorders have a high psychiatric co-morbidity. This study aimed to investigate and characterise gastrointestinal symptoms in relation to depressive symptoms and trait anxiety in a well-defined population of young adult psychiatric outpatients and healthy controls. METHODS Gastrointestinal symptoms were assessed with the Gastrointestinal Symptom Rating Scale for Irritable Bowel Syndrome (GSRS-IBS). Depressive symptoms were assessed with the Montgomery-Åsberg Depression Rating Scale- Self assessment (MADRS-S). Trait anxiety was estimated with three of the Swedish universities of Personality (SSP) scales: Somatic trait anxiety, Psychic trait anxiety and Stress susceptibility. Self-ratings were collected from 491 young adult psychiatric outpatients and 85 healthy controls. Gastrointestinal symptom severity was compared between patients with and without current psychotropic medication and controls. Associations between gastrointestinal symptoms, depressive symptoms and trait anxiety were assessed using Spearman's coefficients and generalized linear models adjusting for possible confounders (sex, body mass index, bulimia nervosa). RESULTS Patients, with and without current psychotropic medication, reported significantly more gastrointestinal symptoms than controls. In the generalized linear models, total MADRS-S score (p < 0.001), Somatic trait anxiety (p < 0.001), Psychic trait anxiety (p = 0.002) and Stress susceptibility (p = 0.002) were independent predictors of the total GSRS-IBS score. Further exploratory analysis using unsupervised learning revealed a diverse spectrum of symptoms that clustered into six groups. CONCLUSION Gastrointestinal symptoms are both highly prevalent and diverse in young adult psychiatric outpatients, regardless of current psychotropic medication. Depressive symptom severity and degree of trait anxiety are independently related to the total gastrointestinal symptom burden.
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Affiliation(s)
- Fanny Söderquist
- Department of Neuroscience, Psychiatry Uppsala University, Uppsala, Sweden
| | - Mikaela Syk
- Department of Neuroscience, Psychiatry Uppsala University, Uppsala, Sweden
| | - David Just
- Department of Neuroscience, Psychiatry Uppsala University, Uppsala, Sweden
| | | | - Annica J Rasmusson
- Department of Neuroscience, Psychiatry Uppsala University, Uppsala, Sweden
| | - Per M Hellström
- Department of Medical Sciences, Gastroenterology/Hepatology, Uppsala University, Uppsala, Sweden
| | - Mia Ramklint
- Department of Neuroscience, Psychiatry Uppsala University, Uppsala, Sweden
| | - Janet L Cunningham
- Department of Neuroscience, Psychiatry Uppsala University, Uppsala, Sweden.
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13
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Balmus IM, Ilie-Dumitru O, Ciobica A, Cojocariu RO, Stanciu C, Trifan A, Cimpeanu M, Cimpeanu C, Gorgan L. Irritable Bowel Syndrome between Molecular Approach and Clinical Expertise-Searching for Gap Fillers in the Oxidative Stress Way of Thinking. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E38. [PMID: 31963795 PMCID: PMC7023055 DOI: 10.3390/medicina56010038] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 01/15/2020] [Accepted: 01/15/2020] [Indexed: 02/05/2023]
Abstract
Irritable bowel syndrome (IBS) remains to date an intriguing functional gastrointestinal disorder. Recent studies described a multitude of exogenous factors that work together in IBS, gradually impairing intestinal lining cellular metabolism, including oxidative status balance, with or without a genetic background. Although the current biomarkers support the differentiation between IBS subtypes and other functional gastrointestinal disorder, they are mostly non-specific, referring to clinical, biochemical, and inflammatory imbalances. Since IBS could be also the result of deficient signaling pathways involving both gastrointestinal secretion and neuro-vegetative stimulation, IBS makes no exception from the oxidative hypothesis in the pathological mechanisms. Regarding the oxidative stress implication in IBS, the previous research efforts showed controversial results, with some animal models and patient studies reporting clear oxidative imbalance both on systemic and local levels, but still with no concrete evidence to point to a direct correlation between oxidative stress and IBS. Additionally, it seems that a major role could be also attributed to gut microbiota and their ability to shape our bodies and behaviors. Moreover, the genetic features study in IBS patients showed that several genetic similarities point to a possible correlation of IBS with affective spectrum disorders. Thus, we focus here the discussion on the assumption that IBS could in fact be more likely a stress-related disorder rather than a gastrointestinal one.
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Affiliation(s)
- Ioana-Miruna Balmus
- Department of Interdisciplinary Research in Science, Alexandru Ioan Cuza University of Iasi, Carol I Avenue, No. 11, 700506 Iasi, Romania;
| | - Ovidiu Ilie-Dumitru
- Department of Biology, Faculty of Biology, Alexandru Ioan Cuza University of Iasi, Carol I Avenue, 20A, 700506 Iasi, Romania (C.C.)
| | - Alin Ciobica
- Department of Research, Faculty of Biology, Alexandru Ioan Cuza University of Iasi, Carol I Avenue, 20A, 700506 Iasi, Romania
| | - Roxana-Oana Cojocariu
- Department of Biology, Faculty of Biology, Alexandru Ioan Cuza University of Iasi, Carol I Avenue, 20A, 700506 Iasi, Romania (C.C.)
| | - Carol Stanciu
- Center of Biomedical Research, Romanian Academy, 8th Carol I Avenue, 700506 Iasi, Romania;
| | - Anca Trifan
- Department of Gastroenterology, Faculty of Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, 16th University Street, 700115 Iasi, Romania
| | - Mirela Cimpeanu
- Department of Biology, Faculty of Biology, Alexandru Ioan Cuza University of Iasi, Carol I Avenue, 20A, 700506 Iasi, Romania (C.C.)
| | - Cristian Cimpeanu
- Department of Biology, Faculty of Biology, Alexandru Ioan Cuza University of Iasi, Carol I Avenue, 20A, 700506 Iasi, Romania (C.C.)
| | - Lucian Gorgan
- Department of Biology, Faculty of Biology, Alexandru Ioan Cuza University of Iasi, Carol I Avenue, 20A, 700506 Iasi, Romania (C.C.)
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Cojocariu R, Ciobica A, Balmus IM, Guenne S, Trifan A, Stanciu C, Hrițcu L, Lefter R. Antioxidant Capacity and Behavioral Relevance of a Polyphenolic Extract of Chrysanthellum americanum in a Rat Model of Irritable Bowel Syndrome. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:3492767. [PMID: 31485290 PMCID: PMC6710773 DOI: 10.1155/2019/3492767] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 07/12/2019] [Accepted: 07/25/2019] [Indexed: 02/08/2023]
Abstract
Chrysanthellum americanum L. (Vatke) is a medicinal plant from the Compositae family used in west-African traditional medicine, known for its flavonoid and saponin richness and for its strong antioxidant potential. In the present study, we assessed the effects of Chrysanthellum americanum polyphenolic extract in the psychological stress-induced rat model of irritable bowel syndrome (IBS), a chronic functional digestive tract disorder marked by immune and inflammatory-related disturbances of central nervous and peripheral intestinal systems, which is often associated with mood disorders including depression and anxiety. Consequently, memory impairment, anxiety and depression behavioral indicators, and cerebral oxidative stress biomarker dynamics were evaluated in a multifactorial heterotypic stress-exposed IBS rats after 6-day gavage with polyphenolic C. americanum extract (100 mg/kg body weight). Y-maze, elevated plus maze, and forced swimming tests were used for assessing behavioral responses. Administration of the extract exhibited significant anxiolytic and antidepressant-like effects coupled with significantly increased temporal lobe antioxidant enzyme specific activity (superoxide dismutase and glutathione peroxidase) and decreased malondialdehyde levels, a well-known lipid peroxidation marker. Furthermore, linear regression statistical analyses showed significant correlations between the oxidative stress parameters and behavioral tests. In conclusion, our results suggest that the administration of Chrysanthellum americanum polyphenolic extract could ameliorate mood and cognitive disturbances related to stress-induced in an IBS rat model. This could be also related to cerebral oxidative stress status attenuation.
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Affiliation(s)
- Roxana Cojocariu
- 1Department of Biology, Faculty of Biology, Alexandru Ioan Cuza University, 11th Carol I Avenue, 700506 Iasi, Romania
| | - Alin Ciobica
- 2Department of Research, Faculty of Biology, Alexandru Ioan Cuza University, 11th Carol I Avenue, 700506 Iasi, Romania
| | - Ioana-Miruna Balmus
- 2Department of Research, Faculty of Biology, Alexandru Ioan Cuza University, 11th Carol I Avenue, 700506 Iasi, Romania
| | - Samson Guenne
- 3Laboratory of Applied Biochemistry and Chemistry, University Joseph KI-ZERBO, 03 BP 7021 Ouagadougou 03, Burkina Faso
| | - Anca Trifan
- 4“Grigore T. Popa” University of Medicine and Pharmacy, 16th Universitatii Street, 700115 Iasi, Romania
| | - Carol Stanciu
- 5Center of Biomedical Research, Romanian Academy, 8th Carol I Avenue, 700506 Iasi, Romania
| | - Luminita Hrițcu
- 6Faculty of Veterinary Medicine, University of Agricultural Sciencies and Veterinary Medicine “”Ion Ionescu de la Brad” of Iasi, 3rd Mihail Sadoveanu Alley, Iasi 700490, Romania
| | - Radu Lefter
- 5Center of Biomedical Research, Romanian Academy, 8th Carol I Avenue, 700506 Iasi, Romania
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