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Zhang Y, Wu X, Sun J, Yue K, Lu S, Wang B, Liu W, Shi H, Zou L. Exploring changes in brain function in IBD patients using SPCCA: a study of simultaneous EEG-fMRI. Math Biosci Eng 2024; 21:2646-2670. [PMID: 38454700 DOI: 10.3934/mbe.2024117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Research on functional changes in the brain of inflammatory bowel disease (IBD) patients is emerging around the world, which brings new perspectives to medical research. In this paper, the methods of canonical correlation analysis (CCA), kernel canonical correlation analysis (KCCA), and sparsity preserving canonical correlation analysis (SPCCA) were applied to the fusion of simultaneous EEG-fMRI data from 25 IBD patients and 15 healthy individuals. The CCA, KCCA and SPCCA fusion methods were used for data processing to compare the results obtained by the three methods. The results clearly show that there is a significant difference in the activation intensity between IBD and healthy control (HC), not only in the frontal lobe (p < 0.01) and temporal lobe (p < 0.01) regions, but also in the posterior cingulate gyrus (p < 0.01), gyrus rectus (p < 0.01), and amygdala (p < 0.01) regions, which are usually neglected. The mean difference in the SPCCA activation intensity was 60.1. However, the mean difference in activation intensity was only 36.9 and 49.8 by using CCA and KCCA. In addition, the correlation of the relevant components selected during the SPCCA calculation was high, with correlation components of up to 0.955; alternatively, the correlations obtained from CCA and KCCA calculations were only 0.917 and 0.926, respectively. It can be seen that SPCCA is indeed superior to CCA and KCCA in processing high-dimensional multimodal data. This work reveals the process of analyzing the brain activation state in IBD disease, provides a further perspective for the study of brain function, and opens up a new avenue for studying the SPCCA method and the change in the intensity of brain activation in IBD disease.
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Affiliation(s)
- Yin Zhang
- School of Microelectronics and Control Engineering, Changzhou University, Changzhou 213164, China
| | - Xintong Wu
- The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Department of Radiology, China
| | - Jingwen Sun
- The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Department of Radiology, China
| | - Kecen Yue
- The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Department of Radiology, China
| | - Shuangshuang Lu
- The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Department of Radiology, China
| | - Bingjian Wang
- The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Department of Radiology, China
| | - Wenjia Liu
- The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Department of Radiology, China
| | - Haifeng Shi
- The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Department of Radiology, China
| | - Ling Zou
- School of Microelectronics and Control Engineering, Changzhou University, Changzhou 213164, China
- School of Computer and Artificial Intelligence, Changzhou University, Changzhou, Jiangsu 213164, China
- Key Laboratory of Brain Machine Collaborative Intelligence Foundation of Zhejiang Province, Hangzhou 310018, China
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Öhlmann H, Lanters LR, Theysohn N, Langhorst J, Engler H, Icenhour A, Elsenbruch S. Distinct Alterations in Central Pain Processing of Visceral and Somatic Pain in Quiescent Ulcerative Colitis Compared to Irritable Bowel Syndrome and Health. J Crohns Colitis 2023; 17:1639-1651. [PMID: 37161902 PMCID: PMC10637045 DOI: 10.1093/ecco-jcc/jjad080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND AND AIMS Despite relevance to pain chronicity, disease burden, and treatment, mechanisms of pain perception for different types of acute pain remain incompletely understood in patients with inflammatory bowel disease [IBD]. Building on experimental research across pain modalities, we herein addressed behavioural and neural correlates of visceral versus somatic pain processing in women with quiescent ulcerative colitis [UC] compared to irritable bowel syndrome [IBS] as a patient control group and healthy women [HC]. METHODS Thresholds for visceral and somatic pain were assessed with rectal distensions and cutaneous thermal pain, respectively. Using functional magnetic resonance imaging, neural and behavioural responses to individually calibrated and intensity-matched painful stimuli from both modalities were compared. RESULTS Pain thresholds were comparable across groups, but visceral thresholds correlated with gastrointestinal symptom severity and chronic stress burden exclusively within UC. Upon experience of visceral and somatic pain, both control groups demonstrated enhanced visceral pain-induced neural activation and greater perceived pain intensity, whereas UC patients failed to differentiate between pain modalities at both behavioural and neural levels. CONCLUSIONS When confronted with acute pain from multiple bodily sites, UC patients' responses are distinctly altered. Their failure to prioritise pain arising from the viscera may reflect a lack of adaptive behavioural flexibility, possibly resulting from long-lasting central effects of repeated intestinal inflammatory insults persisting during remission. The role of psychological factors, particularly chronic stress, in visceral sensitivity and disease-specific alterations in the response to acute pain call for dedicated mechanistic research as a basis for tailoring interventions for intestinal and extraintestinal pain symptoms in IBD.
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Affiliation(s)
- Hanna Öhlmann
- Department of Medical Psychology and Medical Sociology, Ruhr University Bochum, Bochum, Germany
| | - Laura Ricarda Lanters
- Department of Neurology, Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Nina Theysohn
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Jost Langhorst
- Department for Internal and Integrative Medicine, Sozialstiftung Bamberg, Bamberg, Germany
- Department for Integrative Medicine, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Harald Engler
- Institute of Medical Psychology and Behavioral Immunobiology, Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Adriane Icenhour
- Department of Medical Psychology and Medical Sociology, Ruhr University Bochum, Bochum, Germany
| | - Sigrid Elsenbruch
- Department of Medical Psychology and Medical Sociology, Ruhr University Bochum, Bochum, Germany
- Department of Neurology, Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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Hall CV, Radford-Smith G, Savage E, Robinson C, Cocchi L, Moran RJ. Brain signatures of chronic gut inflammation. Front Psychiatry 2023; 14:1250268. [PMID: 38025434 PMCID: PMC10661239 DOI: 10.3389/fpsyt.2023.1250268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Gut inflammation is thought to modify brain activity and behaviour via modulation of the gut-brain axis. However, how relapsing and remitting exposure to peripheral inflammation over the natural history of inflammatory bowel disease (IBD) contributes to altered brain dynamics is poorly understood. Here, we used electroencephalography (EEG) to characterise changes in spontaneous spatiotemporal brain states in Crohn's Disease (CD) (n = 40) and Ulcerative Colitis (UC) (n = 30), compared to healthy individuals (n = 28). We first provide evidence of a significantly perturbed and heterogeneous microbial profile in CD, consistent with previous work showing enduring and long-standing dysbiosis in clinical remission. Results from our brain state assessment show that CD and UC exhibit alterations in the temporal properties of states implicating default-mode network, parietal, and visual regions, reflecting a shift in the predominance from externally to internally-oriented attentional modes. We investigated these dynamics at a finer sub-network resolution, showing a CD-specific and highly selective enhancement of connectivity between the insula and medial prefrontal cortex (mPFC), regions implicated in cognitive-interoceptive appraisal mechanisms. Alongside overall higher anxiety scores in CD, we also provide preliminary support to suggest that the strength of chronic interoceptive hyper-signalling in the brain co-occurs with disease duration. Together, our results demonstrate that a long-standing diagnosis of CD is, in itself, a key factor in determining the risk of developing altered brain network signatures.
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Affiliation(s)
- Caitlin V. Hall
- Clinical Brain Networks Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Graham Radford-Smith
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Gut Health Research Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Department of Gastroenterology, Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia
| | - Emma Savage
- Clinical Brain Networks Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Conor Robinson
- Clinical Brain Networks Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Luca Cocchi
- Clinical Brain Networks Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Rosalyn J. Moran
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, United Kingdom
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Rolls A. Immunoception: the insular cortex perspective. Cell Mol Immunol 2023; 20:1270-1276. [PMID: 37386172 PMCID: PMC10616063 DOI: 10.1038/s41423-023-01051-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 05/29/2023] [Indexed: 07/01/2023] Open
Abstract
To define the systemic neuroimmune interactions in health and disease, we recently suggested immunoception as a term that refers to the existence of bidirectional functional loops between the brain and the immune system. This concept suggests that the brain constantly monitors changes in immune activity and, in turn, can regulate the immune system to generate a physiologically synchronized response. Therefore, the brain has to represent information regarding the state of the immune system, which can occure in multiple ways. One such representation is an immunengram, a trace that is partially stored by neurons and partially by the local tissue. This review will discuss our current understanding of immunoception and immunengrams, focusing on their manifestation in a specific brain region, the insular cortex (IC).
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Affiliation(s)
- Asya Rolls
- Department of Immunology, Department of Neuroscience, Technion, Israel Institute of Technology, Haifa, Israel.
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Vinni E, Karaivazoglou K, Tourkochristou E, Tsounis E, Kalogeropoulou M, Konstantopoulou G, Lourida T, Kafentzi T, Lampropoulou E, Rodi M, Aggeletopoulou I, Diamantopoulou G, Theocharis G, Thomopoulos K, Gourzis P, Mouzaki A, Triantos C. Alexithymic characteristics and interoceptive abilities are associated with disease severity and levels of C-reactive protein and cytokines in patients with inflammatory bowel disease. Ann Gastroenterol 2023; 36:412-422. [PMID: 37396003 PMCID: PMC10304527 DOI: 10.20524/aog.2023.0813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 05/12/2023] [Indexed: 07/04/2023] Open
Abstract
Background Alexithymia and atypical gut-brain signaling have been linked to the pathophysiology of inflammatory bowel disease (IBD). We herein assessed IBD patients' alexithymia levels and interoceptive abilities, and detected potential correlations with psychological distress, symptom severity and disease activity, and inflammation indices. Methods Adult IBD outpatients and healthy controls were recruited. Alexithymia was assessed using the Toronto Alexithymia Scale, interoceptive accuracy using the Heartbeat Counting Test (cardiac interoception) and the Water Load Test-II (gastric interoception), and interoceptive sensibility using the Multidimensional Assessment of Interoceptive Awareness (MAIA). Results Forty-one patients with Crohn's disease (CD), 16 with ulcerative colitis (UC), and 50 healthy controls were included. In CD patients, the level of externally oriented thinking and total alexithymia score were correlated with disease activity (P=0.027 and P=0.047, respectively), while in UC patients difficulties in identifying emotions were linked to disease activity (P=0.007). In CD patients, the Noticing, Not-Worrying and Emotional Awareness MAIA subscale score were correlated with C-reactive protein levels (P=0.005, P=0.048 and P=0.005), the Noticing subscale score with interleukin (IL)-1β levels (r=-0.350, P=0.039), the Not-Distracting subscale score with IL-6 levels (r=-0.402, P=0.017), and the Emotional Awareness subscale score with IL-1β (r=-0.367, P=0.030) and IL-6 (r=-0.379, P=0.025) levels. Finally, in UC patients, the Not-Worrying subscale score was significantly associated with IL-6 levels (r=-0.532, P=0.049), while difficulties in identifying emotions were linked to IL-8 levels (r=0.604, P=0.022). Conclusion Emotional and interoceptive processing is associated with IBD disease activity, suggesting a potential implication for IBD pathophysiology.
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Affiliation(s)
- Eleni Vinni
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Katerina Karaivazoglou
- Department of Psychiatry (Katerina Karaivazoglou, Maria Kalogeropoulou, Georgia Konstantopoulou, Philippos Gourzis)
| | - Evanthia Tourkochristou
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Efthymios Tsounis
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Maria Kalogeropoulou
- Department of Psychiatry (Katerina Karaivazoglou, Maria Kalogeropoulou, Georgia Konstantopoulou, Philippos Gourzis)
| | - Georgia Konstantopoulou
- Department of Psychiatry (Katerina Karaivazoglou, Maria Kalogeropoulou, Georgia Konstantopoulou, Philippos Gourzis)
| | - Theoni Lourida
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Theodora Kafentzi
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Efi Lampropoulou
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Maria Rodi
- Division of Hematology, Department of Internal Medicine, Medical School (Maria Rodi, Ioanna Aggeletopoulou, Athanasia Mouzaki), University of Patras, Greece
| | - Ioanna Aggeletopoulou
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
- Division of Hematology, Department of Internal Medicine, Medical School (Maria Rodi, Ioanna Aggeletopoulou, Athanasia Mouzaki), University of Patras, Greece
| | - Georgia Diamantopoulou
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Georgios Theocharis
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Konstantinos Thomopoulos
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
| | - Philippos Gourzis
- Department of Psychiatry (Katerina Karaivazoglou, Maria Kalogeropoulou, Georgia Konstantopoulou, Philippos Gourzis)
| | - Athanasia Mouzaki
- Division of Hematology, Department of Internal Medicine, Medical School (Maria Rodi, Ioanna Aggeletopoulou, Athanasia Mouzaki), University of Patras, Greece
| | - Christos Triantos
- Division of Gastroenterology, Department of Internal Medicine (Eleni Vinni, Evanthia Tourkochristou, Efthymios Tsounis, Theoni Lourida, Theodora Kafentzi, Efi Lampropoulou, Ioanna Aggeletopoulou, Georgia Diamantopoulou, Georgios Theocharis, Konstantinos Thomopoulos, Christos Triantos)
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Kamp KJ, Morgan H, Yoo L, Munson SA, Heitkemper MM, Levy RL. Symptom management needs of patients with irritable bowel syndrome and concurrent anxiety and/or depression: A qualitative study. J Adv Nurs 2023; 79:775-788. [PMID: 36511394 PMCID: PMC9877173 DOI: 10.1111/jan.15532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 11/09/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022]
Abstract
AIMS To understand the experiences and needs of symptom management among individuals with irritable bowel syndrome and concurrent symptoms of anxiety and/or depression. DESIGN This study used a qualitative descriptive research design. METHODS Individuals with a diagnosis of irritable bowel syndrome and concurrent symptoms of anxiety and/or depression participated were recruited through an online ResearchMatch and a listserv. Semi-structured interviews focused on symptoms and experiences with symptom management interventions conducted from June to August 2020. Interviews were transcribed and data were analysed based on thematic analysis. RESULTS Twelve individuals participated in this study; all reported current irritable bowel syndrome and anxiety/depression symptoms. The data analysis cumulated with three themes related to symptom management: (a) irritable bowel syndrome negatively impacts physical and mental well-being; (b) a trial and error approach to symptom management; and (c) challenges with healthcare professionals supporting symptom management including negative interactions with healthcare professionals and lack of nutritional expertize and support. CONCLUSION There is a need for individualized approaches which consider patients' current symptoms of anxiety and depression, previous experiences with the trial-and-error process and consideration for intervention delivery methods. IMPACT There is a limited qualitative research focusing on the experiences of individuals with irritable bowel syndrome and concurrent symptoms of anxiety and/or depression. This research highlights the need for individualized approaches to enhance symptom management that acknowledges patients' psychological state and past negative experiences with providers and prior dietary regimens.
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Affiliation(s)
- Kendra J. Kamp
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington, USA
| | | | - Linda Yoo
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington, USA
| | - Sean A. Munson
- Department of Human Centered Design & Engineering, University of Washington, Seattle, Washington, USA
| | - Margaret M. Heitkemper
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington, USA
| | - Rona L. Levy
- School of Social Work, University of Washington, Seattle, Washington, USA
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Waikhom L, Patgiri R. A survey of graph neural networks in various learning paradigms: methods, applications, and challenges. Artif Intell Rev 2022. [DOI: 10.1007/s10462-022-10321-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Zhang S, Xu X, Li Q, Chen J, Liu S, Zhao W, Cai H, Zhu J, Yu Y. Brain Network Topology and Structural–Functional Connectivity Coupling Mediate the Association Between Gut Microbiota and Cognition. Front Neurosci 2022; 16:814477. [PMID: 35422686 PMCID: PMC9002058 DOI: 10.3389/fnins.2022.814477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
Increasing evidence indicates that gut microbiota can influence cognition via the gut–brain axis, and brain networks play a critical role during the process. However, little is known about how brain network topology and structural–functional connectivity (SC–FC) coupling contribute to gut microbiota-related cognition. Fecal samples were collected from 157 healthy young adults, and 16S amplicon sequencing was used to assess gut diversity and enterotypes. Topological properties of brain structural and functional networks were acquired by diffusion tensor imaging (DTI) and resting-state functional magnetic resonance imaging (fMRI data), and SC–FC coupling was further calculated. 3-Back, digit span, and Go/No-Go tasks were employed to assess cognition. Then, we tested for potential associations between gut microbiota, complex brain networks, and cognition. The results showed that gut microbiota could affect the global and regional topological properties of structural networks as well as node properties of functional networks. It is worthy of note that causal mediation analysis further validated that gut microbial diversity and enterotypes indirectly influence cognitive performance by mediating the small-worldness (Gamma and Sigma) of structural networks and some nodal metrics of functional networks (mainly distributed in the cingulate gyri and temporal lobe). Moreover, gut microbes could affect the degree of SC–FC coupling in the inferior occipital gyrus, fusiform gyrus, and medial superior frontal gyrus, which in turn influence cognition. Our findings revealed novel insights, which are essential to provide the foundation for previously unexplored network mechanisms in understanding cognitive impairment, particularly with respect to how brain connectivity participates in the complex crosstalk between gut microbiota and cognition.
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Affiliation(s)
- Shujun Zhang
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Xiaotao Xu
- Department of Radiology, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Qian Li
- Department of Radiology, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Jingyao Chen
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Siyu Liu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Wenming Zhao
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Huanhuan Cai
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
| | - Jiajia Zhu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
- *Correspondence: Jiajia Zhu,
| | - Yongqiang Yu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center of Clinical Medical Imaging, Hefei, China
- Anhui Provincial Institute of Translational Medicine, Hefei, China
- Department of Radiology, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Radiology, Chaohu Hospital of Anhui Medical University, Hefei, China
- Yongqiang Yu,
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9
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Wang H, Labus JS, Griffin F, Gupta A, Bhatt RR, Sauk JS, Turkiewicz J, Bernstein CN, Kornelsen J, Mayer EA. Functional brain rewiring and altered cortical stability in ulcerative colitis. Mol Psychiatry 2022; 27:1792-1804. [PMID: 35046525 PMCID: PMC9095465 DOI: 10.1038/s41380-021-01421-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 12/04/2021] [Accepted: 12/08/2021] [Indexed: 12/12/2022]
Abstract
Despite recent advances, there is still a major need to better understand the interactions between brain function and chronic gut inflammation and its clinical implications. Alterations in executive function have previously been identified in several chronic inflammatory conditions, including inflammatory bowel diseases. Inflammation-associated brain alterations can be captured by connectome analysis. Here, we used the resting-state fMRI data from 222 participants comprising three groups (ulcerative colitis (UC), irritable bowel syndrome (IBS), and healthy controls (HC), N = 74 each) to investigate the alterations in functional brain wiring and cortical stability in UC compared to the two control groups and identify possible correlations of these alterations with clinical parameters. Globally, UC participants showed increased functional connectivity and decreased modularity compared to IBS and HC groups. Regionally, UC showed decreased eigenvector centrality in the executive control network (UC < IBS < HC) and increased eigenvector centrality in the visual network (UC > IBS > HC). UC also showed increased connectivity in dorsal attention, somatomotor network, and visual networks, and these enhanced subnetwork connectivities were able to distinguish UC participants from HCs and IBS with high accuracy. Dynamic functional connectome analysis revealed that UC showed enhanced cortical stability in the medial prefrontal cortex (mPFC), which correlated with severe depression and anxiety-related measures. None of the observed brain changes were correlated with disease duration. Together, these findings are consistent with compromised functioning of networks involved in executive function and sensory integration in UC.
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Affiliation(s)
- Hao Wang
- grid.19006.3e0000 0000 9632 6718G. Oppenheimer Center for Neurobiology of Stress & Resilience, UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-7378 USA ,grid.54549.390000 0004 0369 4060Institute of Fundamental and Frontier Sciences, University of Electronic Science and Technology of China, Chengdu, 611731 P. R. China
| | - Jennifer S. Labus
- grid.19006.3e0000 0000 9632 6718G. Oppenheimer Center for Neurobiology of Stress & Resilience, UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-7378 USA
| | - Fiona Griffin
- grid.19006.3e0000 0000 9632 6718G. Oppenheimer Center for Neurobiology of Stress & Resilience, UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-7378 USA
| | - Arpana Gupta
- grid.19006.3e0000 0000 9632 6718G. Oppenheimer Center for Neurobiology of Stress & Resilience, UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-7378 USA
| | - Ravi R. Bhatt
- grid.42505.360000 0001 2156 6853Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School Medicine at USC, University of Southern California, 4676 Admiralty Way, Marina Del Rey, CA 90292 USA
| | - Jenny S. Sauk
- grid.19006.3e0000 0000 9632 6718G. Oppenheimer Center for Neurobiology of Stress & Resilience, UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-7378 USA
| | - Joanna Turkiewicz
- grid.266093.80000 0001 0668 7243University of California, Irvine School of Medicine, Irvine, CA 92697 USA
| | - Charles N. Bernstein
- grid.21613.370000 0004 1936 9609University of Manitoba IBD Clinical and Research Centre, Department of Internal Medicine, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Jennifer Kornelsen
- grid.21613.370000 0004 1936 9609University of Manitoba IBD Clinical and Research Centre, Department of Internal Medicine, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Emeran A. Mayer
- grid.19006.3e0000 0000 9632 6718G. Oppenheimer Center for Neurobiology of Stress & Resilience, UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-7378 USA
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10
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Grinsvall C, Van Oudenhove L, Dupont P, Ryu HJ, Ljungberg M, Labus JS, Törnblom H, Mayer EA, Simrén M. Altered Structural Covariance of Insula, Cerebellum and Prefrontal Cortex Is Associated with Somatic Symptom Levels in Irritable Bowel Syndrome (IBS). Brain Sci 2021; 11:1580. [PMID: 34942882 DOI: 10.3390/brainsci11121580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/18/2021] [Accepted: 11/27/2021] [Indexed: 11/29/2022] Open
Abstract
Somatization, defined as the presence of multiple somatic symptoms, frequently occurs in irritable bowel syndrome (IBS) and may constitute the clinical manifestation of a neurobiological sensitization process. Brain imaging data was acquired with T1 weighted 3 tesla MRI, and gray matter morphometry were analyzed using FreeSurfer. We investigated differences in networks of structural covariance, based on graph analysis, between regional gray matter volumes in IBS-related brain regions between IBS patients with high and low somatization levels, and compared them to healthy controls (HCs). When comparing IBS low somatization (N = 31), IBS high somatization (N = 35), and HCs (N = 31), we found: (1) higher centrality and neighbourhood connectivity of prefrontal cortex subregions in IBS high somatization compared to healthy controls; (2) higher centrality of left cerebellum in IBS low somatization compared to both IBS high somatization and healthy controls; (3) higher centrality of the anterior insula in healthy controls compared to both IBS groups, and in IBS low compared to IBS high somatization. The altered structural covariance of prefrontal cortex and anterior insula in IBS high somatization implicates that prefrontal processes may be more important than insular in the neurobiological sensitization process associated with IBS high somatization.
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11
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Koren T, Yifa R, Amer M, Krot M, Boshnak N, Ben-Shaanan TL, Azulay-Debby H, Zalayat I, Avishai E, Hajjo H, Schiller M, Haykin H, Korin B, Farfara D, Hakim F, Kobiler O, Rosenblum K, Rolls A. Insular cortex neurons encode and retrieve specific immune responses. Cell 2021; 184:5902-5915.e17. [PMID: 34752731 DOI: 10.1016/j.cell.2021.10.013] [Citation(s) in RCA: 103] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 09/05/2021] [Accepted: 10/12/2021] [Indexed: 02/07/2023]
Abstract
Increasing evidence indicates that the brain regulates peripheral immunity, yet whether and how the brain represents the state of the immune system remains unclear. Here, we show that the brain's insular cortex (InsCtx) stores immune-related information. Using activity-dependent cell labeling in mice (FosTRAP), we captured neuronal ensembles in the InsCtx that were active under two different inflammatory conditions (dextran sulfate sodium [DSS]-induced colitis and zymosan-induced peritonitis). Chemogenetic reactivation of these neuronal ensembles was sufficient to broadly retrieve the inflammatory state under which these neurons were captured. Thus, we show that the brain can store and retrieve specific immune responses, extending the classical concept of immunological memory to neuronal representations of inflammatory information.
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Affiliation(s)
- Tamar Koren
- Department of Immunology, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel; Department of Neuroscience, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Re'ee Yifa
- Department of Immunology, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel; Department of Neuroscience, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Mariam Amer
- Department of Immunology, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel; Department of Neuroscience, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Maria Krot
- Department of Immunology, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel; Department of Neuroscience, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Nadia Boshnak
- Department of Immunology, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel; Department of Neuroscience, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Tamar L Ben-Shaanan
- Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA, USA; Howard Hughes Medical Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Hilla Azulay-Debby
- Department of Immunology, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel; Department of Neuroscience, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Itay Zalayat
- Department of Immunology, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel; Department of Neuroscience, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Eden Avishai
- Department of Immunology, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel; Department of Neuroscience, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Haitham Hajjo
- Department of Immunology, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel; Department of Neuroscience, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Maya Schiller
- Department of Immunology, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel; Department of Neuroscience, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Hedva Haykin
- Department of Immunology, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel; Department of Neuroscience, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Ben Korin
- Department of Research Biology, Genentech, South San Francisco, CA, USA
| | - Dorit Farfara
- Department of Immunology, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel; Department of Neuroscience, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Fahed Hakim
- Pediatric Pulmonary Unit, Rambam Health Care Campus, Haifa, Israel; Cancer Research Center, EMMS Hospital, Nazareth, Israel
| | - Oren Kobiler
- Sackler School of Medicine, Tel Aviv University, Israel
| | - Kobi Rosenblum
- Sagol Department of Neurobiology, University of Haifa, Haifa, Israel; Center for Gene Manipulation in the Brain, University of Haifa, Haifa, Israel
| | - Asya Rolls
- Department of Immunology, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel; Department of Neuroscience, Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
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12
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Öhlmann H, Koenen LR, Labrenz F, Engler H, Theysohn N, Langhorst J, Elsenbruch S. Altered Brain Structure in Chronic Visceral Pain: Specific Differences in Gray Matter Volume and Associations With Visceral Symptoms and Chronic Stress. Front Neurol 2021; 12:733035. [PMID: 34744973 PMCID: PMC8564184 DOI: 10.3389/fneur.2021.733035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/21/2021] [Indexed: 12/12/2022] Open
Abstract
Structural brain alterations in chronic pain conditions remain incompletely understood, especially in chronic visceral pain. Patients with chronic-inflammatory or functional bowel disorders experience recurring abdominal pain in concert with other gastrointestinal symptoms, such as altered bowel habits, which are often exacerbated by stress. Despite growing interest in the gut-brain axis and its underlying neural mechanisms in health and disease, abnormal brain morphology and possible associations with visceral symptom severity and chronic stress remain unclear. We accomplished parallelized whole-brain voxel-based morphometry analyses in two patient cohorts with chronic visceral pain, i.e., ulcerative colitis in remission and irritable bowel syndrome, and healthy individuals. In addition to analyzing changes in gray matter volume (GMV) in each patient cohort vs. age-matched healthy controls using analysis of covariance (ANCOVA), multiple regression analyses were conducted to assess correlations between GMV and symptom severity and chronic stress, respectively. ANCOVA revealed reduced GMV in frontal cortex and anterior insula in ulcerative colitis compared to healthy controls, suggesting alterations in the central autonomic and salience networks, which could however not be confirmed in supplemental analyses which rigorously accounted for group differences in the distribution of sex. In irritable bowel syndrome, more widespread differences from healthy controls were observed, comprising both decreased and increased GMV within the sensorimotor, central executive and default mode networks. Associations between visceral symptoms and GMV within frontal regions were altered in both patient groups, supporting a role of the central executive network across visceral pain conditions. Correlations with chronic stress, on the other hand, were only found for irritable bowel syndrome, encompassing numerous brain regions and networks. Together, these findings complement and expand existing brain imaging evidence in chronic visceral pain, supporting partly distinct alterations in brain morphology in patients with chronic-inflammatory and functional bowel disorders despite considerable overlap in symptoms and comorbidities. First evidence pointing to correlations with chronic stress in irritable bowel syndrome inspires future translational studies to elucidate the mechanisms underlying the interconnections of stress, visceral pain and neural mechanisms of the gut-brain axis.
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Affiliation(s)
- Hanna Öhlmann
- Department of Medical Psychology and Medical Sociology, Ruhr University Bochum, Bochum, Germany
| | - Laura Ricarda Koenen
- Institute of Medical Psychology and Behavioral Immunobiology, Center for Translational Neuro-and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Franziska Labrenz
- Department of Medical Psychology and Medical Sociology, Ruhr University Bochum, Bochum, Germany
| | - Harald Engler
- Institute of Medical Psychology and Behavioral Immunobiology, Center for Translational Neuro-and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Nina Theysohn
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Jost Langhorst
- Department for Internal and Integrative Medicine, Sozialstiftung Bamberg, Bamberg, Germany.,Department for Integrative Medicine, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Sigrid Elsenbruch
- Department of Medical Psychology and Medical Sociology, Ruhr University Bochum, Bochum, Germany.,Department of Neurology, Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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13
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Neudorf J, Kress S, Borowsky R. Structure can predict function in the human brain: a graph neural network deep learning model of functional connectivity and centrality based on structural connectivity. Brain Struct Funct 2021; 227:331-343. [PMID: 34633514 PMCID: PMC8741721 DOI: 10.1007/s00429-021-02403-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 09/30/2021] [Indexed: 02/07/2023]
Abstract
Although functional connectivity and associated graph theory measures (e.g., centrality; how centrally important to the network a region is) are widely used in brain research, the full extent to which these functional measures are related to the underlying structural connectivity is not yet fully understood. Graph neural network deep learning methods have not yet been applied for this purpose, and offer an ideal model architecture for working with connectivity data given their ability to capture and maintain inherent network structure. Here, we applied this model to predict functional connectivity from structural connectivity in a sample of 998 participants from the Human Connectome Project. Our results showed that the graph neural network accounted for 89% of the variance in mean functional connectivity, 56% of the variance in individual-level functional connectivity, 99% of the variance in mean functional centrality, and 81% of the variance in individual-level functional centrality. These results represent an important finding that functional centrality can be robustly predicted from structural connectivity. Regions of particular importance to the model's performance as determined through lesioning are discussed, whereby regions with higher centrality have a higher impact on model performance. Future research on models of patient, demographic, or behavioural data can also benefit from this graph neural network method as it is ideally-suited for depicting connectivity and centrality in brain networks. These results have set a new benchmark for prediction of functional connectivity from structural connectivity, and models like this may ultimately lead to a way to predict functional connectivity in individuals who are unable to do fMRI tasks (e.g., non-responsive patients).
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Affiliation(s)
- Josh Neudorf
- Cognitive Neuroscience Lab, Department of Psychology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Shaylyn Kress
- Cognitive Neuroscience Lab, Department of Psychology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Ron Borowsky
- Cognitive Neuroscience Lab, Department of Psychology, University of Saskatchewan, Saskatoon, SK, Canada.
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14
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Faghih M, Drewes AM, Singh VK. Psychiatric Disease Susceptibility and Pain in Chronic Pancreatitis: Association or Causation? Am J Gastroenterol 2021; 116:2026-8. [PMID: 34459451 DOI: 10.14309/ajg.0000000000001491] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 08/04/2021] [Indexed: 12/11/2022]
Abstract
Pain perception in chronic pancreatitis (CP) is governed by the transmission of nociceptive inputs into the pain processing centers of the brain. These regions of the brain overlap with those that regulate and process emotions and cognition. Disorders in these regions also result in psychiatric conditions such as depression, anxiety, and posttraumatic stress disorder. The present study by Dunbar et al. evaluated 24 single nucleotide polymorphisms associated with anxiety and/or posttraumatic stress disorder and found correlations with constant and severe pain phenotypes in CP patients from a large cross-sectional cohort study. Although causation cannot be proven, the findings suggest that there may be a role for neuromodulator drugs for the treatment of pain in CP based on individual genetic susceptibility.
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15
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Engel F, Berens S, Gauss A, Schaefert R, Eich W, Tesarz J. Higher Levels of Psychological Burden and Alterations in Personality Functioning in Crohn's Disease and Ulcerative Colitis. Front Psychol 2021; 12:671493. [PMID: 34248767 PMCID: PMC8264053 DOI: 10.3389/fpsyg.2021.671493] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/03/2021] [Indexed: 12/19/2022] Open
Abstract
Aims: Is there evidence for increased psychological distress and alterations in personality functioning in patients with Crohn’s disease (CD) and ulcerative colitis (UC) compared to healthy controls (HCs)? Background: In patients with CD and UC, perceived stress is closely associated with changes in disease activity. The stress response is influenced by psychological burden and personality functioning, but only little is known about these factors in inflammatory bowel diseases (IBD). Study: A total of 62 patients with an endoscopic ensured CD/UC without remission (n = 31 per group) and 31 HC were included. Patients with an active CD/UC and HC were individually matched (n = 93, 31 per group) for age, sex, education, and disease activity. Depression and anxiety were assessed to evaluate the effect of psychological burden (Patient Health Questionnaire-9/PHQ-9, Generalized Anxiety Disorder-7/GAD-7). Personality functioning was measured by validated questionnaires for psychodynamic structural characteristics, mentalization, and attachment (Operationalized Psychodynamic Diagnosis-Structure Questionnaire/OPD-SQ, Mentalization Questionnaire/MZQ, and Experiences in Close Relationships scale/ECR-RD 12). Results: Levels of depression and anxiety were higher in CD/UC patients than in HC with large effect sizes. Comparing personality functioning in CD/UC with HC, psychodynamic structural characteristics differed between CD/UC and HC with medium effect sizes, with structural differences occurring primarily in the domain of self-perception and regulation. Only minor differences were found regarding mentalization and attachment. CD and UC differed only with small effect sizes. Conclusion: Our data show that compared to HC, patients with CD/UC are characterized by a higher level of psychological burden and structural alterations in the domain of self.
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Affiliation(s)
- Felicitas Engel
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Sabrina Berens
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany.,Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | - Annika Gauss
- Department of Gastroenterology and Hepatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Rainer Schaefert
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany.,Division of Internal Medicine, Department of Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Wolfgang Eich
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Jonas Tesarz
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
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