Background & Aims
5-HT3 receptor (5-HT3R) antagonists are effective in treating patients with irritable bowel syndrome (IBS) and have anxiolytic effects. Their therapeutic effects are related, in part, to reducing amygdala engagement during expected visceral pain. A single nucleotide polymorphism (SNP) in HTR3A, c.-42C>T;(C178T; rs1062613), is associated with altered reactivity of the amygdala during emotional face processing in healthy subjects (controls). We evaluated the influence of this SNP on amygdala reactivity to emotional faces and non-emotional stimuli in female patients with IBS and controls.
Methods
We measured brain responses during an affect-matching paradigm in 54 women (26 with IBS, 29 controls) using functional magnetic resonance imaging. We examined associations between HTR3A c.-42C>T genotype (C/C vs. T carrier) and responses in amygdala and other regions of brain that expressed high levels of 5-HT3R.
Results
The C/C genotype was associated with greater anxiety symptoms in patients with IBS and controls and increased activation of the amygdala under emotional and non-emotional conditions. Among patients with IBS, the C/C genotype was associated with greater symptom ratings; a subset of IBS patients with the C/C genotype had increased amygdala responses to non-emotional stimuli, compared to other subjects with C/C genotype.
Conclusions
Regardless of diagnosis, the C/C genotype of the c.-42C>T polymorphism in HTR3A, compared to T carrier status, is associated with increased anxiety and amygdala responsiveness during emotional and non-emotional tasks. This polymorphism was associated with severity of IBS symptoms. Although this genotype is not sufficient for diagnosis of IBS, it is associated with severity of symptoms.