Association between pain sensitivity and gray matter properties in the sensorimotor network in women with irritable bowel syndrome

Grinsvall, Cecilia; Ryu, Hyo Jin; Oudenhove, Lukas Van; Labus, Jennifer S.; Gupta, Abha R.; Ljungberg, Maria; Törnblom, Hans; Mayer, Emeran A.; Simrén, Magnus

doi:10.1111/nmo.14027

Cited by 13 publications

(13 citation statements)

References 59 publications

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“…The postcentral gyrus is a key component of sensorimotor network and contributes to the process of visceral stimulation. The cortical thickness of primary somatosensory cortex was associated with pain intensity in female irritable bowel syndrome (IBS) patients ( Grinsvall et al, 2021 ). Previous studies have reported aberrant activity and function of sensorimotor network in functional GI disorders ( Mayer et al, 2009 ; Duan et al, 2021 ; Liu G. et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Altered Brain Functional Asymmetry in Patients With Major Depressive Disorder Related to Gastrointestinal Symptoms

Ding

Chen

et al. 2022

Front. Neurosci.

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ObjectiveDisrupted brain functional asymmetry has been reported in major depressive disorder (MDD). The comorbidity may be a crucial factor to this functional asymmetry. It is quite common that gastrointestinal (GI) symptoms are comorbid with MDD, but limited evidence focuses on the effect of GI comorbidity on the neuropathology of MDD from a functional lateralization perspective.MethodsResting-state functional magnetic resonance imaging was obtained in 28 healthy controls (HCs), 35 MDD patients with GI symptoms (GI-MDD patients), and 17 patients with MDD without GI symptoms (nGI-MDD patients). The parameter of asymmetry (PAS) was used to analyze the imaging data and evaluate the changes of functional asymmetry.ResultsThe GI-MDD patients showed increased PAS scores in the left inferior frontal gyrus (IFG) and superior medial prefrontal cortex (MPFC) and decreased PAS scores in the right postcentral gyrus in comparison with nGI-MDD patients. The PAS scores of the left IFG and left superior MPFC were correlated with the severity of GI problems and could be applied to distinguish GI-MDD patients from nGI-MDD patients with an accuracy, a sensitivity, and a specificity of 92.31, 100, and 76.47%, respectively. Furthermore, GI-MDD and nGI-MDD patients both displayed increased PAS scores in the PCC/precuneus.ConclusionsThis study revealed the influence of concomitant GI symptoms on functional asymmetry in MDD patients. Increased PAS scores of the left IFG and superior MPFC might represent an unbalanced regulation of brain over GI function and had the potential to be regarded as distinctive features related to functional GI symptoms in MDD.

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Section: Discussionmentioning

confidence: 99%

Altered Brain Functional Asymmetry in Patients With Major Depressive Disorder Related to Gastrointestinal Symptoms

Ding

Chen

et al. 2022

Front. Neurosci.

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“…38 Visceral sensitivity was associated with regional grey matter differences in the sensorimotor network in female patients with IBS, using anatomical measures of structural MRI, which the authors speculated may represent neuroplastic changes. 39 Whereas central sensitisation was common in IBS, this was more pain specific rather than global sensitivity in a questionnaire based study. 40 However, in another study hypersensitive patients with IBS were characterised by increased perception of both pain and non-painful sensations.…”

Section: Painementioning

confidence: 92%

Review article: current and future treatment approaches for pain in IBS

Paine

2021

Aliment Pharmacol Ther

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SummaryBackgroundAbdominal pain is a core symptom of IBS and a primary driver of care seeking. Visceral hypersensitivity is a key pathophysiological mechanism and therapeutic target for pain in IBS, with components of peripheral and central sensitisation and psychological factors.AimTo review current and future treatment approaches specifically for the pain component of IBS.MethodsPubmed search terms included combinations of irritable bowel, pain, visceral hypersensitivity, novel, new, emerging, future and advances.ResultsEstablished non‐pharmacological treatments for IBS pain include the low FODMAP diet, probiotics and psychological interventions, especially hypnotherapy. Tricyclics remain the best evidenced pharmacological approach with GCC agonists, tenapanor, lubiprostone, eluxadoline and 5HT3 antagonists second line according to patient characteristics and availability. Less well‐evidenced current options include anti‐spasmodics, peppermint oil, SSRIs, SNRIs, alpha 2 delta ligands, melatonin and histamine antagonists. Patients are vulnerable to iatrogenesis and harmful approaches to be avoided include opioids and unwarranted surgical interventions. For severe pain, the concept of augmentation with combined gut‐brain neuromodulators and psychotherapy in a multi‐disciplinary setting is considered. A plethora of molecular targets and ligands are emerging from pre‐clinical studies, together with early clinical evidence for a range of pharmacological, dietary, neurostimulation and novel psychological treatment delivery methods which are reviewed. The history of such emerging approaches, however, merits both caution and optimism in equal measure.ConclusionsDespite good in‐roads and emerging options, the management of abdominal pain remains one of the biggest challenges and research priorities for patients with IBS.

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“…The work in this article have been carried out in accordance with The Code of Ethics of the World Medical Association (Declaration of Helsinki). This study population has also been used to study resting state fMRI connectivity [30], and associations between regional gray matter metrics with visceral sensitivity measures [31].…”

Section: Subjectsmentioning

confidence: 99%

Altered Structural Covariance of Insula, Cerebellum and Prefrontal Cortex Is Associated with Somatic Symptom Levels in Irritable Bowel Syndrome (IBS)

et al. 2021

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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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Association between pain sensitivity and gray matter properties in the sensorimotor network in women with irritable bowel syndrome

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 13 publications

References 59 publications

Altered Brain Functional Asymmetry in Patients With Major Depressive Disorder Related to Gastrointestinal Symptoms

Altered Brain Functional Asymmetry in Patients With Major Depressive Disorder Related to Gastrointestinal Symptoms

Review article: current and future treatment approaches for pain in IBS

Altered Structural Covariance of Insula, Cerebellum and Prefrontal Cortex Is Associated with Somatic Symptom Levels in Irritable Bowel Syndrome (IBS)

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