Asymptomatic Brain Lesions on Cranial Magnetic Resonance Imaging in Inflammatory Bowel Disease

Dolapcioglu, Can; Guleryuzlu, Yuksel; Uygur-Bayramiçli, Oya; Ahıshalı, Emel; Dabak, Reşat

doi:10.5009/gnl.2013.7.2.169

Cited by 13 publications

(11 citation statements)

References 22 publications

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“…IBD are a very heterogeneous group of disorders, and even patients with the same diagnosis can have very different disease courses and characteristics. Nonetheless, some previous studies have analyzed data from patients with different diagnoses in a combined IBD group . We sought to avoid some of this potential bias by choosing a rather homogenous cohort by excluding patients with ulcerative or indeterminate colitis and including only CD patients with a mild disease course in stable remission without prior exposure to biological agents.…”

Section: Discussionmentioning

confidence: 99%

Aberrant brain structural large‐scale connectome in Crohn’s disease

Thomann

Reindl

Wüstenberg

et al. 2019

Neurogastroenterology Motil

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Background Disturbed brain‐gut interactions and a bidirectional relationship between inflammation and psychiatric symptoms such as anxiety and depression are being discussed in patients with inflammatory bowel diseases (IBD). Alterations of brain structure and function in IBD have been reported with heterogeneous results. Whether these changes reflect independent localized deficits or rather a systematic disruption in the anatomical organization of large‐scale brain networks remains unclear. The present study investigated the gray matter structural connectome in patients with Crohn's disease (CD). Methods Sixty participants (30 with quiescent CD and 30 matched healthy controls [HC]) underwent high‐resolution brain MRI at 3 Tesla. Well‐established graph theoretical metrics were analyzed at the global and regional network level and compared between groups. Key Results The networks in both groups followed a small‐world organization, that is, an architecture that is simultaneously highly segregated and integrated. However, transitivity, a measure of global network segregation, was significantly reduced in patients (P = 0.003). Regionally, patients showed a reduction of nodal betweenness centrality in the right insula and cuneus and the left superior frontal cortex and reduced nodal degree within the left‐hemispheric cingulate and the left lateral and right medial orbitofrontal cortex. Conclusion and Inferences These findings lend support to the hypothesis that CD is accompanied by alterations in both global network organization and regional connectivity. A deeper understanding of neural central networks in IBD may facilitate the development of complementary strategies in the treatment of “extraintestinal” comorbid conditions such as depression or anxiety.

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Section: Discussionmentioning

confidence: 99%

Aberrant brain structural large‐scale connectome in Crohn’s disease

Thomann

Reindl

Wüstenberg

et al. 2019

Neurogastroenterology Motil

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“…However, there are no significant differences between UC and Crohn's disease patients with regard to magnetic resonance imaging (MRI) findings. In addition, the incidence of white matter lesions and other brain parenchymal lesions, sinusitis, and otitis-mastoiditis does not differ significantly with disease activity (P > 0.05 for all) [6] . Scheid et al [7] (2007) proposed the following three possible mechanisms for peripheral and central nervous system involvement in ulcerative colitis (UC): cerebrovascular conditions due to thromboembolic events, systemic and cerebral vasculitis, and neuropathy and cerebral demyelination due to immune-related mechanisms.…”

Section: Introductionmentioning

confidence: 99%

Psychiatric comorbidity in the treatment of patients with inflammatory bowel disease

Filipović¹,

Filipović²

2014

WJG

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Ulcerative colitis and Crohn's disease, commonly known as inflammatory bowel disease (IBD), draw attention from specialists of various disorders, including gastroenterology, psychiatry, and radiology. The involvement of a cortical influence in the brain-gut axis as well as the interaction of the hypothalamic-pituitary-adrenal axis and the peripheral nervous system provide an initial explanation of the psychological symptoms associated with IBD. The involvement of structures the limbic system, such as the anterior cingulate cortex, the prefrontal cortex, and the amygdala, paves the way for the discovery of the mechanisms underlying depression depression, anxiety, alexithymia, personality traits, and other psychological impairments following the onset of IBD. Psychiatric therapy in IBD patients is almost as important as the gastroenterological approach and consists of pharmacological treatment and psychotherapy. Neither of the available psychiatric treatment methods is considered the golden standard because both methods have side effects, and psychotropic medication can provoke the worsening of IBD symptoms. Thus, both approaches must be applied with awareness of the possibility of side effects. We suggest that psychiatrists and gastroenterologists work together to reach a consensus on IBD therapy to ensure success and to reduce side effects and relapse to the lowest possible rates.© 2014 Baishideng Publishing Group Co., Limited. All rights reserved.Key words: Inflammatory bowel disease; Psychiatry; Treatment; Personality traits; Depression; Anxiety Core tip: The involvement of a dysfunction of brain-gut interactions in the pathogenesis of inflammatory bowel disease (IBD) is represented by a dysfunction of the autonomic nervous system, an abnormal hypothalamicpituitary-adrenal axis and cholinergic anti-inflammatory pathway, a deleterious effect of stress and depression, an abnormal coupling of the prefrontal cortex-amygdaloid complex, and an abnormal relation between the microbiota and the brain as pro-inflammatory factors. New investigations have provided a critical link between forebrain changes and abdominal pain independent of active disease and drug treatment, providing a potential basis for an explanation of the psychological symptoms and brain influence in the pathogenesis of IBD.

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“…In a study made by Dolapcioglu et all including radiological findings in patients previously diagnosed with IBD and normal neurological examination showed mostly white matter lesions on cranial MRI. According to the same study the incidence of white matter lesions seemed to be similar in IBD patients and normal healthy individuals, and the lesions detected did not pose any clinical significance [8]. Our case previously diagnosed with İBH differs from other secondary CNS vasculitis, as the CNS involvement was showed by solely leptomeningeal enhancement.…”

Section: Discussionmentioning

confidence: 89%

Leptomeningeal Enhancement As A Sole Magnetic Resonance Imaging Finding of Secondary Central Nervous System Vasculitis: A Case Report

Bajrami¹,

Azman²,

Kara³

et al. 2016

Türk Beyin Damar Hast Derg

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The main radiological findings of central nervous system (CNS) consist of multiple subcortical infarcts, parenchymal and leptomeningeal enhancement, petechial hemorrhages on MRI and multifocal caliber changes of the vessels on MRA and DSA. Solely or prominent leptomeningeal enhancement is rarely seen as an isolated manifestation of CNS. We report a case of intracerebral vasculitis secondary to inflammatory bowel disease (IBD) showing leptomeningeal enhancement as a unique finding in routine contrast-enhanced cranial MRI and aimed to emphasize the importance of these finding in diagnosing CNS.

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Asymptomatic Brain Lesions on Cranial Magnetic Resonance Imaging in Inflammatory Bowel Disease

Cited by 13 publications

References 22 publications

Aberrant brain structural large‐scale connectome in Crohn’s disease

Aberrant brain structural large‐scale connectome in Crohn’s disease

Psychiatric comorbidity in the treatment of patients with inflammatory bowel disease

Leptomeningeal Enhancement As A Sole Magnetic Resonance Imaging Finding of Secondary Central Nervous System Vasculitis: A Case Report

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