Functional brain rewiring and altered cortical stability in ulcerative colitis

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.

Psychological stress in inflammatory bowel disease: Psychoneuroimmunological insights into bidirectional gut–brain communications

“…Meanwhile, the researchers also found that the hippocampal nerve activity is increased with IBD in the active phase compared with those in remission ( 168 ). Additionally, a dynamic brain functional connectome analysis using fMRI has revealed medial prefrontal cortex dysfunction, which is involved in the deterioration of depression and anxiety in patients with UC ( 169 ). Those studies provide a promising perspective and convincing neuroimaging evidence of potential neuromechanisms of UC.…”

Inflammatory bowel diseases, interleukin-6 and interleukin-6 receptor subunit alpha in causal association with cerebral cortical structure: a Mendelian randomization analysis

“…In addition to functional changes, organism changes in the brain have been observed in patients with IBDs. Wang et al found that UC participants showed enhanced cortical stability in the medial prefrontal cortex (mPFC), which correlated with severe depression and anxietyrelated measures (39). Bernstein et al cortically mapped visceral pain in patients with gastrointestinal disorders by functional MRI and identified specific areas of activation (40).…”

“…Wang et al. found that UC participants showed enhanced cortical stability in the medial prefrontal cortex (mPFC), which correlated with severe depression and anxiety-related measures ( 39 ). Bernstein et al.…”

Symptom-associated alterations in functional connectivity in primary and secondary provoked vestibulodynia

“…64 Similar increases in connectivity between the dorsal attention network and the somatomotor and occipital/visual network have been reported in irritable bowel syndrome and ulcerative colitis. 94 Functional alterations in the occipital network have also been reported in patients with chronic inflammation and those with chronic pain symptoms, including migraine, chronic low back pain, and fibromyalgia. 53,63,82,94 These alterations involving the occipital network are believed to reflect compromised central processing and modulation of nonpainful multisensory signals and may be a shared central mechanism across chronic pain disorders.…”