Structural Imaging Changes and Behavioral Correlates in Patients with Crohn’s Disease in Remission

Nair, Veena A.; Beniwal-Patel, Poonam; Mbah, Ifeanyi; Young, Brittany M.; Prabhakaran, Vivek; Saha, Sumona

doi:10.3389/fnhum.2016.00460

Cited by 33 publications

(48 citation statements)

References 75 publications

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“…Our study suggests that brain white matter microstructural properties are significantly altered in CD patients. Our findings support the growing number of studies that have applied neuroimaging to examine the neural substrates impacted by the disease as well as its relationship to cognitive or affective processes 5 and disease duration 3,8,20 .…”

Section: Discussionsupporting

confidence: 81%

Alterations in brain white matter microstructural properties in patients with Crohn’s disease in remission

Hou

Dodd

Nair

et al. 2020

Sci Rep

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Patients with inflammatory bowel disease have been shown to have abnormal brain morphometry or function, which are associated with psychological symptoms such as stress, depression or anxiety. The present work recruited 20 Crohn's disease patients in remission (CDs) and 20 age-gender-handednesseducation matched healthy controls (HCs) and compared their brain white matter microstructural properties using Diffusion Tensor Imaging (DTI). Additionally, we examined the correlations between the microstructural properties and cognition (verbal fluency language task, VF) and affect (anxiety) in both groups as well as disease duration in CDs. Results showed that CDs exhibited significant alterations in microstructural properties compared to Hcs in various white matter tracts relevant to language function despite no significant difference in VF scores. Furthermore, CDs' microstructural changes exhibited correlations with anxiety level and disease duration. These findings suggest that CD patients may experience changes in white matter microstructural properties which may be a biomarker of neuropsychiatric comorbidities of CD.Crohn's disease (CD), as one subtype of inflammatory bowel disease (IBD), is thought to be caused by disruption of the normal immune system and also perhaps by altered intestinal permeability 1 and it can affect any gastrointestinal part from the mouth to the anus 2 . The impact of IBD may also extend to the brain and lead to anatomical and functional changes. Several studies have reported anatomical and functional brain changes in CD patients, possibly due to increased proinflammatory cytokines or chemokines and microglial cells which play an important role in communication between the brain, gut, and systemic immune system. These systemic changes have been posited to lead to a cascade of neuroplastic events that result in anatomical or functional brain changes that affect cognitive or affective abilities 3-5 . The observed brain changes might also account for the increased sensitivity of the CD patients to their related external environment which has been described among CDs and the inadequate ability to modulate cognitive and emotional states 3,6,7 . Moreover, the comorbidities assciated with IBD such as psychological stress, anxiety, depression, chronic pain may also influence anatomical and functional changes in the brain 1 .A growing body of evidence suggests that abnormalities in the brain morphometry or function of CD patients may correlate with cognitive and affective changes. Several studies, in CD patients, have reported changes in brian morphometry compared to age-matched healthy controls (HCs). For exmaple, Bao et al. reported decreased cortical thickness in several regions and this decrease was correlated to pain score or disease duration 8 . Increased cortical thickness has also been reported as well as decreased sub-cortical volumes have been correlated to pain score or disease duration 3 ; Zikou et al. showed decreased volume in the bilateral fusiform, inferior temporal gyrus (emotional...

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Section: Discussionsupporting

confidence: 81%

Alterations in brain white matter microstructural properties in patients with Crohn’s disease in remission

Hou

Dodd

Nair

et al. 2020

Sci Rep

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“…ICA results show CD females had decreased FC of the visual network with the right temporal occipital fusiform gyrus, which supports the multiple ROI findings of altered visual network FC for CD females. Although perhaps not intuitive that visual network changes would be involved in CD, differences in visual processing regions have been reported in previous CD studies, including cortical thickness differences in left lateral occipital cortex (24), hypergyrification of left lingual gyrus (41) for CD, and increased FC within visual medial and frontoparietal networks in IBD (42), and similar reports are seen for other chronic conditions, such as knee osteoarthritis (43), persistent somatoform pain disorder (44), postherpetic neuralgia (45), migraine (46), and fibromyalgia (47). Having recognized the plethora of studies reporting visual system FC alterations in chronic pain populations, Shen et al (48) investigated the FC of visual network nodes in a chronic low back pain population using an ROI analysis and a support vector machine classifier.…”

Section: Networkmentioning

confidence: 84%

“…Investigations into altered brain structure and function in CD have increased; however, the existing body of literature is limited and there is a lack of consistency among the techniques used and the results reported that prohibits any key brain alterations to be identified. Studies of brain structure in CD may be in agreement on one result, altered gray matter (GM) of the superior frontal gyrus, although laterality and direction of alteration are inconsistent (22)(23)(24). Studies of brain function in CD have reported numerous FC alterations with very little overlap (25)(26)(27)(28)(29)(30)(31)(32) aside from some agreement on changes in brain networks or regions involved in executive function and/or default mode (26,30,32).…”

Section: Introductionmentioning

confidence: 99%

Brain Resting-State Network Alterations Associated With Crohn's Disease

Kornelsen

Wilson

Labus³

et al. 2020

Front. Neurol.

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Inflammatory bowel disease (IBD) is a chronic disease that is associated with aspects of brain anatomy and activity. In this preliminary MRI study, we investigated differences in brain structure and in functional connectivity (FC) of brain regions in 35 participants with Crohn's disease (CD) and 21 healthy controls (HC). Voxel-based morphometry (VBM) analysis was performed to contrast CD and HC structural images. Region of interest (ROI) analyses were run to assess FC for resting-state network nodes. Independent component analysis (ICA) identified whole brain differences in FC associated with resting-state networks. Though no structural differences were found, ROI analyses showed increased FC between the frontoparietal (FP) network and salience network (SN), and decreased FC between nodes of the default mode network (DMN). ICA results revealed changes involving cerebellar (CER), visual (VIS), and SN components. Differences in FC associated with sex were observed for both ROI analysis and ICA. Taken together, these changes are consistent with an influence of CD on the brain and serve to direct future research hypotheses.

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“…We have previously reported significant changes in brain morphometric measures in CD patients compared to age and gender‐matched controls . Additionally, disrupted resting state functional connectivity has been reported in CD patients in remission .…”

Section: Introductionmentioning

confidence: 88%

“…10 We have previously reported significant changes in brain morphometric measures in CD patients compared to age and gender-matched controls. 11 Additionally, disrupted resting state functional connectivity has been reported in CD patients in remission. 12 Thomann et al 12 also reported significant association between disrupted connectivity and anxiety scores in these patients.…”

Section: Introductionmentioning

confidence: 99%

A Verbal Fluency Task‐Based Brain Activation fMRI Study in Patients with Crohn's Disease in Remission

Nair

Dodd

Rajan

et al. 2019

Journal of Neuroimaging

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BACKGROUND AND PURPOSE In this pilot study, we investigated functional brain activation changes in patients with Crohn's disease (CD) in remission compared to age and gender‐matched healthy controls (HCs). METHODS Data from 20 patients with CD in remission (age range 19‐63 years) and 20 HCs (matched in age and gender) were analyzed. Task functional MRI (fMRI) data were collected while participants performed a cognitive (phonemic verbal fluency) task in the scanner. All participants also performed the same task outside the scanner. RESULTS Task fMRI results showed greater bi‐hemispheric activation in CD patients compared to controls. Because this pattern is commonly reported with normal aging, we performed further analyses to investigate fMRI responses in a subset of the younger CD patients (N = 12, age < = 35 years) compared to matched young HCs (age < = 35 years), and an older cohort of HCs (age > = 50 years). Results showed that task activation patterns were similar between young CD patients and older HCs, and that both groups differed significantly from younger HCs. Activation intensity in specific brain regions for patients was associated with disease duration. CONCLUSIONS These results suggest that CD patients in remission may show accelerated signs of aging in terms of brain responses to a typical cognitive task. Future work with larger sample size will need to replicate these results as well as investigate the influence of factors, such as chronicity of the disease and medication effects on task‐associated brain activation patterns in this patient population.

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Structural Imaging Changes and Behavioral Correlates in Patients with Crohn’s Disease in Remission

Cited by 33 publications

References 75 publications

Alterations in brain white matter microstructural properties in patients with Crohn’s disease in remission

Alterations in brain white matter microstructural properties in patients with Crohn’s disease in remission

Brain Resting-State Network Alterations Associated With Crohn's Disease

A Verbal Fluency Task‐Based Brain Activation fMRI Study in Patients with Crohn's Disease in Remission

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