A neuropsychosocial signature predicts longitudinal symptom changes in women with irritable bowel syndrome.
A neuropsychosocial signature predicts longitudinal symptom changes in women with irritable bowel syndrome.
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DOI：
10.1038/s41380-021-01375-9
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发表时间：
2022-03
影响因子：
11
通讯作者：
Mayer, Emeran A.
中科院分区：
文献类型：
--
作者：
Bhatt, Ravi R.;Gupta, Arpana;Labus, Jennifer S.;Liu, Cathy;Vora, Priten P.;Stains, Jean;Naliboff, Bruce D.;Mayer, Emeran A.
肠易激综合征（IBS）是一种常见的脑-肠相互作用的疾病，其特征是慢性腹痛、排便改变，通常伴有躯体和精神共病。我们的目的是检验以下假设：由多模态神经影像学和临床特征组成的基线表型预测在3个月和12个月时IBS症状严重程度量表（IBS-SSS）的临床改善，而无需任何靶向干预。女性参与者（N = 60）被确定为“改善者”（IBS-SSS较基线下降50分）或“非改善者”。将使用潜在成分的数据整合分析（DIABLO）应用于训练和测试数据集，以确定有限数量的多个相关基线组学数据类型的集合（包括脑形态测量、解剖连接、静息状态功能连接和临床特征）是否可以准确地预测改善者状态。衍生的预测模型预测3个月和12个月时的改善状态，准确率分别为91%和83%。在这两个时间点，非改善者被归类为具有更大的相关形态测量学，解剖连接性和静息状态功能连接性特征的显着性和感觉运动网络与更大的疼痛不愉快，但较低的默认模式网络的完整性和连接性。这表明非改善者有更大的注意力系统参与痛苦的内脏刺激，预测IBS恶化。基线多模态脑临床特征预测症状轨迹的能力可能对指导精准医学时代的综合治疗具有影响，例如针对改变注意力系统的治疗，如正念或认知行为疗法。
Irritable bowel syndrome (IBS) is a common disorder of brain-gut interactions characterized by chronic abdominal pain, altered bowel movements, often accompanied by somatic and psychiatric comorbidities. We aimed to test the hypothesis that a baseline phenotype composed of multi-modal neuroimaging and clinical features predicts clinical improvement on the IBS Symptom Severity Scale (IBS-SSS) at 3 and 12 months without any targeted intervention. Female participants (N = 60) were identified as “improvers” (50-point decrease on IBS-SSS from baseline) or “non-improvers.” Data integration analysis using latent components (DIABLO) was applied to a training and test dataset to determine whether a limited number of sets of multiple correlated baseline’omics data types, including brain morphometry, anatomical connectivity, resting-state functional connectivity, and clinical features could accurately predict improver status. The derived predictive models predicted improvement status at 3-months and 12-months with 91% and 83% accuracy, respectively. Across both time points, non-improvers were classified as having greater correlated morphometry, anatomical connectivity and resting-state functional connectivity characteristics within salience and sensorimotor networks associated with greater pain unpleasantness, but lower default mode network integrity and connectivity. This suggests that non-improvers have a greater engagement of attentional systems to perseverate on painful visceral stimuli, predicting IBS exacerbation. The ability of baseline multimodal brain-clinical signatures to predict symptom trajectories may have implications in guiding integrative treatment in the age of precision medicine, such as treatments targeted at changing attentional systems such as mindfulness or cognitive behavioral therapy.
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影响因子：
5
作者：
COHEN, S;KAMARCK, T;MERMELSTEIN, R
通讯作者：
MERMELSTEIN, R
影响因子：
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通讯作者：
Apkarian, A. Vania