Brain functional connectivity is associated with visceral sensitivity in women with Irritable Bowel Syndrome.
Brain functional connectivity is associated with visceral sensitivity in women with Irritable Bowel Syndrome.
复制标题
DOI：
10.1016/j.nicl.2017.06.001
复制
发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Walter S
中科院分区：
文献类型：
--
作者：
Icenhour A;Witt ST;Elsenbruch S;Lowén M;Engström M;Tillisch K;Mayer EA;Walter S
内脏刺激的感知增加是肠易激综合征（IBS）的一个关键特征。虽然在IBS中也有静息状态功能连接改变（rsFC）的报道，但内脏超敏反应与rsFC异常之间的关系尚不清楚。因此，我们评估了有和没有内脏超敏反应的患者以及健康对照（hc）中显著性、感觉运动和默认模式网络中的rsFC。对41名IBS女性和20名hc患者进行了静息状态功能磁共振成像研究。采用组独立成分分析法推导脑内在网络。确定直肠阈值，并将患者细分为内脏敏感性增高组（21例为过敏性肠易激综合征）和正常组（20例为正常敏感性肠易激综合征）。采用兴趣区域分析对rsFC进行组间比较，提取峰值rsFC值进行相关性分析。与正常敏感型IBS相比，超敏感型IBS患者的前扣带皮层、突出网络内的丘脑和感觉运动网络内的后岛的rsFC阳性增加。与超敏IBS和hc相比，正常敏感IBS表现为杏仁核rsFC阳性减少，DMN内岛背前部rsFC阴性减少。DMN和感觉运动网络rsFC与直肠感知阈值相关，后岛rsFC与IBS报告的症状严重程度相关。我们的探索性研究结果表明，肠易激综合征的内脏敏感性与静息状态网络中与内感受、显著性和感觉加工相关的FC变化有关。这些改变可能在肠易激综合征的高警觉性和痛觉过敏中起重要作用。比较超敏感和正常敏感IBS患者的功能连通性（FC）。超敏性IBS表现为显著性和感觉运动网络FC增强。正常敏感型肠易激综合征在DMN内的杏仁核和前岛FC减少。FC的变化与内脏敏感性和症状严重程度有关。改变的FC可能在IBS的高警觉性和痛觉过敏中起关键作用。
Increased perception of visceral stimuli is a key feature of Irritable Bowel Syndrome (IBS). While altered resting-state functional connectivity (rsFC) has been also reported in IBS, the relationship between visceral hypersensitivity and aberrant rsFC is unknown. We therefore assessed rsFC within the salience, sensorimotor and default mode networks in patients with and without visceral hypersensitivity and in healthy controls (HCs). An exploratory resting-state functional magnetic resonance imaging study was performed in 41 women with IBS and 20 HCs. Group independent component analysis was used to derive intrinsic brain networks. Rectal thresholds were determined and patients were subdivided into groups with increased (hypersensitive IBS, N = 21) or normal (normosensitive IBS, N = 20) visceral sensitivity. Between-group comparisons of rsFC were carried-out using region-of-interest analyses and peak rsFC values were extracted for correlational analyses. Relative to normosensitive IBS, hypersensitive patients showed increased positive rsFC of pregenual anterior cingulate cortex and thalamus within the salience network and of posterior insula within the sensorimotor network. When compared to both hypersensitive IBS and HCs, normosensitive IBS showed decreased positive rsFC of amygdala and decreased negative rsFC in dorsal anterior insula within the DMN. DMN and sensorimotor network rsFC were associated with rectal perception thresholds, and rsFC in posterior insula was correlated with reported symptom severity in IBS. Our exploratory findings suggest that visceral sensitivity in IBS is related to changes in FC within resting-state networks associated with interoception, salience and sensory processing. These alterations may play an important role in hypervigilance and hyperalgesia in IBS. Functional connectivity (FC) was compared between hyper- and normosensitive IBS. Hypersensitive IBS showed enhanced salience and sensorimotor network FC. Normosensitive IBS had decreased amygdala and anterior insula FC within the DMN. Changes in FC were associated with visceral sensitivity and symptom severity. Altered FC may play a key role in hypervigilance and hyperalgesia in IBS.