Altered Brain Structure and Functional Connectivity and Its Relation to Pain Perception in Girls With Irritable Bowel Syndrome
Altered Brain Structure and Functional Connectivity and Its Relation to Pain Perception in Girls With Irritable Bowel Syndrome
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DOI：
10.1097/psy.0000000000000655
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发表时间：
2019-02-01
影响因子：
3.3
通讯作者：
Tillisch, Kirsten
中科院分区：
文献类型：
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作者：
Bhatt, Ravi R.;Gupta, Arpana;Tillisch, Kirsten
目的 对成人肠易激综合征 (IBS) 进行的影像学研究表明，形态学和静息态 (RS) 功能连接 (FC) 发生变化，与感觉处理的皮质调节相关。由于类似的差异尚未在儿童中得到充分研究，本研究比较了患有 IBS 的女孩和健康对照 (HC) 之间的灰质体积 (GMV) 和 RS-FC，并测试了大脑指标和基于实验室的疼痛阈值 (Pth) 之间的相关性。方法招募了具有罗马 III 标准 IBS 的女孩 (n = 32) 和匹配的 HC (n = 26)。在一部分患者中，Pth 是通过前臂上的热电极来确定的。获得结构和RS扫描。应用基于体素的一般线性模型（根据年龄进行调整）来比较各组之间的差异。从具有组 GMV 差异的区域中选择种子进行种子到体素全脑 RS-FC 分析。在控制错误发现率后，p < .05 被视为分析的显着性。显着的组间差异与 Pth 相关。结果 患有 IBS 的女孩的丘脑、尾状核、伏隔核、前中扣带回 (aMCC) 和背外侧前额皮质的 GMV 较低。他们还表现出 aMCC 和楔前叶之间较低的 RS-FC，但尾状核和中央前回之间的连接性较高。患有 IBS 的女孩的 Pth 较高，效应大小适中 (t((22.81)) = 1.63，p = .12，d = 0.64），双侧丘脑 GMV 较低，与较高的 Pth 相关（左：r = -.62，p((FDR)) = .008；右：r = -.51，p((FDR)) = .08）。结论 患有 IBS 的女孩PFC、基底神经节和 aMCC 的 GMV 较低，多个大脑网络之间的 FC 也发生改变，这表明与 IBS 相关的结构变化发生在大脑发育的早期。患有肠易激综合症的女孩还表现出疼痛敏感性和大脑结构之间的关系发生了变化。
Objective Imaging studies in adults with irritable bowel syndrome (IBS) have shown both morphological and resting state (RS) functional connectivity (FC) alterations related to cortical modulation of sensory processing. Because analogous differences have not been adequately investigated in children, this study compared gray matter volume (GMV) and RS-FC between girls with IBS and healthy controls (HC) and tested the correlation between brain metrics and laboratory-based pain thresholds (Pth).Methods Girls with Rome III criteria IBS (n = 32) and matched HCs (n = 26) were recruited. In a subset of patients, Pth were determined using a thermode to the forearm. Structural and RS scans were acquired. A voxel-based general linear model, adjusting for age, was applied to compare differences between groups. Seeds were selected from regions with group GMV differences for a seed-to-voxel whole brain RS-FC analysis. Significance for analyses was considered at p < .05 after controlling for false discovery rate. Significant group differences were correlated with Pth.Results Girls with IBS had lower GMV in the thalamus, caudate nucleus, nucleus accumbens, anterior midcingulate (aMCC), and dorsolateral prefrontal cortex. They also exhibited lower RS-FC between the aMCC and the precuneus, but greater connectivity between the caudate nucleus and precentral gyrus. Girls with IBS had higher Pth with a moderate effect size (t((22.81)) = 1.63, p = .12, d = 0.64) and lower thalamic GMV bilaterally was correlated with higher Pth (left: r = -.62, p((FDR)) = .008; right: r = -.51, p((FDR)) = .08).Conclusions Girls with IBS had lower GMV in the PFC, basal ganglia, and aMCC, as well as altered FC between multiple brain networks, suggesting that structural changes related to IBS occur early in brain development. Girls with IBS also showed altered relationships between pain sensitivity and brain structure.