Diffusion tensor imaging detects microstructural reorganization in the brain associated with chronic irritable bowel syndrome.
Diffusion tensor imaging detects microstructural reorganization in the brain associated with chronic irritable bowel syndrome.
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DOI：
10.1016/j.pain.2013.04.010
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发表时间：
2013-09
期刊：
影响因子：
7.4
通讯作者：
Tillisch K
中科院分区：
文献类型：
--
作者：
Ellingson BM;Mayer E;Harris RJ;Ashe-McNally C;Naliboff BD;Labus JS;Tillisch K
肠易激综合症（IBS）是一种常见的胃肠道疾病，其特征是与排便习惯改变相关的反复腹痛。我们假设患有IBS相关慢性内脏疼痛的患者与健康对照受试者（HC）相比，其大脑可能存在微观结构差异，这表明慢性疼痛通路和与感觉统合相关的区域存在长期神经重组。在当前的研究中，我们对 IBS (n=33) 和 HC (n=93) 表型患者的大样本进行了基于人群的体素 DTI 比较和概率纤维束成像。患者丘脑区、基底神经节和感觉/运动关联/整合区的各向异性分数 (FA) 较低，而额叶区和胼胝体的 FA 较高。此外，患者苍白球内的平均扩散率（MD）降低，而丘脑、内囊和投射到感觉/运动区域的冠状辐射的MD较高，表明这些区域的轴突/树突密度存在差异变化。在患者中也观察到 FA 和 MD 的性别差异，但在 HC 中未观察到。概率纤维束成像证实患者丘脑和前额叶皮质、丘脑内侧核和前扣带皮层之间的连接程度较高，而苍白球和丘脑之间的连接程度较低。总之，这些结果支持这样的假设：IBS 导致的慢性复发性内脏疼痛患者的大脑内部存在长期的微结构变化，特别是与感觉信息整合和皮质丘脑调节相关的区域。
Irritable bowel syndrome (IBS) is a common gastrointestinal disorder characterized by recurring abdominal pain associated with alterations in bowel habits. We hypothesized patients with chronic visceral pain associated with IBS may have microstructural differences in the brain compared with healthy control subjects (HCs), indicative of long-term neural reorganization of chronic pain pathways and regions associated with sensory integration. In the current study we performed population-based voxel-wise DTI comparisons and probabilistic tractography in a large sample of phenotyped patients with IBS (n=33) and HCs (n=93). Patients had lower fractional anisotropy (FA) in thalamic regions, the basal ganglia and sensory/motor association/integration regions as well as higher FA in frontal lobe regions and the corpus callosum. In addition, patients had reduced mean diffusivity (MD), within the globus pallidus, and higher MD in the thalamus, internal capsule, and coronal radiata projecting to sensory/motor regions, suggestive of differential changes in axon/dendritic density in these regions. Sex differences in FA and MD were also observed in the patients but not in HCs. Probabilistic tractography confirmed a higher degree of connectivity in patients between the thalamus and pre-frontal cortex, as well as the medial dorsal thalamic nuclei and anterior cingulate cortex, and a lower degree of connectivity between the globus pallidus and thalamus. Together, these results support the hypothesis that patients with chronically recurring visceral pain from IBS have long-term microstructural changes within the brain, particular in regions associated with integration of sensory information and cortico thalamic modulation.
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