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Altered brain structure in irritable bowel syndrome: potential contributions of pre-existing and disease-driven factors.
Gastroenterology. 2010 May; 138(5):1783-9.G

Abstract

BACKGROUND & AIMS

Brain imaging studies have identified abnormal rectal-evoked responses and cortical thinning in patients with irritable bowel syndrome (IBS). However, it is not known whether these abnormalities are pre-existing or develop as result of long-term IBS. Therefore, we tested whether abnormal structural gray matter integrity in IBS correlates with individual disease symptoms, duration of the IBS, or the personality characteristic of pain catastrophizing.

METHODS

Eleven IBS patients and 16 age-matched healthy subjects underwent structural magnetic resonance imaging. Voxel-based morphometry and cortical thickness analysis were used to identify abnormalities in subcortical and cortical regions, respectively, and their correlation to individual characteristics.

RESULTS

The IBS group showed increased hypothalamic gray matter and cortical thinning in the anterior midcingulate cortex compared with controls, a strong negative correlation between dorsolateral prefrontal cortex thickness and pain catastrophizing, and a positive correlation between anterior insula thickness and pain duration. In the insula, there was cortical thinning in patients with short-term IBS, but long-term IBS pain was associated with a more normal insula thickness.

CONCLUSIONS

Our findings provide new insight into IBS and chronic pain through evidence for structural changes that could fit with functional abnormalities. We report that patients with IBS have increased hypothalamic gray matter, which may be related to the association among IBS, stress, and the hypothalamic-pituitary-adrenal axis. Furthermore, we have identified some supraspinal abnormalities that may be pre-existing and contribute to vulnerability, and others that may develop over time, possibly because of chronic abnormal inputs.

Authors+Show Affiliations

Division of Brain, Imaging and Behaviour-Systems Neuroscience, Toronto Western Research Institute, Toronto, Ontario, Canada.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20045701

Citation

Blankstein, Udi, et al. "Altered Brain Structure in Irritable Bowel Syndrome: Potential Contributions of Pre-existing and Disease-driven Factors." Gastroenterology, vol. 138, no. 5, 2010, pp. 1783-9.
Blankstein U, Chen J, Diamant NE, et al. Altered brain structure in irritable bowel syndrome: potential contributions of pre-existing and disease-driven factors. Gastroenterology. 2010;138(5):1783-9.
Blankstein, U., Chen, J., Diamant, N. E., & Davis, K. D. (2010). Altered brain structure in irritable bowel syndrome: potential contributions of pre-existing and disease-driven factors. Gastroenterology, 138(5), 1783-9. https://doi.org/10.1053/j.gastro.2009.12.043
Blankstein U, et al. Altered Brain Structure in Irritable Bowel Syndrome: Potential Contributions of Pre-existing and Disease-driven Factors. Gastroenterology. 2010;138(5):1783-9. PubMed PMID: 20045701.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Altered brain structure in irritable bowel syndrome: potential contributions of pre-existing and disease-driven factors. AU - Blankstein,Udi, AU - Chen,Jerry, AU - Diamant,Nicholas E, AU - Davis,Karen D, Y1 - 2010/01/04/ PY - 2009/08/26/received PY - 2009/11/03/revised PY - 2009/12/21/accepted PY - 2010/1/5/entrez PY - 2010/1/5/pubmed PY - 2010/5/8/medline SP - 1783 EP - 9 JF - Gastroenterology JO - Gastroenterology VL - 138 IS - 5 N2 - BACKGROUND & AIMS: Brain imaging studies have identified abnormal rectal-evoked responses and cortical thinning in patients with irritable bowel syndrome (IBS). However, it is not known whether these abnormalities are pre-existing or develop as result of long-term IBS. Therefore, we tested whether abnormal structural gray matter integrity in IBS correlates with individual disease symptoms, duration of the IBS, or the personality characteristic of pain catastrophizing. METHODS: Eleven IBS patients and 16 age-matched healthy subjects underwent structural magnetic resonance imaging. Voxel-based morphometry and cortical thickness analysis were used to identify abnormalities in subcortical and cortical regions, respectively, and their correlation to individual characteristics. RESULTS: The IBS group showed increased hypothalamic gray matter and cortical thinning in the anterior midcingulate cortex compared with controls, a strong negative correlation between dorsolateral prefrontal cortex thickness and pain catastrophizing, and a positive correlation between anterior insula thickness and pain duration. In the insula, there was cortical thinning in patients with short-term IBS, but long-term IBS pain was associated with a more normal insula thickness. CONCLUSIONS: Our findings provide new insight into IBS and chronic pain through evidence for structural changes that could fit with functional abnormalities. We report that patients with IBS have increased hypothalamic gray matter, which may be related to the association among IBS, stress, and the hypothalamic-pituitary-adrenal axis. Furthermore, we have identified some supraspinal abnormalities that may be pre-existing and contribute to vulnerability, and others that may develop over time, possibly because of chronic abnormal inputs. SN - 1528-0012 UR - https://www.unboundmedicine.com/medline/citation/20045701/Altered_brain_structure_in_irritable_bowel_syndrome:_potential_contributions_of_pre_existing_and_disease_driven_factors_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(09)02240-9 DB - PRIME DP - Unbound Medicine ER -