肠易激综合征的脑内固有异常及焦虑和抑郁的影响

Intrinsic brain abnormalities in irritable bowel syndrome and effect of anxiety and depression.

作者信息

Qi Rongfeng, Liu Chang, Ke Jun, Xu Qiang, Zhong Jianhui, Wang Fangyu, Zhang Long Jiang, Lu Guang Ming

机构信息

Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu Province, 210002, China.

Department of Gastroenterology, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu Province, 210002, China.

出版信息

Brain Imaging Behav. 2016 Dec;10(4):1127-1134. doi: 10.1007/s11682-015-9478-1.

Abstract

UNLABELLED

This resting-state functional magnetic resonance imaging (rs-fMRI) study investigated intrinsic brain abnormalities in irritable bowel syndrome (IBS) and effect of anxiety and depression. Thirty IBS patients and 31 matched healthy controls underwent rs-fMRI scanning. Regional brain activity was evaluated by measuring the amplitude of low-frequency fluctuation (ALFF) and compared between IBS patients and healthy controls with a two-sample t-test. Areas with abnormal ALFF were further used as seeds in subsequent inter-regional functional connectivity (FC) analysis. Statistical analyses were also performed by including anxiety and depression as covariates to evaluate their effect. Compared to healthy controls, IBS patients showed decreased ALFF in several core default mode network regions (medial prefrontal cortex [MPFC], posterior cingulate cortex [PCC], bilateral inferior parietal cortices [IPC]), and in middle frontal cortex, right orbital part of the superior frontal gyrus (ORBsup), dorsal anterior cingulate cortex (dACC), and ventral anterior cingulated cortex (vACC), while they showed increased ALFF in bilateral posterior insula and cuneus. In addition, IBS patients revealed decreased inter-regional positive FC between MPFC and right ORBsup, between vACC and PCC, as well as decreased negative FC between MPFC and left posterior insula, while they showed increased negative FC between MPFC and cuneus. The inclusion of anxiety and depression as covariates abolished ALFF differences in dACC and vACC, but none of the FC differences.

IN CONCLUSION

IBS patients had disturbed intrinsic brain function. High levels of anxiety and depression in IBS patients could account for their decreased intrinsic brain activity in regions (the ACC) involved in affective processing.

摘要

未标注

这项静息态功能磁共振成像(rs-fMRI)研究调查了肠易激综合征(IBS)患者大脑的内在异常以及焦虑和抑郁的影响。30名IBS患者和31名匹配的健康对照者接受了rs-fMRI扫描。通过测量低频波动幅度(ALFF)评估大脑区域活动,并采用两样本t检验比较IBS患者和健康对照者之间的差异。随后,将ALFF异常的区域作为种子点进行区域间功能连接(FC)分析。同时,将焦虑和抑郁作为协变量进行统计分析,以评估其影响。与健康对照者相比,IBS患者在多个核心默认模式网络区域(内侧前额叶皮质[MPFC]、后扣带回皮质[PCC]、双侧下顶叶皮质[IPC])以及额中回、额上回右侧眶部(ORBsup)、背侧前扣带回皮质(dACC)和腹侧前扣带回皮质(vACC)的ALFF降低,而双侧后岛叶和楔叶的ALFF升高。此外,IBS患者在MPFC与右侧ORBsup之间、vACC与PCC之间的区域间正性FC降低,在MPFC与左侧后岛叶之间的负性FC降低,而在MPFC与楔叶之间的负性FC升高。将焦虑和抑郁作为协变量纳入分析后,消除了dACC和vACC中ALFF的差异,但FC差异均未消除。

结论

IBS患者存在内在脑功能紊乱。IBS患者的高焦虑和抑郁水平可能是其情感处理相关区域(前扣带回皮质)内在脑活动降低的原因。

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