Qi R, Liu C, Ke J, Xu Q, Ye Y, Jia L, Wang F, Zhang L J, Lu G M
From the Departments of Medical Imaging (R.Q., J.K., Q.X., L.J.Z., G.M.L.).
Gastroenterology (C.L., Y.Y., F.W.).
AJNR Am J Neuroradiol. 2016 Jun;37(6):1139-45. doi: 10.3174/ajnr.A4655. Epub 2016 Jan 14.
Functional neuroimaging studies in irritable bowel syndrome have revealed abnormalities in the corticolimbic regions, specifically, hyperactivity of the amygdala during visceral and somatic stimulation. This study investigated changes in the neural circuitry of the amygdala in patients with irritable bowel syndrome based on resting-state functional connectivity.
Functional MR imaging data were acquired from 31 patients with irritable bowel syndrome and 32 healthy controls (matched for age, sex, and educational level) during rest, and the resting-state functional connectivity of bilateral amygdalae was compared. Multiple regression was performed to investigate the relationship between clinical indices of patients with irritable bowel syndrome and resting-state functional connectivity.
Compared with healthy controls, patients with irritable bowel syndrome had higher positive resting-state functional connectivity between the amygdala and insula, midbrain, parahippocampal gyrus, pre- and postcentral gyri, and supplementary motor area. The inclusion of anxiety and depression as covariates did not alter amygdala resting-state functional connectivity differences between the study groups. Multiple covariate regression results showed that the pain intensity in patients with irritable bowel syndrome positively correlated with resting-state functional connectivity between the amygdala and supplementary motor area, pre- and postcentral gyri, and insula, while the Irritable Bowel Syndrome-Symptom Severity Score positively correlated with resting-state functional connectivity between the amygdala and insula and midbrain.
Patients with irritable bowel syndrome showed disturbed amygdala resting-state functional connectivity with the corticolimbic regions, which could partly account for the enhanced emotional arousal and visceral information processing associated with irritable bowel syndrome.
肠易激综合征的功能神经影像学研究显示皮质边缘区域存在异常，具体而言，在内脏和躯体刺激期间杏仁核活性增强。本研究基于静息态功能连接性，调查了肠易激综合征患者杏仁核神经回路的变化。
在静息状态下，从31例肠易激综合征患者和32名健康对照者（年龄、性别和教育水平相匹配）获取功能磁共振成像数据，并比较双侧杏仁核的静息态功能连接性。进行多元回归分析，以研究肠易激综合征患者的临床指标与静息态功能连接性之间的关系。
与健康对照者相比，肠易激综合征患者杏仁核与脑岛、中脑、海马旁回、中央前回和中央后回以及辅助运动区之间的静息态功能连接性呈更高的正相关。将焦虑和抑郁作为协变量纳入分析，并未改变研究组之间杏仁核静息态功能连接性的差异。多元协变量回归结果显示，肠易激综合征患者的疼痛强度与杏仁核和辅助运动区、中央前回和中央后回以及脑岛之间的静息态功能连接性呈正相关，而肠易激综合征症状严重程度评分与杏仁核和脑岛以及中脑之间的静息态功能连接性呈正相关。
肠易激综合征患者的杏仁核与皮质边缘区域的静息态功能连接性出现紊乱，这可能部分解释了与肠易激综合征相关的情绪唤醒增强和内脏信息处理增加的现象。
