School of Life Science and Technology, Life Science Research Center, Xidian University, Xi'an, China.
School of Life Science and Technology, Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, Xidian University, Xi'an, China.
Neurogastroenterol Motil. 2018 Sep;30(9):e13345. doi: 10.1111/nmo.13345. Epub 2018 Apr 23.
Functional dyspepsia (FD) is a common functional gastrointestinal disease. Neuroimaging studies have identified that insula is involved in the pathogenesis of FD. However, less is known about structural and functional connectivity of insula in FD.
In this study, 67 FD patients and 46 healthy controls (HCs) underwent structural MRI, resting-state functional MRI, diffusion tensor imaging (DTI) scans, and clinical assessment. We used the 3 neuroimaging modalities to investigate structural and functional connectivity of insula between FD patients and HCs, and we examined relationships between the neuroimaging findings and clinical symptoms.
Compared with HCs, (i) FD patients had decreased gray matter density in right insula according to voxel-based morphometry method, which region was targeted as region of interest for further analysis of structural and functional connectivity; (ii) FD patients had lower connection probability in right anterior insula with right thalamus, right internal capsule (IC), and right external capsule (EC); (iii) FD patients had decreased functional connectivity of the right anterior insula with right thalamus and right pregenual anterior cingulate cortex (pACC); and (iv) FD patients had negative correlation between disease duration and the functional connectivity of right anterior insula with thalamus.
The present findings reveal that alterations of structural and/or functional connectivity of right anterior insula with regions, including thalamus, IC, EC, and pACC, may be mainly implicated in abnormalities of visceral sensory processing and related affective responses in FD patients. Finally, this study could enhance understanding of the pathophysiology of FD.
功能性消化不良（FD）是一种常见的功能性胃肠道疾病。神经影像学研究表明，脑岛参与了 FD 的发病机制。然而，对于 FD 患者脑岛的结构和功能连接知之甚少。
本研究纳入 67 例 FD 患者和 46 例健康对照者（HCs），进行结构 MRI、静息态功能 MRI、弥散张量成像（DTI）扫描和临床评估。我们使用 3 种神经影像学方法，研究 FD 患者和 HCs 之间脑岛的结构和功能连接，并检查神经影像学发现与临床症状之间的关系。
与 HCs 相比，（i）FD 患者基于体素的形态测量学方法显示右侧脑岛灰质密度降低，该区域被确定为进一步分析结构和功能连接的感兴趣区；（ii）FD 患者右侧前脑岛与右侧丘脑、右侧内囊（IC）和右侧外囊（EC）之间的连接概率降低；（iii）FD 患者右侧前脑岛与右侧丘脑和右侧扣带回前回（pACC）的功能连接降低；（iv）FD 患者疾病持续时间与右侧前脑岛与丘脑的功能连接呈负相关。
本研究结果表明，右侧前脑岛与丘脑、IC、EC 和 pACC 等区域的结构和/或功能连接的改变可能主要与 FD 患者内脏感觉处理和相关情感反应的异常有关。最后，本研究可以增进对 FD 病理生理学的理解。
