G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Neurogastroenterology Group, Queen Mary University of London, London, UK.
Gut. 2019 Sep;68(9):1701-1715. doi: 10.1136/gutjnl-2019-318308. Epub 2019 Jun 7.
Imaging of the living human brain is a powerful tool to probe the interactions between brain, gut and microbiome in health and in disorders of brain-gut interactions, in particular IBS. While altered signals from the viscera contribute to clinical symptoms, the brain integrates these interoceptive signals with emotional, cognitive and memory related inputs in a non-linear fashion to produce symptoms. Tremendous progress has occurred in the development of new imaging techniques that look at structural, functional and metabolic properties of brain regions and networks. Standardisation in image acquisition and advances in computational approaches has made it possible to study large data sets of imaging studies, identify network properties and integrate them with non-imaging data. These approaches are beginning to generate brain signatures in IBS that share some features with those obtained in other often overlapping chronic pain disorders such as urological pelvic pain syndromes and vulvodynia, suggesting shared mechanisms. Despite this progress, the identification of preclinical vulnerability factors and outcome predictors has been slow. To overcome current obstacles, the creation of consortia and the generation of standardised multisite repositories for brain imaging and metadata from multisite studies are required.
活体人脑成像技术是一种强大的工具,可用于研究大脑、肠道和微生物组在健康和大脑-肠道相互作用障碍(尤其是 IBS)中的相互作用。虽然内脏发出的信号改变会导致临床症状,但大脑会以非线性的方式将这些内脏感觉信号与情绪、认知和记忆相关的输入整合起来,从而产生症状。在开发新的成像技术方面取得了巨大进展,这些技术可以观察大脑区域和网络的结构、功能和代谢特性。图像采集的标准化和计算方法的进步使得研究大型成像研究数据集、识别网络特性以及将其与非成像数据集成成为可能。这些方法开始在 IBS 中生成具有与其他经常重叠的慢性疼痛障碍(如泌尿生殖系统盆腔疼痛综合征和外阴痛)中获得的特征相似的脑特征,这表明存在共同的机制。尽管取得了这些进展,但临床前脆弱性因素和预后预测因子的识别仍然缓慢。为了克服当前的障碍,需要创建联盟并生成用于大脑成像的标准化多站点存储库以及来自多站点研究的元数据。
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