Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China; Department of Radiology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China.
Center for Language and Brain, Shenzhen Institute of Neuroscience, Shenzhen, Guangdong, China.
Neurosci Lett. 2020 Apr 1;723:134865. doi: 10.1016/j.neulet.2020.134865. Epub 2020 Feb 25.
Irritable bowel syndrome (IBS) is a brain-gut disorder that is often accompanied by psychiatric comorbidities, particularly depression. However, the neuroanatomical substrates of IBS with depressive symptoms (DEP-IBS) and how depressive symptoms and brain morphology modulate IBS symptoms remain unknown. In this study, structural MRI data were processed using a voxel-based morphometry technique and one-way analysis of covariance (ANCOVA) and post-hoc t-tests were performed to compare gray matter volume (GMV) among 28 patients with DEP-IBS, 21 patients with IBS who lacked depressive symptoms (nDEP-IBS), and 36 healthy controls (HC). Correlation and mediation analyses were performed to evaluate the relationship between differing GMV in DEP-IBS and clinical variables. We found that GMV in the bilateral prefrontal, insular, and dorsal striatal areas, as well as the left temporal pole, were significantly lower in the DEP-IBS group than in the HC group. Moreover, compared with the nDEP-IBS group, the DEP-IBS group exhibited decreased GMV in the bilateral medial, dorsolateral prefrontal, and orbitofrontal cortices, bilateral dorsal striatum, and left insular cortices. Correlation analysis revealed that GMV in these atrophic brain areas of the DEP-IBS group was negatively correlated with depression, gastrointestinal symptoms, and disease duration. Our results further revealed that depressive symptoms served as a mediator between gastrointestinal symptoms and GMV in the left insula, right medial prefrontal cortex, and right middle frontal gyrus, while gastrointestinal symptoms served as a mediator between depression and GMV in these regions. Our results suggest convergent syndromic atrophy in the pain and emotional systems of patients with DEP-IBS.
肠易激综合征（IBS）是一种脑-肠疾病，常伴有精神共病，特别是抑郁症。然而，有抑郁症状的 IBS（DEP-IBS）的神经解剖学基础以及抑郁症状和大脑形态如何调节 IBS 症状尚不清楚。在这项研究中，我们使用基于体素的形态计量学技术处理结构 MRI 数据，并使用单向方差分析（ANCOVA）和事后 t 检验比较了 28 例 DEP-IBS 患者、21 例无抑郁症状的 IBS 患者（nDEP-IBS）和 36 例健康对照组（HC）的灰质体积（GMV）。我们进行了相关性和中介分析，以评估 DEP-IBS 中不同 GMV 与临床变量之间的关系。我们发现，DEP-IBS 组双侧前额叶、岛叶和背侧纹状体区域以及左侧颞极的 GMV 明显低于 HC 组。此外，与 nDEP-IBS 组相比，DEP-IBS 组双侧内侧、背外侧前额叶和眶额皮质、双侧背侧纹状体和左侧岛叶皮质的 GMV 减少。相关性分析显示，DEP-IBS 组这些萎缩脑区的 GMV 与抑郁、胃肠道症状和疾病持续时间呈负相关。我们的结果进一步表明，抑郁症状是胃肠道症状与左侧岛叶、右侧内侧前额叶和右侧额中回 GMV 之间的中介，而胃肠道症状是抑郁与这些区域 GMV 之间的中介。我们的结果表明，DEP-IBS 患者的疼痛和情绪系统存在会聚的综合征性萎缩。
