Abdelnaim Mohamed A, Hebel Tobias, Lang-Hambauer Verena, Schlaier Juergen, Langguth Berthold, Reissmann Andreas
Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany.
Center for Deep Brain Stimulation, University Regensburg, Regensburg, Germany.
Front Psychiatry. 2025 Mar 5;16:1545318. doi: 10.3389/fpsyt.2025.1545318. eCollection 2025.
Irritable bowel syndrome (IBS) is a common condition characterized by abdominal pain and altered bowel habits, affecting around 11% of individuals globally. It is linked to dysregulation of the brain-gut axis, with altered activity and connectivity in various brain regions. IBS patients often have psychiatric comorbidities like anxiety, or obsessive-compulsive disorder (OCD). Deep brain stimulation (DBS) is an established treatment option for severe, therapy-refractory OCD. It has been suggested that DBS for OCD could also have a beneficial effect on accompanying IBS-symptoms.
Nine patients with treatment-refractory OCD who underwent DBS in the bed nucleus striae terminalis (BNST) have been included in this study (4 males, 5 females, mean age: 39.1 ± 11.5 years). Patients were examined with the Gastrointestinal Symptom Rating Scale for Irritable Bowel Syndrome (GSRS-IBS) as well as the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) both before the beginning of DBS as well as throughout several follow-up visits for 12 months following the start of DBS.
Three patients displayed clinically relevant levels of IBS-symptoms at baseline (GSRS-IBS scores at or beyond 32). All of those three patients showed a reduction of the GSRS-IBS score at the last follow-up (12-40%). For the other 6 patients, 5 of them showed also a reduction of the GSRS-IBS compared to the score at baseline. The mean score for all patients showed a descriptive trend toward score reduction throughout the study period and until the last follow up visit after 12 months. The mean Y-BOCS decreased from 31.11 at baseline to 16.50 at the last follow-up. Out of the 9 patients, 7 (78%) were considered responders with Y-BOCS scores decreasing between 37% to 74%. Moderate-to-large correlations between both scales could be observed at both the 9-month and the 12-month follow-up visit. However, none of these associations was statistically significant.
In this study, we found alleviation of IBS symptoms after DBS of the BNST, along with improvement in OCD symptoms. Future research using larger sample sizes should address whether the reductions are tied to the improvement of OCD symptoms or if DBS exerts positive effects on IBS independently of OCD symptoms.
肠易激综合征（IBS）是一种常见疾病，其特征为腹痛和排便习惯改变，全球约11%的人受其影响。它与脑-肠轴失调有关，不同脑区的活动和连接性发生改变。IBS患者常伴有焦虑或强迫症（OCD）等精神共病。深部脑刺激（DBS）是治疗严重、难治性OCD的既定治疗选择。有人提出，针对OCD的DBS对伴随的IBS症状也可能有有益影响。
本研究纳入了9例在终纹床核（BNST）接受DBS治疗的难治性OCD患者（4例男性，5例女性，平均年龄：39.1±11.5岁）。在DBS开始前以及DBS开始后的12个月内的多次随访中，使用肠易激综合征胃肠道症状评分量表（GSRS-IBS）以及耶鲁-布朗强迫症量表（Y-BOCS）对患者进行检查。
3例患者在基线时表现出具有临床意义的IBS症状水平（GSRS-IBS评分达到或超过32）。这3例患者在最后一次随访时GSRS-IBS评分均有所降低（降低了12%-40%）。对于其他6例患者，其中5例与基线评分相比，GSRS-IBS评分也有所降低。在整个研究期间直至12个月后的最后一次随访，所有患者的平均评分呈现出降低的描述性趋势。平均Y-BOCS评分从基线时的31.11降至最后一次随访时的16.50。9例患者中，7例（78%）被视为有反应者，Y-BOCS评分降低了37%至74%。在9个月和12个月的随访中，两个量表之间均观察到中度至高度的相关性。然而，这些关联均无统计学意义。
在本研究中，我们发现BNST的DBS术后IBS症状得到缓解，同时OCD症状也有所改善。未来使用更大样本量的研究应探讨这些症状的减轻是与OCD症状的改善相关，还是DBS独立于OCD症状对IBS产生了积极影响。
