McIver Theresa A, Bernstein Charles N, Marrie Ruth Ann, Figley Chase R, Uddin Md Nasir, Fisk John D, Graff Lesley A, Patel Ronak, Mazerolle Erin L, Kornelsen Jennifer
Department of Radiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
IBD Clinical and Research Centre, University of Manitoba, Winnipeg, MB, Canada.
Front Hum Neurosci. 2025 Apr 25;19:1561421. doi: 10.3389/fnhum.2025.1561421. eCollection 2025.
Crohn's disease is one phenotype of inflammatory bowel disease (IBD). Fatigue is a common and burdensome symptom for persons with Crohn's disease. Despite its detrimental impact on health-related quality of life, the pathophysiology of fatigue in Crohn's disease is not fully understood. Specifically, basic research on the difference in brain functioning associated with fatigue in Crohn's disease is scarce. This study aimed to address this knowledge gap by identifying fatigue-related differences in brain resting state functional connectivity. in Crohn's disease.
Participants included 49 adults with Crohn's Disease ( 53 yrs, 35 females) and 49 healthy controls ( 50 yrs, 31 females). The Fatigue Impact Scale (FIS) assessed impact of fatigue across three domains (physical, cognitive, and psychosocial) as well as total impact of fatigue. The Harvey-Bradshaw Inventory (HBI) assessed disease activity. Magnetic Resonance Imaging of brain functional connectivity during resting state (i.e.,: wakeful rest) was assessed in relation to scores on the FIS (total and for each domain). Moderation analyses tested whether brain resting state functional connectivity moderates the relationship between disease activity and fatigue.
The Crohn's disease group reported more severe fatigue than the healthy control group in each domain of the FIS. For the Crohn's disease group, increasing fatigue was associated with decreasing synchronicity of brain function (i.e., functional connectivity) between the superior parietal lobule and the parahippocampal gyrus/hippocampus. Unlike in the healthy control group, an increasing impact of physical fatigue was associated with decreasing functional connectivity between these ROIs for the Crohn's disease group (TFCE = 16.88, p-FDR = 0.03). Moderation analyses revealed a significant interaction between disease activity, total fatigue, and functional connectivity of the right superior parietal lobule and left anterior parahippocampal gyrus (ΔR = 0.058, F = 5.445, = 0.0245). Higher scores on the HBI were only associated with higher total scores on the FIS in persons with Crohn's disease who exhibited negative functional connectivity between these brain regions.
In people with Crohn's disease, fatigue increases as functional connectivity between brain regions involved in sensorimotor integration and memory processing decreases.
克罗恩病是炎症性肠病（IBD）的一种表型。疲劳是克罗恩病患者常见且令人负担沉重的症状。尽管疲劳对健康相关生活质量有不利影响，但克罗恩病中疲劳的病理生理学尚未完全了解。具体而言，关于克罗恩病中与疲劳相关的脑功能差异的基础研究很少。本研究旨在通过识别克罗恩病患者脑静息态功能连接中与疲劳相关的差异来填补这一知识空白。
参与者包括49名成年克罗恩病患者（年龄53岁，女性35名）和49名健康对照者（年龄50岁，女性31名）。疲劳影响量表（FIS）评估疲劳在三个领域（身体、认知和心理社会）的影响以及疲劳的总体影响。哈维 - 布拉德肖指数（HBI）评估疾病活动度。在静息状态（即清醒休息）下对脑功能连接进行磁共振成像，并与FIS（总分及各领域得分）进行关联分析。调节分析检验脑静息态功能连接是否调节疾病活动度与疲劳之间的关系。
克罗恩病组在FIS的每个领域报告的疲劳都比健康对照组更严重。对于克罗恩病组，疲劳增加与顶上小叶和海马旁回/海马之间的脑功能同步性降低（即功能连接性降低）相关。与健康对照组不同，对于克罗恩病组，身体疲劳影响的增加与这些感兴趣区域（ROI）之间的功能连接性降低相关（TFCE = 16.88，p-FDR = 0.03）。调节分析显示疾病活动度、总疲劳与右上顶叶和左前海马旁回的功能连接性之间存在显著交互作用（ΔR = 0.058，F = 5.445，p = 0.0245）。只有在这些脑区之间表现出负功能连接的克罗恩病患者中，HBI得分越高才与FIS总分越高相关。
在克罗恩病患者中，随着参与感觉运动整合和记忆处理的脑区之间的功能连接性降低，疲劳会增加。
