Hartmann Hanna A, Berthold Marja L, Ramkiran Shukti, Bündgens Lukas, Jaeger Julius W, Hagen Jana, Backhaus Maria, Collée Maria, Schnellbächer Gereon J, Veselinović Tanja, Shah N Jon, Schneider Kai M, Rajkumar Ravichandran, Neuner Irene
Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany.
Institute of Neuroscience and Medicine 4, INM-4, Forschungszentrum Jülich, Jülich, Germany.
Commun Med (Lond). 2025 Sep 17;5(1):388. doi: 10.1038/s43856-025-01117-w.
Emerging evidence highlights the profound impact of the central nervous system on the gut. This is particularly evident in inflammatory bowel disease, where psychological stress has been shown to modulate the inflammatory response and precede disease flares. The neuropsychological correlates of the brain's involvement in Crohn's disease (CD), as well as its overlapping neurobiological pathways with major depressive disorder (MDD), remain poorly defined. This study aims to delineate these shared mechanisms using ultra-high-field neuroimaging.
Resting-state functional magnetic resonance imaging was conducted on 13 CD patients (age range: 20-41 years; 9 males), 13 age-matched MDD patients (20-42 years; 9 males), and 13 healthy controls (HC) (19-42 years; 9 males) using a 7 Tesla MR scanner. Assessments for symptom severity included the Beck Depression Inventory-II (BDI-II) for depression and the Gastrointestinal Symptom Rating Scale (GSRS) for CD.
Significant differences in BDI-II scores are observed among the groups (χ = 37.16, p < 0.0001), with CD patients scoring higher than HCs but lower than MDD patients. Correlation shows a positive association between GSRS and BDI-II scores in CD patients. Group-level fMRI analysis of normalized fALFF maps reveals significant clusters in the precuneus cortex. Subsequent seed-based connectivity analysis using the precuneus as seed region shows increased connectivity with the left supramarginal gyrus and decreased connectivity with the precuneus and anterior cingulate gyrus in MDD and CD compared to HCs.
These exploratory findings reveal similar abnormalities in brain activity and connectivity in CD and MDD. A deeper understanding of these interactions may enable integrated treatment approaches that address both psychological and physiological aspects of these interconnected conditions.
新出现的证据凸显了中枢神经系统对肠道的深远影响。这在炎症性肠病中尤为明显，心理压力已被证明可调节炎症反应并先于疾病发作。大脑参与克罗恩病（CD）的神经心理学关联及其与重度抑郁症（MDD）重叠的神经生物学途径仍未明确界定。本研究旨在使用超高场神经成像来描绘这些共同机制。
使用7特斯拉磁共振扫描仪对13名CD患者（年龄范围：20 - 41岁；9名男性）、13名年龄匹配的MDD患者（20 - 42岁；9名男性）和13名健康对照者（HC）（19 - 42岁；9名男性）进行静息态功能磁共振成像。症状严重程度评估包括用于评估抑郁的贝克抑郁量表第二版（BDI-II）和用于评估CD的胃肠道症状评定量表（GSRS）。
各组间BDI-II评分存在显著差异（χ = 37.16，p < 0.0001），CD患者得分高于HC，但低于MDD患者。相关性分析显示CD患者中GSRS与BDI-II评分呈正相关。对标准化fALFF图进行组水平功能磁共振成像分析，发现楔前叶皮质有显著簇集。随后以楔前叶为种子区域进行基于种子的连通性分析显示，与HC相比，MDD和CD患者与左侧缘上回的连通性增加，与楔前叶和前扣带回的连通性降低。
这些探索性发现揭示了CD和MDD在大脑活动和连通性方面存在相似异常。对这些相互作用的更深入理解可能有助于采用综合治疗方法来解决这些相互关联病症的心理和生理方面问题。
