Abstract
Patients with inflammatory bowel disease have been shown to have abnormal brain morphometry or function, which are associated with psychological symptoms such as stress, depression or anxiety. The present work recruited 20 Crohn’s disease patients in remission (CDs) and 20 age-gender-handedness-education matched healthy controls (HCs) and compared their brain white matter microstructural properties using Diffusion Tensor Imaging (DTI). Additionally, we examined the correlations between the microstructural properties and cognition (verbal fluency language task, VF) and affect (anxiety) in both groups as well as disease duration in CDs. Results showed that CDs exhibited significant alterations in microstructural properties compared to HCs in various white matter tracts relevant to language function despite no significant difference in VF scores. Furthermore, CDs’ microstructural changes exhibited correlations with anxiety level and disease duration. These findings suggest that CD patients may experience changes in white matter microstructural properties which may be a biomarker of neuropsychiatric comorbidities of CD.
Highlights
Patients with inflammatory bowel disease have been shown to have abnormal brain morphometry or function, which are associated with psychological symptoms such as stress, depression or anxiety
The observed brain changes might account for the increased sensitivity of the Crohn’s disease patients in remission (CDs) patients to their related external environment which has been described among CDs and the inadequate ability to modulate cognitive and emotional states[3,6,7]
A task-based functional neuroimaging study with verbal fluency (VF) task showed CDs’ activity intensity in right hemisphere regions to be positively correlated with disease duration[13]; another study with a stress task consisting of Stroop color-word interference showed increased activity in the midcingulate cortex in CDs’ which possibly indicates an association between stress and symptomatic disease[14]; Another study showed increased sub-cortical activity in CDs’ while responding to an uncertainty condition[15]
Summary
Patients with inflammatory bowel disease have been shown to have abnormal brain morphometry or function, which are associated with psychological symptoms such as stress, depression or anxiety. CDs with extraintestinal manifestations showed increased cortical surface area in the left middle frontal gyrus and hypergyrification in the left lingual gyrus (responsible for depression)[10,11], while CDs without extraintestinal manifestations showed hypogyrification of the right insular gyrus and hypergyrification www.nature.com/scientificreports of the right anterior cingulate cortex (responsible for emotional processing such as grief, sadness, pain)[12]. These differences in results are possibly due to differences in patients age, handedness, disease characteristics and comorbidities, as well as sample size of these different studies. We used DTI to examine the alterations in microstructural properties in CDs in remission when compared to HCs and examined the association between DTI metrics and cognitive and affective measures, as well as disease duration
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