Abstract
Acupuncture is a traditional Chinese medicine treatment that has widely been used to modulate gastrointestinal dysfunction caused by irritable bowel syndrome (IBS) and to alleviate the resulting pain. Recent studies have shown that gastrointestinal dysfunction caused by IBS is associated with dysregulation of the brain's central and peripheral nervous system, while functional magnetic resonance imaging (fMRI) helps explore functional abnormality of the brain. However, previous studies rarely used fMRI to study the correlations between brain functional connection, interaction, or segregation (e.g., network degree and clustering coefficient) and acupuncture stimulation in IBS. To bridge this knowledge gap, we study the changed brain functional connection, interaction, and segregation before and after acupuncture stimulation for diarrhea-dominant IBS (IBS-D) with the help of complex network methods based on fMRI. Our results indicate that the abnormal functional connections (FCs) in the right hippocampus, right superior occipital gyrus, left lingual gyrus, left middle occipital gyrus, and the cerebellum, and abnormal network degree in right middle occipital gyrus, where normal controls are significantly different from IBS-D patients, are improved after acupuncture stimulation. These changed FCs and the network degree before and after acupuncture stimulation have significant correlations with the changed clinical information including IBS symptom severity score (r = −0.54, p = 0.0065) and IBS quality of life (r = 0.426, p = 0.038). We conclude that the changes of the brain functional connection, interaction, and segregation in the hippocampus, middle and superior occipital gyrus, cerebellum, and the lingual gyrus may be related to acupuncture stimulation. The abnormal functional connection, interaction, and segregation in IBS-D may be improved after acupuncture stimulation.
Highlights
Irritable bowel syndrome (IBS) is a kind of intestinal disorder characterized by abdominal pain, abdominal distension, changed defecation habits, and stool characteristics, accompanying gastrointestinal dysfunction and biochemical abnormalities (Mayer, 2008)
The term “cured” denotes that IBSbs have changed functional connections and network characteristics compared to normal controls (NC), these changed connections and characteristics still existed between IBSbs and IBS1st, but these connections and characteristics of IBS1st returned to the normal level after acupuncture stimulation
The term “activated” denotes that irritable bowel syndrome (IBS)-D patients without acupuncture stimulation have similar functional connections and network characteristics compared to NC, i.e., the functional connections and network characteristics of IBSbs and NC were from the same probability distribution
Summary
Irritable bowel syndrome (IBS) is a kind of intestinal disorder characterized by abdominal pain, abdominal distension, changed defecation habits, and stool characteristics, accompanying gastrointestinal dysfunction and biochemical abnormalities (Mayer, 2008). Recent studies have shown that gastrointestinal dysfunction caused by IBS is associated with the dysregulation of the brain’s central and peripheral nervous system (Omalley, 2016; Wang et al, 2017) and may be altered by psychological factors such as stress, anxiety, and depression (Ke et al, 2015). Few of these studies make the effort to utilize functional interaction and segregation to investigate the brain dysfunction mechanism of IBS and those modulated by related treatments such as acupuncture stimulation
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