Abstract
The study focuses on evaluation of the Default Mode Network (DMN) activity in functional magnetic resonance imaging (fMRI) in resting state in patients with functional dyspepsia (FD) and irritable bowel syndrome (IBS), Crohn's disease and colitis ulcerosa (IBD) in comparison to healthy volunteers. We assume that etiology of both functional and non-specific inflammatory bowel diseases is correlated with disrupted structure of axonal connections. We would like to identify the network of neuronal connections responsible for presentation of symptoms in these diseases. 56 patients (functional dyspepsia, 18; Crohn's disease and colitis ulcerosa, 18; irritable bowel syndrome, 20) and 18 healthy volunteers underwent examination in MRI of the brain with assessment of brain morphology and central nervous system activity in functional imaging in resting state performed in 3T scanner. Compared to healthy controls' DMN in patients with non-specific digestive tract diseases comprised additional areas in superior frontal gyrus of left hemisphere, in left cingulum and in the left supplementary motor area. Discovered differences in the DMNs can be interpreted as altered processing of homeostatic stimuli. Our study group involved patients suffering from both functional and non-specific inflammatory bowel diseases. Nevertheless a spectrum of changes in the study group (superior frontal gyrus of the left hemisphere, in the left cingulum and in the left supplementary motor area) we were able to find common features, differentiating the whole study group from the healthy controls.
Highlights
Functional disorders of the gastrointestinal tract (FGIDs) may explain from 25% up to 40% gastrointestinal tract (GI) derived symptoms in young adults [1]
FGIDs are often described as immunohormonal mucosal disorders or functional mucosal syndromes and symptoms seem to derive from a disturbance of balance between inflammatory cytokines released from intraepithelial lymphocytes and cytokines inhibiting inflammatory processes [7,8,9]
Patients suffering from FGIDs have been enrolled according to Rome III Criteria summarized in Table 1 [5, 6]
Summary
Functional disorders of the gastrointestinal tract (FGIDs) may explain from 25% up to 40% gastrointestinal tract (GI) derived symptoms in young adults [1]. Epidemiological data prove that chronic stress disorders underlie both FGIDs and IBDs [2, 3]. FGIDs are often described as immunohormonal mucosal disorders or functional mucosal syndromes and symptoms seem to derive from a disturbance of balance between inflammatory cytokines released from intraepithelial lymphocytes and cytokines inhibiting inflammatory processes [7,8,9]. Studies reported that chronic pain is causing functional reorganization in the default mode network [26,27,28]. There is a limited number of studies which examined the role of DMN in inflammatory bowel diseases, among others, Liu et al [29] reported disrupted local and global topological patterns of functional neural networks, including DMN in CD patients. We decided to focus on the default mode network as the one most activated during processing the self-specific stimuli [31]
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