Magnetic resonance imaging and functional constipation

Abstract

With the rapid development of society, the incidence of functional constipation (FC) is steadily increasing annually. As it poses an elevated risk for various physical and neuropsychiatric illnesses, the occurrence and development mechanisms of FC have garnered escalating attention from researchers. Accumulating evidence from studies using magnetic resonance imaging (MRI) suggests that FC is associated with alternations in brain function and structure, particularly within brain regions and networks involved in emotion regulation, motor control, somatic sensation, and self-reference. Specifically, significant differences in baseline brain activity and functional connectivity integrity exist between patients with FC and healthy controls. Patients with FC exhibit abnormal cortical morphometry, a lower gray/white matter volume, and impaired white matter integrity. These changes correlate with somatic symptoms, such as the difficulty level of defecation and the sensation of incomplete evacuation. Differences between patients with anxiety/depressive disorders (FCAD) and those without such disorders (FCNAD) underscore the pivotal role of psychiatric factors in FC development. In addition, studies have verified that female patients experience decreased emotional regulation, contributing to a higher prevalence of FC and more severe constipation symptoms than their male counterparts. This paper provides a comprehensive literature review, drawing upon existing MRI studies to explore the various brain abnormalities evident in patients with FC. Through the analysis of these studies, our aim is to shed light on the underlying neural mechanisms and offer valuable insights into the development of novel and effective treatments for FC.