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Related Concept Videos

Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy01:30

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Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
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A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
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Inflammatory Bowel Disease III: Crohn's Disease01:25

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Crohn’s disease is a chronic, relapsing form of inflammatory bowel disease characterized by segmental, transmural inflammation that can affect any part of the gastrointestinal tract. Its pathogenesis arises from a combination of genetic susceptibility, environmental exposures, epithelial barrier dysfunction, and immune dysregulation. Together, these factors lead to an exaggerated immune response against components of the gut microbiome.Genetic and Environmental InfluencesMultiple genetic...
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Inflammatory Bowel Disease I: Introduction01:26

Inflammatory Bowel Disease I: Introduction

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Inflammatory bowel disease is a group of chronic disorders marked by recurrent inflammation of the gastrointestinal tract due to an abnormal immune response against gut microflora. This leads to tissue damage. The two main forms are Crohn’s disease and ulcerative colitis.Crohn’s DiseaseCrohn’s disease is a relapsing inflammatory disorder that can affect any part of the GI tract, from the mouth to the anus. It involves all layers of the bowel wall (transmural) and shows...
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Inflammatory Bowel Disease IV: Clinical Manifestations01:20

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Inflammatory bowel disease (IBD) encompasses two major chronic disorders—ulcerative colitis and Crohn’s disease—each characterized by relapsing episodes of gastrointestinal inflammation. Although they share certain clinical features, their patterns of involvement and manifestations differ in ways that aid diagnosis and guide management.Ulcerative ColitisUlcerative colitis is limited to the colon and rectum and involves continuous inflammation of the mucosal layer. The...
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Understanding and evaluating diffusion and perfusion is critical in assessing a patient's respiratory and circulatory health. These processes play key roles in maintaining the body's internal environment, ensuring that tissues receive adequate oxygen while waste products are efficiently removed.
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Ulcerative colitis is a chronic inflammatory disorder of the colon characterized by continuous mucosal inflammation that typically begins in the rectum and extends proximally in a uniform pattern. Its pathogenesis involves a complex interplay of genetic predisposition, immune dysregulation, and environmental influences. These factors converge to impair the colon’s epithelial defenses and promote an exaggerated inflammatory response against luminal contents.Breakdown of the Mucosal...
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Brain involvement in patients with inflammatory bowel disease: a voxel-based morphometry and diffusion tensor imaging

Anastasia K Zikou1, Maria Kosmidou, Loukas G Astrakas

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Inflammatory bowel disease (IBD) patients exhibit brain atrophy and white matter changes, indicating central nervous system involvement. These structural brain abnormalities may be linked to vasculitis and ischemia, impacting neurological function.

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Area of Science:

  • Neuroscience
  • Gastroenterology
  • Radiology

Background:

  • Inflammatory bowel disease (IBD) is increasingly recognized to involve extraintestinal manifestations, including potential central nervous system (CNS) effects.
  • Understanding the neurobiological underpinnings of IBD is crucial for comprehensive patient care.

Purpose of the Study:

  • To investigate structural brain alterations in patients with inflammatory bowel disease (IBD) using advanced neuroimaging techniques.
  • To identify specific patterns of grey matter atrophy and white matter abnormalities in IBD.

Main Methods:

  • Brain magnetic resonance imaging (MRI) was conducted on 18 IBD patients and 20 age-matched controls.
  • Voxel-based morphometry (VBM) analyzed grey matter volume, while tract-based spatial statistics (TBSS) assessed white matter microstructure (axial diffusivity).
  • White matter hyperintensities (WMHIs) were evaluated on FLAIR images.

Main Results:

  • VBM revealed significant grey matter (GM) atrophy in IBD patients in regions including the fusiform gyrus, inferior temporal gyrus, and precentral gyrus.
  • TBSS demonstrated reduced axial diffusivity (AD) in the corticospinal tract and superior longitudinal fasciculus in IBD patients.
  • A higher prevalence of white matter hyperintensities (WMHIs) was observed in the IBD cohort compared to controls.

Conclusions:

  • Patients with IBD show evidence of brain atrophy and increased WMHIs, suggesting CNS involvement.
  • Microstructural brain abnormalities, detected by diffusion tensor imaging, and GM atrophy are present in IBD.
  • These findings may be associated with cerebral vasculitis, ischemia, and secondary Wallerian degeneration.