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Aberrant Brain Function in Active-Stage Ulcerative Colitis Patients: A Resting-State Functional MRI Study.

Weijie Fan1, Si Zhang1, Junhao Hu1

  • 1Department of Radiology, XinQiao Hosptial, Third Military Medical University, ChongQing, China.

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|April 20, 2019
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Summary

Cognitive impairments in ulcerative colitis (UC) are linked to altered brain activity in the limbic system. Specifically, reduced hippocampal activity correlates with memory loss, and increased posterior cingulate cortex activity impacts executive function.

Keywords:
amplitude of low-frequency fluctuationbrain-gut axiscognitionemotionfunctional connectivityfunctional magnetic resonance imagingulcerative colitis

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Area of Science:

  • Neuroscience
  • Gastroenterology
  • Psychiatry

Background:

  • Ulcerative colitis (UC) patients often experience cognitive deficits, including memory loss and attention issues, especially during active disease phases.
  • The underlying neurological mechanisms for these cognitive impairments in UC remain largely unknown.
  • Understanding these mechanisms is crucial for developing targeted interventions.

Purpose of the Study:

  • To investigate the neuroimaging correlates of cognitive impairments in patients with active ulcerative colitis.
  • To explore the relationship between brain activity, functional connectivity, and cognitive performance in UC patients.
  • To elucidate the role of the brain-gut axis in UC-associated cognitive dysfunction.

Main Methods:

  • Recruited 41 patients with active UC and 42 healthy controls for assessment.
  • Utilized psychological scales, cognitive function tests, and resting-state functional magnetic resonance imaging (rs-fMRI).
  • Analyzed Amplitude of Low-Frequency Fluctuation (ALFF) to identify seed regions and calculated functional connectivity (FC) between these regions and the whole brain.

Main Results:

  • UC patients showed lower ALFF in the hippocampus/parahippocampal region and higher ALFF in the posterior cingulate cortex and middle frontal gyrus compared to controls.
  • Altered functional connectivity was observed, with increased FC in regions including the middle frontal gyrus, anterior cingulate cortex, and caudate nucleus when using the hippocampus as a seed point.
  • Increased FC in the middle cingulate cortex and angular gyrus was noted using the posterior cingulate cortex as a seed point, with these regions primarily in the limbic system.
  • Decreased hippocampal activity correlated with memory loss, while increased posterior cingulate cortex activity and its connectivity with the angular gyrus were associated with executive function and attention deficits.

Conclusions:

  • The limbic lobe appears central to the brain-gut axis (BGA) and plays a significant role in cognitive impairments observed in active UC.
  • Altered activity and connectivity within the limbic system, particularly involving the hippocampus and posterior cingulate cortex, are potential mechanisms underlying cognitive dysfunction in UC.
  • These findings highlight the importance of considering neurological involvement in the management of ulcerative colitis.