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Functional constipation is associated with alterations in thalamo-limbic/parietal structural connectivity.

Zhida Zhang1, Yang Hu1, Ganggang Lv1

  • 1Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China.

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Summary

Functional constipation (FCon) is linked to altered brain structural connectivity (SC). Specifically, FCon patients show reduced SC between the thalamus and other brain regions, impacting sensory and motor control.

Keywords:
diffusion tensor imagingfunctional constipationlimbic/parietal cortexstructural connectivitythalamus

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Area of Science:

  • Neuroscience
  • Gastroenterology
  • Medical Imaging

Background:

  • Functional constipation (FCon) is a prevalent functional gastrointestinal disorder (FGID).
  • Previous research indicates FCon is associated with functional and structural brain alterations.
  • The relationship between FCon and structural connectivity (SC) among key brain regions is not well understood.

Purpose of the Study:

  • To investigate structural connectivity (SC) differences in the brains of patients with functional constipation (FCon) compared to healthy controls (HC).
  • To identify specific brain pathways affected in FCon using diffusion tensor imaging (DTI).

Main Methods:

  • Diffusion tensor imaging (DTI) with probabilistic tractography was used.
  • 29 patients with FCon and 31 healthy controls (HC) were included.
  • Brain regions with known functional and structural abnormalities in FCon served as seed regions.

Main Results:

  • Patients with FCon exhibited lower fractional anisotropy (FA) in thalamic connections to the amygdala, hippocampal gyrus, precentral gyrus, postcentral gyrus, supplementary motor area, and precuneus.
  • Increased mean diffusivity (MD) and radial diffusivity (RD) were observed in thalamic connections to the amygdala and hippocampal gyrus in FCon patients.
  • Higher RD was found in the thalamus-supplementary motor area tract in FCon.
  • Reduced FA in thalamus-postcentral gyrus and thalamus-hippocampal gyrus tracts correlated with sensation of incomplete evacuation.
  • Reduced FA in the thalamus-supplementary motor area tract correlated with difficulty of defecation.

Conclusions:

  • Functional constipation is associated with altered structural connectivity (SC) between the thalamus and limbic/parietal cortical regions.
  • These findings underscore the thalamus's crucial role in the brain's structural network in the context of FCon.
  • SC alterations may contribute to the pathophysiology of functional constipation.