Changes in the anterior cingulate cortex in Crohn's disease: A neuroimaging perspective

Area of Science:

• Neuroscience
• Gastroenterology
• Psychiatry

Background:

• Crohn's disease (CD) pathophysiology extends beyond the gut, impacting brain function.
• The anterior cingulate cortex (ACC) shows abnormalities in CD patients, affecting pain perception and emotional regulation.
• The ACC is a key region within the default mode network (DMN) and pain matrix.

Purpose of the Study:

• To review and summarize studies investigating changes in the ACC in Crohn's disease.
• To analyze structural, functional, and metabolic alterations in the ACC using neuroimaging.
• To correlate ACC changes with clinical symptoms such as abdominal pain and mood disorders.

Main Methods:

• Comprehensive PubMed literature search (1980-August 2020).
• Review focused on nine studies examining the ACC.
• Neuroimaging techniques included structural MRI, resting-state fMRI, and MR spectroscopy.

Main Results:

• Structural changes: Decreased gray matter volume and cortical thickness, increased gyrification.
• Functional changes: Altered functional connectivity (FC) within the DMN and between ACC and amygdala.
• Metabolic changes: Increased glutamate and decreased GABA, linked to abdominal pain.

Conclusions:

• The ACC exhibits significant structural, functional, and metabolic changes in Crohn's disease patients.
• ACC dysfunction is implicated in the development of depression, anxiety, and abdominal pain in CD.
• Modulating ACC pathways offers potential therapeutic targets for managing CD symptoms.