Enhanced interhemispheric functional connectivity in patients with functional anorectal pain

Area of Science:

• Neuroscience
• Gastroenterology
• Psychiatry

Background:

• Functional anorectal pain (FAP) is a chronic condition with poorly understood causes, often associated with psychological distress.
• Brain imaging studies are crucial for understanding the neural underpinnings of FAP.

Purpose of the Study:

• To investigate aberrant interhemispheric functional connectivity in FAP patients using resting-state functional magnetic resonance imaging (rs-fMRI).
• To explore potential neural biomarkers and therapeutic targets for FAP.

Main Methods:

• rs-fMRI was used to compare functional connectivity (FC) and voxel-mirrored homotopic connectivity (VMHC) between 30 FAP patients and 21 healthy controls (HC).
• Seed-based FC analysis focused on the left middle frontal gyrus (MFG.L).

Main Results:

• FAP patients exhibited enhanced FC between MFG.L and regions including the right MFG (MFG.R) and left superior temporal gyrus (STG.L).
• Increased VMHC patterns were observed in MFG.L and the left superior medial frontal gyrus (SFGmed.L) in FAP patients.
• Heightened FC between MFG.L and MFG.R showed a negative correlation with age.

Conclusions:

• FAP is characterized by aberrant interhemispheric hyperconnectivity, potentially influencing pain perception and emotional processing.
• These neural alterations may serve as diagnostic biomarkers and therapeutic targets, suggesting a brain-gut axis dysregulation framework for FAP.
• The age-dependent decline in FC suggests diminishing neuroplasticity in aging FAP patients, necessitating circuit-specific therapeutics.