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Increased Cortical Thickness Combined With Altered Structural Covariance Networks in Functional Anorectal Pain
Lili Liu1, Yiding Wang1,2, Xiangjun Xu1
1Department of Anorectal Surgery, Affiliated Hospital of Jining Medical University, Jining, China.
Neurogastroenterology and Motility
|May 22, 2026
Summary
Functional anorectal pain (FAP) involves brain changes, including thickened cortex and altered brain networks. These neuroanatomical differences correlate with pain and anxiety, offering insight into FAP's biological underpinnings.
Area of Science:
- Neuroscience
- Gastroenterology
- Medical Imaging
Background:
- Functional anorectal pain (FAP) is a chronic gut-brain interaction disorder with poorly understood pathophysiology.
- Previous studies indicated localized brain alterations in FAP, but large-scale structural network organization remained unexplored.
Purpose of the Study:
- To investigate cortical thickness (CTh) and structural covariance networks (SCNs) in patients with FAP.
- To explore the relationship between neuroanatomical changes and clinical symptoms in FAP.
Main Methods:
- Acquired T1-weighted MRI scans from 29 FAP patients and 19 healthy controls.
- Employed surface-based morphometry for CTh analysis and graph theory for SCN topological characterization.
- Conducted partial correlation analyses to link neuroanatomy with clinical measures.
Main Results:
- FAP patients showed increased CTh in the left supramarginal/postcentral gyri and left medial orbitofrontal cortex.
- Widespread alterations in nodal centrality and efficiency were observed in FAP brain networks.
- Thicker left medial orbitofrontal cortex correlated with increased anxiety, overall pain, and pain intensity.
Conclusions:
- FAP exhibits distinct neuroanatomical changes: regional cortical thickening and reorganized structural networks.
- Medial orbitofrontal cortex alterations are linked to key clinical symptoms, emphasizing affective processing's role in FAP.
- This study provides the first system-level neural evidence for FAP, advancing understanding of its neurobiology.
