METHODS: A total of 39 IBS patients, 39 MDD patients, and 40 healthy controls (HCs) were enrolled and matched for sex, age, and educational level. All subjects underwent resting-state functional MRI. The clinical variables of anxiety, depression, gastrointestinal symptoms and alexithymia were recorded. The 12 subregions of the striatum were employed as seeds to assess their functional connectivity (FC) with every voxel throughout the whole brain.
RESULTS: Compared to HC, IBS and MDD patients exhibited aberrant frontal-striatal circuitry. We observed a common decrease in FC between the dorsal striatum and regions of the hippocampus, sensorimotor cortex, and prefrontal cortex (PFC) in both IBS and MDD patients. Patients with IBS exhibited disorder-specific decreases in FC within the striatum, along with reduced connectivity between the ventral striatum and sensorimotor cortex. In contrast, MDD patients showed disorder-specific hyperconnectivity in the medial PFC-limbic system. Receiver operating characteristic curve analysis showed that frontal-striatal FC values could serve as transdiagnostic markers of IBS and MDD. Within the IBS group, striatal connectivity was not only negatively associated with weekly abdominal pain days but also negatively correlated with the levels of anxiety and alexithymia.
CONCLUSIONS: This exploratory analysis indicated that patients with IBS and MDD exhibited both shared and disorder-specific frontal-striatal circuit impairments, potentially explaining both comorbidity and distinct phenotypes.
方法:共39例IBS患者,39例MDD患者,40名健康对照(HCs)被纳入并进行性别匹配,年龄,和教育水平。所有受试者均接受静息状态功能MRI。焦虑的临床变量,抑郁症,记录胃肠道症状和述情障碍。纹状体的12个子区域被用作种子以评估它们与整个大脑中每个体素的功能连通性(FC)。
结果:与HC相比,IBS和MDD患者表现出异常的额叶纹状体回路。我们观察到背侧纹状体和海马区之间FC的共同下降,感觉运动皮层,IBS和MDD患者的前额叶皮质(PFC)。IBS患者纹状体内FC表现出疾病特异性下降,腹侧纹状体和感觉运动皮层之间的连通性降低。相比之下,MDD患者在内侧PFC-边缘系统中显示出特定于疾病的超连接。受试者工作特征曲线分析表明,额纹状体FC值可作为IBS和MDD的诊断标志物。在IBS组内,纹状体连接不仅与每周腹痛天数呈负相关,而且与焦虑和述情障碍水平呈负相关.
结论:这项探索性分析表明,患有IBS和MDD的患者表现出共同的和特定于疾病的额叶纹状体回路损伤,可能解释合并症和不同表型。