- Fecal Incontinence
|Role of brain imaging in disorders of brain-gut interaction: a Rome Working Team Report
Mayer EA1, Labus J1, Aziz Q2, Tracey I3, Kilpatrick L1, Elsenbruch S4, Schweinhardt P5, Van Oudenhove L6, Borsook D7. Gut. 2019 Jun 7. pii: gutjnl-2019-318308. doi: 10.1136/gutjnl-2019-318308. [Epub ahead of print]
1 G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
2 Neurogastroenterology Group, Queen Mary University of London, London, UK.
3 Departments of Anaesthetics and Clinical Neurology, Pembroke College, Oxford, UK.
4 Institute of Medical Psychology & Behavioral Immunobiology, University Hospital Essen, University of Duisburg, Duisburg, Germany.
5 Division of Biomedical Sciences, McGill University, Canada.
6 Translational Research in GastroIntestinal Disorders, KU Leuven Department of Clinical and Experimental Medicine, University of Leuven, Leuven, Belgium.
7 Center for Pain and the Brain, Boston Children's, Massachusetts General and McLean Hospitals, Harvard Medical School, Boston, Massachusetts, USA.
Imaging of the living human brain is a powerful tool to probe the interactions between brain, gut and microbiome in health and in disorders of brain-gut interactions, in particular IBS. While altered signals from the viscera contribute to clinical symptoms, the brain integrates these interoceptive signals with emotional, cognitive and memory related inputs in a non-linear fashion to produce symptoms. Tremendous progress has occurred in the development of new imaging techniques that look at structural, functional and metabolic properties of brain regions and networks. Standardisation in image acquisition and advances in computational approaches has made it possible to study large data sets of imaging studies, identify network properties and integrate them with non-imaging data. These approaches are beginning to generate brain signatures in IBS that share some features with those obtained in other often overlapping chronic pain disorders such as urological pelvic pain syndromes and vulvodynia, suggesting shared mechanisms. Despite this progress, the identification of preclinical vulnerability factors and outcome predictors has been slow. To overcome current obstacles, the creation of consortia and the generation of standardised multisite repositories for brain imaging and metadata from multisite studies are required.