Associations between brain morphology, inflammatory markers and symptoms of fatigue, depression or anxiety in active and remitted [CD], 2024, Thomann+

[Andy]

Full title: Associations between brain morphology, inflammatory markers and symptoms of fatigue, depression or anxiety in active and remitted Crohn’s disease

Abstract

Background
Fatigue and psychosocial impairments are highly prevalent in IBD, especially during active disease. Disturbed brain-gut-interactions may contribute to these symptoms. This study examined associations between brain structure, faecal calprotectin and symptoms of fatigue, depression and anxiety in persons with Crohn’s Disease (CD) in different disease states.

Methods
In this prospective observational study, n=109 participants (n=67 persons with CD, n=42 healthy controls) underwent cranial magnetic resonance imaging, provided stool samples for analysis of faecal calprotectin and completed questionnaires to assess symptoms of fatigue, depression and anxiety. We analysed differences in grey matter volume (GMV) between patients and controls and associations between regional GMV alterations, neuropsychiatric symptoms and faecal calprotectin.

Results
Symptoms of fatigue, depression and anxiety were increased in patients with CD compared to controls, with highest scores in active CD. Patients exhibited regionally reduced GMV in cortical and subcortical sensorimotor regions, occipitotemporal and medial frontal areas. Regional GMV differences showed a significant negative association with fatigue, but not with depression or anxiety. Subgroup analyses revealed symptom-GMV-associations for fatigue in remitted, but not in active CD, while fatigue was positively associated with faecal calprotectin in active, but not remitted disease.

Conclusion
Our findings support disturbed brain-gut-interactions in CD which may be particularly relevant for fatigue during remitted disease. Reduced GMV in the precentral gyrus and other sensorimotor areas could reflect key contributions to fatigue pathophysiology in CD. A sensorimotor model of fatigue in CD could also pave the way for novel treatment approaches.

Paywall, https://academic.oup.com/ecco-jcc/advance-article-abstract/doi/10.1093/ecco-jcc/jjae078/7675647

 

[rvallee]

Symptoms of fatigue, depression and anxiety were increased in patients with CD compared to controls, with highest scores in active CD

Exactly as expected given that many questions overlap. So what is even the point of using questionnaires that have overlapping questions? If other fields of science did this it would lead to completely absurd findings, but here it seems to bother basically no one.

All organs are connected with and influence the brain bi-directionally, diseased or not. Talking about this makes as much sense as there being a blood-liver interaction. Of course there is such an interaction, it all works as an organism.

Also we keep seeing brain matter, usually white or gray, being reduced, but other than observations no one seems to have dug further into it. What does it mean for that volume to be reduced? Is it cells dying out, permanent brain shrinkage? Cells morphing to a different state? What is causing it? What does it do?