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eNeuro. 2018 Aug 14;5(4). pii: ENEURO.0354-17.2018. doi: 10.1523/ENEURO.0354-17.2018. eCollection 2018 Jul-Aug.

Microstructural White Matter Abnormalities in the Dorsal Cingulum of Adolescents with IBS.

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Center for Pain and the Brain, Boston Children's Hospital, Waltham, MA.
Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA.
Department of Anaesthesia, Harvard Medical School, Boston, MA.
Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA.
Department of Radiology, Harvard Medical School, Boston, MA.
Division of Gastroenterology, Hepatology and Nutrition, Center for Motility and Functional Gastrointestinal Disorders, Boston Children's Hospital, Boston, MA.
Department of Pediatrics, Harvard Medical School, Boston, MA.


Alterations in fractional anisotropy (FA) have been considered to reflect microstructural white matter (WM) changes in disease conditions; however, no study to date has examined WM changes using diffusion tensor imaging (DTI) in adolescents with irritable bowel syndrome (IBS). The objective of the present study was two-fold: (1) to determine whether differences in FA, and other non-FA metrics, were present in adolescents with IBS compared to healthy controls using whole-brain, region of interest (ROI)-restricted tract-based spatial statistics (TBSS) and canonical ROI DTI analyses for the cingulum bundle, and (2) to determine whether these metrics were related to clinical measures of disease duration and pain intensity in the IBS group. A total of 16 adolescents with a Rome III diagnosis of IBS (females = 12; mean age = 16.29, age range: 11.96-18.5 years) and 16 age- and gender-matched healthy controls (females = 12; mean age = 16.24; age range: 11.71-20.32 years) participated in this study. Diffusion-weighted images were acquired using a Siemens 3-T Trio Tim Syngo MRI scanner with a 32-channel head coil. The ROI-restricted TBSS and canonical ROI-based DTI analyses revealed that adolescents with IBS showed decreased FA in the right dorsal cingulum bundle compared to controls. No relationship between FA and disease severity measures was found. Microstructural WM alterations in the right dorsal cingulum bundle in adolescents with IBS may reflect a premorbid brain state or the emergence of a disease-driven process that results from complex changes in pain- and affect-related processing via spinothalamic and corticolimbic pathways.


DTI; IBS; abdominal pain; functional GI disorders; pediatrics

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