Format

Send to

Choose Destination
PLoS One. 2019 Feb 8;14(2):e0211906. doi: 10.1371/journal.pone.0211906. eCollection 2019.

Primary biliary cholangitis patients exhibit MRI changes in structure and function of interoceptive brain regions.

Mosher V1,2, Swain M1,3,4, Pang J1,5, Kaplan G1, Sharkey K3,5,6, MacQueen G5,7,8, Goodyear BG2,5,7,9,10.

Author information

1
Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
2
Seaman Family MR Research Centre, University of Calgary, Calgary, Alberta, Canada.
3
Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta, Canada.
4
Liver Unit - Calgary Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada.
5
Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
6
Department of Physiology & Pharmacology, University of Calgary, Calgary, Alberta, Canada.
7
Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
8
Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Alberta, Canada.
9
Department of Radiology, University of Calgary, Calgary, Alberta, Canada.
10
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.

Abstract

BACKGROUND:

Many patients with primary biliary cholangitis (PBC) experience non-hepatic symptoms that are possibly linked to altered interoception, the sense of the body's internal state. We used magnetic resonance imaging (MRI) to determine if PBC patients exhibit structural and functional changes of the thalamus and insula, brain regions that process signals related to interoception.

METHODS:

Fifteen PBC patients with mild disease and 17 controls underwent 3 Tesla T1-weighted MRI, resting-state functional MRI, and quantitative susceptibility mapping (QSM), to measure thalamic and insular volume, neuronal activity and iron deposition, respectively. Group differences were assessed using analysis of covariance, and stepwise linear regression was used to determine the predictive power of clinical indicators of disease.

RESULTS:

PBC patients exhibited reduced thalamic volume (p < 0.01), and ursodeoxycholic acid (UDCA) non-responders exhibited lower left thalamus activity (p = 0.05). PBC patients also exhibited reduced anterior insula activity (p = 0.012), and liver stiffness positively correlated with MRI indicators of anterior insula iron deposition (p < 0.02).

CONCLUSIONS:

PBC affects structure and function of brain regions critically important to interoception. Moreover, these brain changes occur in patients with early, milder disease and thus may potentially be reversible.

PMID:
30735529
DOI:
10.1371/journal.pone.0211906
Free full text

Conflict of interest statement

The authors have declared that no competing interests exist.

Supplemental Content

Full text links

Icon for Public Library of Science
Loading ...
Support Center