Negative correlation of cortical thickness with the severity and duration of abdominal pain in Asian women with irritable bowel syndrome

August Negative correlation of cortical thickness with the severity and duration of abdominal pain in Asian women with irritable bowel syndrome Chian Sem Chua 0 1 2 Chyi-Huey Bai 2 Chen-Yu Shiao 2 Chien-Yeh Hsu 2 Chiao- Wen Cheng 2 Kuo-Ching Yang 2 Hung-Wen Chiu 1 2 Jung-Lung Hsu 2 0 Western Medicine Division, Hospital Lam Wah Ee, Penang, Malaysia, 4 Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University , Taipei, Taiwan , 5 School of Public Health, College of Public Health and Nutrition, Taipei Medical University , Taipei, Taiwan , 6 Department of Diagnostic Radiology, Shin-Kong Wu Ho-Su Memorial Hospital , Taipei, Taiwan , 7 Department of Information Management, National Taipei University of Nursing and Health Sciences , Taipei, Taiwan , 8 Master Program in Global Health and Development, College of Public Health and Nutrition, Taipei Medical University , Taipei, Taiwan , 9 Department of Transportation & Logistics Management, National Chiao Tung University , Taipei, Taiwan , 10 School of Medicine, Taipei Medical University , Taipei, Taiwan , 11 Department of Neurology, Chang Gung Memorial Hospital Linkou Medical Center and College of Medicine, Chang-Gung University , Taoyuan, Taiwan , 12 Graduate Institute of Humanities in Medicine, Taipei Medical University , Taipei , Taiwan 1 Graduate Institute of Biomedical Informatics, Taipei Medical University , Taipei, Taiwan , 2 Division of Gastroenterology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital , Taipei , Taiwan 2 Editor: Kewei Chen, Banner Alzheimer's Institute , UNITED STATES Background & aims Irritable bowel syndrome (IBS) manifests as chronic abdominal pain. One pathophysiological theory states that the brain±gut axis is responsible for pain control in the intestine. Although several studies have discussed the structural changes in the brain of IBS patients, most of these studies have been conducted in Western populations. Different cultures and sexes experience different pain sensations and have different pain responses. Accordingly, we aimed to identify the specific changes in the cortical thickness of Asian women with IBS and to compare these data to those of non-Asian women with IBS. - Data Availability Statement: All relevant data are within the paper. Funding: Shin Kong Wu Ho-Su Memorial Hospital (SKH-8302-102-DR-14). The funders had no role iin study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist. Methods Thirty Asian female IBS patients (IBS group) and 39 healthy individuals (control group) were included in this study. Brain structural magnetic resonance imaging was performed. We used FreeSurfer to analyze the differences in the cortical thickness and their correlations with patient characteristics. Results The left cuneus, left rostral middle frontal cortex, left supramarginal cortex, right caudal anterior cingulate cortex, and bilateral insula exhibited cortical thinning in the IBS group compared with those in the controls. Furthermore, the brain cortical thickness correlated negatively the severity as well as duration of abdominal pain. Conclusions Some of our findings differ from those of Western studies. In our study, all of the significant brain regions in the IBS group exhibited cortical thinning compared with those in the controls. The differences in cortical thickness between the IBS patients and controls may provide useful information to facilitate regulating abdominal pain in IBS patients. These findings offer insights into the association of different cultures and sexes with differences in cortical thinning in patients with IBS. Introduction Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disease. Patients with IBS frequently suffer from chronic abdominal pain and bloating. IBS affects 10%±20% of the global population and is more common in Western countries, affecting 7%±15% of the population in the United States [ 1 ]. IBS affects 6%±11.5% of the population in various Asian countries [ 2 ]. Among IBS patients, women have a 38% higher prevalence of constipationpredominant IBS [ 3 ]. Most IBS patients are aged between 30 and 50 years [ 4 ]. In Taiwan, the prevalence of functional gastrointestinal disorder is 26.2%, and 4.4% of these patients fulfill the Rome III criteria [ 5 ]. IBS patients in Taiwan are younger than those in other Asian countries and are predominantly female. Several diseases, including major depression, anxiety [ 6 ], fibromyalgia, chronic fatigue syndrome, and chronic pelvic pain, have been associated with IBS [ 7 ]. Several clinical criteria, more commonly the ROME III criteria [ 8 ], are used to diagnose IBS. The brain±gut axis regulates the food digestion process in humans. However, this axis is also related to stress, mood disorder, abdominal pain, and altered bowel (...truncated)