Comparison of resting state brain function in different subtypes of functional dyspepsia

2521 

Abstract Submission 

yi luo¹, Yue Ma¹, Chunlei Guo¹, Shanshan Gao¹, Qingyan Chen¹, Jiliang Fang¹

¹Guanganmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China, Beijing, China

yi luo  
Guanganmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
Beijing, China

Yue Ma  
Guanganmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
Beijing, China

Chunlei Guo  
Guanganmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
Beijing, China

Shanshan Gao  
Guanganmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
Beijing, China

Qingyan Chen  
Guanganmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
Beijing, China

Jiliang Fang  
Guanganmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
Beijing, China

Functional dyspepsia is a group of clinical syndromes with postprandial fullness, early satiation, epigastric pain or burning as the main symptoms with no structural disease on routine investigations. According to different symptoms, it was divided into postprandial discomfort syndrome (PDS), upper abdominal pain syndrome (EPS) and overlap PDS/EPS[1], the pathogenesis is complex and needs to be further explored. The theory of "brain-gut axis" is a bidirectional information communication pathway between digestive tract and the center proposed in recent years[2]. The newly published Rome IV listed the dysfunction of brain-gut axis as one of the main pathogenesis. We aimed to collect resting state functional Magnetic Resonance Imaging(rest-fMRI) data and explore the brain mechanism of PDS and Overlap PDS/EPS by analyzing brain function abnormalities.

Eighty-three patients with FD were randomly enrolled and divided into 35 FD group with pain (Overlap PDS/EPS) and 48 FD group without pain (PDS) according to whether they were accompanied by epigastric pain, and 45 healthy controls (HCs) matched by age and sex were included. After the three groups were included, fMRI scans were performed, and 17 items of Hamilton Depression Scale (17-HAMD) and Hamilton Anxiety Scale (HAMA) were scored. Nepean Dyspepsia Index (NDI) and functional dyspepsia Quality of Life scale (FDDQL) were scored in PDS and Overlap PDS/EPS. Then we analyzed the differences in scale scores and partial correlations, further analyzed the differences in ALFF values of brain functions among the three groups, and compared the differences in FC values by using the brain areas with differences in ALFF values as Regions of Interest (ROI).

The results of the clinical scales showed that the NDI scores in the Overlap PDS/EPS were significantly higher than those of the PDS (P < 0.05).The HAMD and HAMA scores of the Overlap PDS/EPS and PDS groups were significantly higher than those of the HC (P < 0.001).The sum of the scores of the first item of the NDI scale (epigastric pain) and the fifth item of the NDI scale (spasmodic pain in the epigastric region) in the Overlap PDS/EPS was significantly positively correlated with the HAMD score (P < 0.05). Analysis of brain imaging data showed that the ALFF values in the left precentral gyrus of the Overlap PDS/EPS were significantly higher than those of the PDS (P < 0.05), the ALFF values in the left insula of the Overlap PDS/EPS were significantly higher than those of the HC group (P < 0.05). Whole-brain FC analysis showed that the FC of the left precentral gyrus and bilateral postcentral gyrus was significantly higher than HC in the PDS (P < 0.05), the FC of the left insula and bilateral postcentral gyrus in the Overlap PDS/EPS was significantly lower than that in the PDS, which was significantly negatively correlated with the HAMD score(P＜0.05).

Patients with FD are often associated with anxiety and depression, and those with overlapping symptoms of PDS and EPS have more severe clinical symptoms and higher levels of depression than those with PDS alone, which is correlated with the degree of epigastric pain. The insula, which is related to emotion and visceral perception, and the sensorimotor network may be areas of differential brain functional activity in different subtypes of FD patients.

Emotion and Motivation Other

fMRI Connectivity and Network Modeling

Task-Independent and Resting-State Analysis

BOLD fMRI ²

Perception: Pain and Visceral ¹

Pain

Other - functional dyspepsia, subtype, postprandial discomfort syndrome, upper abdominal pain syndrome, overlap, fMRI