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Cine gastric MRI reveals altered Gut-Brain Axis in Functional Dyspepsia: gastric
motility is linked with brainstem-cortical fMRI connectivity.
Sclocco R, Fisher H, Staley R, Han K, Mendez A, Bolender A, Coll-Font J, Kettner
NW, Nguyen C, Kuo B, Napadow V
Submitted Externally on 6/21/2022
Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society, REFERENCES
Volume : Pages
Functional dyspepsia (FD) is a disorder of gut-brain interaction, and its
putative pathophysiology involves dysregulation of gastric motility and central
processing of gastric afference. The vagus nerve modulates gastric peristalsis
and carries afferent sensory information to brainstem nuclei, specifically the
nucleus tractus solitarii (NTS). Here, we combine MRI assessment of gastric
kinematics with measures of NTS functional connectivity to the brain in patients
with FD and healthy controls (HC), in order to elucidate how gut-brain axis
communication is associated with FD pathophysiology., Functional dyspepsia and
HC subjects experienced serial gastric MRI and brain fMRI following ingestion of
a food-based contrast meal. Gastric function indices estimated from 4D cine MRI
data were compared between FD and HC groups using repeated measure ANOVA models,
controlling for ingested volume. Brain connectivity of the NTS was contrasted
between groups and associated with gastric function indices., Propagation
velocity of antral peristalsis was significantly lower in FD compared to HC. The
brain network defined by NTS connectivity loaded most strongly onto the Default
Mode Network, and more strongly onto the Frontoparietal Network in FD. FD also
demonstrated higher NTS connectivity to insula, anterior cingulate and
prefrontal cortices, and pre-supplementary motor area. NTS connectivity was
linked to propagation velocity in HC, but not FD, whereas peristalsis frequency
was linked with NTS connectivity in patients with FD., Our multi-modal MRI
approach revealed lower peristaltic propagation velocity linked to altered
brainstem-cortical functional connectivity in patients suffering from FD
suggesting specific plasticity in gut-brain communication.
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Financial support for this work was provided by the NIDDK Mouse Metabolic Phenotyping Centers (National MMPC, RRID:SCR_008997,
) under the MICROMouse Program, grants DK076169.
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