Introduction Structural brain alterations in grey and white matter have been previously documented in adult Crohn’s Disease (CD) patients in remission, however data is inconsistent and not available in the active disease state. We aim to investigate changes in brain anatomy in patients with active CD, and their correlation with inflammatory markers and pain scores.
Method 12 active CD patients and 8 age-, BMI- and gender-matched healthy controls (HC), underwent anatomical MRI brain scans. Patient inclusion criteria was active CD (Harvey Bradshaw index >5 and CRP>5 mg/dl, or faecal calprotectin >250 ug/g, or as assessed through ileocolonoscopy/magnetic resonance enterography). Pain was assessed using validated questionnaires and interleukin-6 (IL-6) was measured from serum samples using ELISA. Anatomical T1-weighted brain images were acquired on a 3T MR scanner (1 mm isotropic resolution). Whole brain volumetry and voxel-based morphometry (VBM) were assessed using Statistical Parametric Mapping (SPM12) to identify regional differences in grey matter (GM) density between HCs and CD patients. A two sample t-test was carried out between HC and CD GM maps, with subjects’ age and total intracranial volume (TIV) as covariates of no interest. In CD patients, pain scores and IL-6 levels were correlated positively/negatively with the GM volume, again using age and TIV as covariates of no interest
Results No significant difference was found between the HCs and CD patients for demographics, pain scores. Serum IL-6 was non-significantly higher in CD than HCs. Significant differences in GM volume (p<0.001, uncorrected) were found between HC and CD patients; decrease in GM volume in CD patient’s in inferior frontal gyrus, mid-frontal gyrus, frontal operculum, temporal gyrus, postcentral gyrus; an increase in GM volume in CD patients in mid-cingulate cortex, post- and pre-central gyrus, and superior frontal gyrus. Blood serum IL-6 was negatively correlated with GM volume in CD patients in bilateral insula could be indicative of impaired pain processing (Fig1) and positively correlated in mid-frontal gyrus. Pain scores positively correlated with GM volume in frontal operculum and mid-frontal gyrus.
Conclusion GM volume in active CD patients is altered compared with HCs, with this possibly associated with a chronic inflammatory response but not to chronic pain as previously reported. These findings will aid our understanding of the cross-linking between chronic inflammation, brain structural changes and behaviour in CD with the aim of informing new medical and psychological therapies
Disclosure of Interest None Declared
- Crohn’s disease
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