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Role of brain imaging in disorders of brain–gut interaction: a Rome Working Team Report
  1. Emeran A Mayer1,
  2. Jennifer Labus1,
  3. Qasim Aziz2,
  4. Irene Tracey3,
  5. Lisa Kilpatrick1,
  6. Sigrid Elsenbruch4,
  7. Petra Schweinhardt5,
  8. Lukas Van Oudenhove6,
  9. David Borsook7
  1. 1 G. Oppenheimer Center for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases David Geffen School of Medicine at UCLA, Los Angeles, California, USA
  2. 2 Neurogastroenterology Group, Queen Mary University of London, London, UK
  3. 3 Departments of Anaesthetics and Clinical Neurology, Pembroke College, Oxford, UK
  4. 4 Institute of Medical Psychology & Behavioral Immunobiology, University Hospital Essen, University of Duisburg, Duisburg, Germany
  5. 5 Division of Biomedical Sciences, McGill University, Canada
  6. 6 Translational Research in GastroIntestinal Disorders, KU Leuven Department of Clinical and Experimental Medicine, University of Leuven, Leuven, Belgium
  7. 7 Center for Pain and the Brain, Boston Children’s, Massachusetts General and McLean Hospitals, Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Dr Emeran A Mayer; emayer{at}, EMayer{at}


Imaging of the living human brain is a powerful tool to probe the interactions between brain, gut and microbiome in health and in disorders of brain–gut interactions, in particular IBS. While altered signals from the viscera contribute to clinical symptoms, the brain integrates these interoceptive signals with emotional, cognitive and memory related inputs in a non-linear fashion to produce symptoms. Tremendous progress has occurred in the development of new imaging techniques that look at structural, functional and metabolic properties of brain regions and networks. Standardisation in image acquisition and advances in computational approaches has made it possible to study large data sets of imaging studies, identify network properties and integrate them with non-imaging data. These approaches are beginning to generate brain signatures in IBS that share some features with those obtained in other often overlapping chronic pain disorders such as urological pelvic pain syndromes and vulvodynia, suggesting shared mechanisms. Despite this progress, the identification of preclinical vulnerability factors and outcome predictors has been slow. To overcome current obstacles, the creation of consortia and the generation of standardised multisite repositories for brain imaging and metadata from multisite studies are required.

  • irritable bowel syndrome
  • functional bowel disorder
  • magnetic resonance imaging
  • brain/gut interaction

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  • Contributors EAM: study design, writing of individual sections and overall manuscript generation.JL: neuroimaging analysis. QA: planning of study; critical review of manuscript. IT: neurobiology of treatment effects. LK: sex differences. SE: Gaps in knowledge. PS: non-pharmacological interventions. LvO: PET imaging. DB: neurobiology of treatment effects. All coauthors: critical review of the entire manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests EAM is on the scientific advisory boards of Axial Biotherapeutics, Bloom Science, Danone, Viome, Whole Biome and Mahana Therapeutics.

  • Provenance and peer review Commissioned; internally peer reviewed.

  • Correction notice This article has been corrected since it published Online First. The eighth author’s name has been corrected.

  • Patient consent for publication Not required.