BLOG

“People with ulcerative colitis have stronger overall brain connectivity, but this increased interconnection may actually make their brain networks less efficient.”

Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) characterized by recurring inflammation of the colon’s mucosal lining, leading to symptoms such as abdominal pain, diarrhea, weight loss, and fatigue. Understanding the interactions between chronic gut inflammation and brain function is essential, as individuals with UC often experience cognitive and emotional challenges.

This post discusses the findings from a study titled “Functional brain rewiring and altered cortical stability in ulcerative colitis,” conducted by Hao Wang and colleagues from the Vatche and Tamar Manoukian Division of Digestive Diseases at UCLA and the University of Manitoba and published in the prestigious Journal of Molecular Psychiatry. The study aimed to explore changes in brain connectivity and stability in people with UC compared to those with irritable bowel syndrome (IBS) and healthy controls (HC), using resting-state functional magnetic resonance imaging (fMRI). The authors aimed to focus on understanding the clinical implications of these alterations.

The researchers utilized resting-state fMRI data from 222 participants divided into three groups: UC, IBS, and HC, with 74 participants in each group. The study focused on identifying global and regional brain network changes and their connection to patient symptoms and health measurements. Participants from UCLA and the University of Manitoba were screened for eligibility and assessed on various health and demographic factors before participating in the study.

“Alterations in brain connectivity, especially in regions like the medial prefrontal cortex, are linked to increased anxiety and depression in those with ulcerative colitis.”

The study uncovered several key differences in how the brains of individuals with UC function compared to those with IBS and HC. First, it was found that people with UC have stronger overall brain connectivity, meaning their brain regions are more interconnected. However, this isn’t necessarily positive—it implies that their brain networks might be less efficient, potentially leading to challenges in information processing.

Additionally, UC patients exhibited lower modularity in their brain networks. Modularity refers to how well the brain can organize different functions into separate, specialized regions. Lower modularity in UC patients indicates that they might struggle with tasks requiring cognitive flexibility and adaptability, which could contribute to difficulties in managing complex tasks or adjusting to new situations.

“These findings suggest that UC may disrupt the balance of brain activity, leading to decreased efficiency in cognitive functions while enhancing activity in other areas, possibly as a compensatory mechanism.”

The study also found that UC patients showed decreased connectivity in areas responsible for executive control, which is critical for decision-making and regulating behavior. At the same time, they had increased connectivity in regions associated with visual processing. These findings suggest that UC may disrupt the balance of brain activity, leading to decreased efficiency in cognitive functions while enhancing activity in other areas, possibly as a compensatory mechanism.

Finally, the study linked these brain changes to symptoms of anxiety and depression often seen in a subset of UC patients. Alterations in brain connectivity, especially in regions like the medial prefrontal cortex, were associated with increased emotional disturbances.
Overall, the study indicates that chronic gut inflammation in UC has a profound impact on brain function, potentially contributing to the cognitive and emotional challenges faced by individuals with the condition.

As someone living with a diagnosis of UC, I have experienced firsthand and seen the changes in my experience with anxiety and depression before and after developing UC. One way I address these cognitive and emotional changes is through gut-directed hypnosis therapy, which uses guided relaxation and focused attention techniques to help alleviate gastrointestinal symptoms by positively influencing the gut-brain axis.

This study provides valuable insights into the functional brain alterations in UC patients, highlighting the need for further research to understand the mechanisms underlying these changes. In view of data from large epidemiology studies about the increased prevalence of early cognitive decline in patients with UC and other chronic inflammatory diseases like rheumatoid arthritis, effective therapies to fully control mucosal inflammation and prevent symptom flares in UC and other chronic inflammatory diseases are essential.