Dataset Information

Anti-TNF? therapy in IBD alters brain activity reflecting visceral sensory function and cognitive-affective biases.

ABSTRACT:

Background

In inflammatory bowel disease (IBD), immune activation with increased circulating TNF-? is linked to the intensity of gastrointestinal symptoms and depression or anxiety. A central feature of depression is cognitive biases linked to negative attributions about self, the world and the future. We aimed to assess the effects of anti-TNF? therapy on the central processing of self-attribution biases and visceral afferent information in patients with Crohn's disease.

Methods

We examined 9 patients with Crohn's disease (age 26.1±10.6. yrs, 5 female, 5 ileocolonic, 2 colonic and 2 ileal disease) during chronic anti-TNF? therapy (5 adalimumab, 4 infliximab). Patients were studied twice in randomized order before and after anti-TNF? administration. On each occasion patients underwent functional magnetic resonance imaging (fMRI) of the brain during a test of implicit attribution biases regarding sickness/health and undertook a standardized nutrient challenge.

Results

Following anti-TNF? treatment, ratings of 'fullness' following nutrient challenge reduced compared to pre-treatment ratings (p<0.05). Reaction times revealed improved processing of self-related and positive health words, consistent with improved implicit sense of wellbeing that correlated with improvements in sensory function after treatment (r = 0.67, p<0.05). Treatment-associated improvements in implicit processing were mirrored by alterations of prefrontal, amygdala, posterior cingulate and visual regions. Between patients, the degree of functional amygdala change was additionally explained by individual differences in attention regulation and body awareness rankings.

Conclusion

In patients with Crohn's disease, anti-TNF? administration reduces visceral sensitivity and improves implicit cognitive-affective biases linked to alterations in limbic (amygdala) function.

SUBMITTER: Gray MA

PROVIDER: S-EPMC5843226 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Publications

Anti-TNFα therapy in IBD alters brain activity reflecting visceral sensory function and cognitive-affective biases.

Gray Marcus A MA Chao Che-Yung CY Staudacher Heidi M HM Kolosky Natasha A NA Talley Nicholas J NJ Holtmann Gerald G

PloS one 20180308 3

<h4>Background</h4>In inflammatory bowel disease (IBD), immune activation with increased circulating TNF-α is linked to the intensity of gastrointestinal symptoms and depression or anxiety. A central feature of depression is cognitive biases linked to negative attributions about self, the world and the future. We aimed to assess the effects of anti-TNFα therapy on the central processing of self-attribution biases and visceral afferent information in patients with Crohn's disease.<h4>Methods</h4> ...[more]

PMID: 29518097

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