Objective:To investigate the changes of brain microstructure in active Crohn's disease (CD) patients with or without anxiety by diffusion kurtosis imaging (DKI), and to explore the relationship between brain microstructure and anxiety in patients with CD.Methods:Thirty-seven patients with CD who were treated in Changzhou Second People's Hospital Affiliated to Nanjing Medical University from January 2022 to January 2023 were included as the CD group, and 20 healthy subjects were included as the healthy control group during the same period. All subjects were assessed with hospital anxiety and depression scale-anxiety (HADS-A) before magnetic resonance imaging(MRI) scan. According to the HADS-A score, CD patients were divided into the CD group with anxiety (16 cases) and the CD group without anxiety (21 cases). After MRI scan, DKI parameters were obtained by DKE software. One-way analysis of variance was used to compare DKI parameters between the two groups of CD patients and the healthy control group. Pearson correlation was used to analyze the correlation between DKI parameters in different brain areas and psychological scale scores in the two groups of CD patients.Results:The axial diffusion kurtosis(AK)values in the right insula, the left superior temporal gyrus, the right thalamus, the left middle temporal gyrus, the right inferior temporal gyrus, the left lingual gyrus and the right anterior cuneus were significantly different among the three groups ( F=3.060-9.627, all P<0.05).There were significant differences in the radial diffusion kurtosis(RK) values in the right cerebellar region 6 and the left hippocampus among the three groups ( F=4.124, 3.536, 4.200, all P<0.05). Further multiple comparison results showed that the AK values of the right insula (0.701±0.028)( P=0.019), the left superior temporal gyrus (0.764±0.016)( P=0.002) and the right thalamus (0.728±0.016)( P=0.001) in the CD group without anxiety were lower than those of the healthy control group(0.726±0.010, 0.780±0.015, 0.771±0.082), and the RK value of the right cerebellar region 6 ( P=0.021) was lower than that of the healthy control group. The AK values of the right insula ( P=0.023), the left superior temporal gyrus ( P=0.015), the right thalamus ( P=0.031), the left middle temporal gyrus ( P=0.006), the right inferior temporal gyrus ( P=0.001) and the left lingual gyrus ( P=0.007) in the CD group with anxiety were lower than those in the healthy control group. The RK values of right cerebellar region 6 ( P=0.012) and left hippocampus ( P=0.004) were lower than those of healthy control group. The AK values of the right insula ( P=0.002) and the right anterior cuneus ( P=0.017) in the group with anxiety were lower than those in the CD group without anxiety. In the CD group with anxiety, the AK value of the right insula was correlated with erythrocyte sedimentation rate(ESR)( r=-0.47, P=0.048), HADS-A score ( r=-0.68, P=0.002), SES-CD( r=-0.84, P<0.001) and duration of disease ( r=-0.61, P=0.008) were negatively correlated. AK values in the left superior temporal gyrus with anxiety CD group were negatively correlated with HADS-A score ( r=-0.51, P=0.030) and SES-CD score ( r=-0.48, P=0.046). Conclusion:The microstructure of some brain regions was damaged in CD patients with or without anxiety, which was manifested as decreased RK and AK values in DKI parameter values, which may be related to the anxiety state in active CD patients.

Objective:To investigate the characteristics of brain functional networks alterations in patients with inflammatory bowel disease (IBD) and explore their correlations with clinical indicators and psycho-psychological scores.Methods:A cross-sectional survey study was conducted. A total of 48 IBD patients diagnosed at the Changzhou Second People′s Hospital from June 2021 to June 2023 were collected, and 32 healthy individuals matched for age, gender, and education level were selected as the healthy control group. Resting-state functional magnetic resonance imaging data were enrolled, and the topological properties of brain networks between the two groups of subjects were compared by using graph theory analysis. Pearson correlation and Spearman′s partial correlation analyses were used to explore the correlations between changes in IBD patients′ brain networks topological properties and clinical indicators and psycho-psychological scores.Results:In the IBD group, 29 patients were males (60.4%) and 19 were females (39.6%) ; the total disease course was 1.0 (0.3, 5.0) years; 34 patients were Crohn′s disease and 14 ulcerative colitis; they were mainly in the active phase (58.84%, 28/48) . The scores of the hospital anxiety and depression scale (HADS-A and HADS-D) in IBD patients were higher than those in the healthy control group (both P<0.01) . In terms of global properties, both the IBD group and the healthy control group had "small-world" properties (both σ>1.1) . Compared with the healthy control group, the IBD group had lower clustering coefficients, global efficiency, and local efficiency, and longer characteristic path lengths, with all differences being statistically significant (all P<0.05) . In terms of local properties, compared with the healthy control group, the IBD group had higher degree centrality and nodal efficiency in the left middle frontal gyrus, higher betweenness centrality in the left thalamus, lower betweenness centrality and degree centrality in the right parahippocampal gyrus, lower nodal clustering coefficients in the bilateral middle temporal gyrus, right anterior cingulate gyrus and paracingulate gyrus, and lower nodal local efficiency in the bilateral caudate nuclei and left middle temporal gyrus, with all differences being statistically significant (all P<0.05) . The degree centrality of the right parahippocampal gyrus in the IBD group was negatively correlated with the HADS-A score ( r = -0.401, P = 0.005) , and the betweenness centrality was also negatively correlated with the HADS-A score ( r = -0.343, P = 0.017) . The nodal clustering coefficient of the right middle temporal gyrus in the IBD group was positively correlated with the total disease course ( rs = 0.589, P<0.001) . Conclusion:IBD patients have decreased overall information transmission capacity in brain networks, reduced limbic system function, and abnormal functions in brain areas related to pain perception, which are correlated to some extent with the disease course and psycho-psychological state.

Objective:To investigate the characteristics of brain functional networks alterations in patients with inflammatory bowel disease (IBD) and explore their correlations with clinical indicators and psycho-psychological scores.Methods:A cross-sectional survey study was conducted. A total of 48 IBD patients diagnosed at the Changzhou Second People′s Hospital from June 2021 to June 2023 were collected, and 32 healthy individuals matched for age, gender, and education level were selected as the healthy control group. Resting-state functional magnetic resonance imaging data were enrolled, and the topological properties of brain networks between the two groups of subjects were compared by using graph theory analysis. Pearson correlation and Spearman′s partial correlation analyses were used to explore the correlations between changes in IBD patients′ brain networks topological properties and clinical indicators and psycho-psychological scores.Results:In the IBD group, 29 patients were males (60.4%) and 19 were females (39.6%) ; the total disease course was 1.0 (0.3, 5.0) years; 34 patients were Crohn′s disease and 14 ulcerative colitis; they were mainly in the active phase (58.84%, 28/48) . The scores of the hospital anxiety and depression scale (HADS-A and HADS-D) in IBD patients were higher than those in the healthy control group (both P<0.01) . In terms of global properties, both the IBD group and the healthy control group had "small-world" properties (both σ>1.1) . Compared with the healthy control group, the IBD group had lower clustering coefficients, global efficiency, and local efficiency, and longer characteristic path lengths, with all differences being statistically significant (all P<0.05) . In terms of local properties, compared with the healthy control group, the IBD group had higher degree centrality and nodal efficiency in the left middle frontal gyrus, higher betweenness centrality in the left thalamus, lower betweenness centrality and degree centrality in the right parahippocampal gyrus, lower nodal clustering coefficients in the bilateral middle temporal gyrus, right anterior cingulate gyrus and paracingulate gyrus, and lower nodal local efficiency in the bilateral caudate nuclei and left middle temporal gyrus, with all differences being statistically significant (all P<0.05) . The degree centrality of the right parahippocampal gyrus in the IBD group was negatively correlated with the HADS-A score ( r = -0.401, P = 0.005) , and the betweenness centrality was also negatively correlated with the HADS-A score ( r = -0.343, P = 0.017) . The nodal clustering coefficient of the right middle temporal gyrus in the IBD group was positively correlated with the total disease course ( rs = 0.589, P<0.001) . Conclusion:IBD patients have decreased overall information transmission capacity in brain networks, reduced limbic system function, and abnormal functions in brain areas related to pain perception, which are correlated to some extent with the disease course and psycho-psychological state.