Functional Neuroimaging in Irritable Bowel Syndrome: A Systematic Review Highlights Common Brain Alterations With Functional Movement Disorders

Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by recurring abdominal pain and altered bowel habits without detectable organic causes. This study aims to provide a comprehensive overview of the literature on functional neuroimaging in IBS and to highlight brain alterations similarities with other functional disorders -functional movement disorders in particular. We conducted the bibliographic search via PubMed in August 2020 and included 50 studies following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines for systematic reviews. Overall, our findings showed an aberrant activation and functional connectivity of the insular, cingulate, sensorimotor and frontal cortices, the amygdala and the hippocampus, suggesting an altered activity of the homeostatic and salience network and of the autonomous nervous system. Moreover, glutamatergic dysfunction in the anterior insula and hypothalamic pituitary axis dysregulation were often reported. These alterations seem to be very similar to those observed in patients with functional movement disorders. Hence, we speculate that different functional disturbances might share a common pathophysiology and we discussed our findings in the light of a Bayesian model framework.

Automated summary

This study provides a comprehensive overview of the literature on functional neuroimaging in irritable bowel syndrome (IBS) and highlights the similarities of brain alterations with other functional disorders, particularly functional movement disorders. Aberrant activation and functional connectivity in multiple brain regions were observed, suggesting altered activity of the homeostatic and salience networks as well as the autonomic nervous system. Glutamatergic dysfunction in the anterior insula and hypothalamic-pituitary axis dysregulation were also frequently reported. These findings suggest a common pathophysiology shared among different functional disturbances.