Interactions between gut permeability and brain structure and function in health and irritable bowel syndrome

Suzanne T. Witt*, Olga Bednarska, Åsa V. Keita, Adriane Icenhour, Michael P. Jones, Sigrid Elsenbruch, Johan D. Söderholm, Maria Engström, Emeran A. Mayer, Susanna Walter

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    26 Citations (Scopus)
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    Changes in brain-gut interactions have been implicated in the pathophysiology of chronic visceral pain in irritable bowel syndrome (IBS). Different mechanisms of sensitization of visceral afferent pathways may contribute to the chronic visceral pain reports and associated brain changes that characterize IBS. They include increased gut permeability and gut associated immune system activation, and an imbalance in descending pain inhibitory and facilitatory mechanisms. In order to study the involvement of these mechanisms, correlations between gut epithelial permeability and live bacterial passage, and structural and functional brain connectivity were measured in women with moderate-to-severe IBS and healthy women. The relationships between gut permeability and functional and anatomical connectivity were significantly altered in IBS compared with the healthy women. IBS participants with lower epithelial permeability reported increased IBS symptoms, which was associated with increased functional and structural connectivity in endogenous pain facilitation regions. The findings suggest that relationships between gut permeability and the brain are significantly altered in IBS and suggest the existence of IBS subtypes based on these interactions.

    Original languageEnglish
    Article number101602
    Pages (from-to)1-12
    Number of pages12
    JournalNeuroImage: Clinical
    Publication statusPublished - 2019

    Bibliographical note

    Copyright the Author(s) 2018. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


    • irritable bowel syndrome
    • gut epithelial permeability
    • resting state fMRI
    • brain-gut interactions
    • default mode network
    • coping skills


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