A Review on the Progress of Multimodal Functional Magnetic Resonance Imaging Studies of Cognitive Function in Functional Gastrointestinal Disorders

Medical (Neurosurgery)

This review offers a thorough examination of brain imaging studies investigating the brain-gut interaction in functional gastrointestinal disorders (FGIDs). Functional neuroimaging during gut stimulation has shown increased brain activity in areas responsible for processing sensory information related to gut homeostasis and stronger reactions to important stimuli. Changes in areas of the brain that control emotional responses and less activity in areas that control the top-down modulation of visceral signals have also been seen. These results suggest a compromised central regulation of the endocrine and autonomic nervous systems, which serve as essential connections between the brain and gut. Investigations employing resting-state functional magnetic resonance imaging have revealed anomalous local and global connectivity in pain-processing areas and the default mode network, linked to self-awareness and memory in functional gastrointestinal disorders (FGIDs). Structural imaging via brain morphometry and diffusion imaging has revealed alterations in gray and white matter in regions previously delineated by functional studies; however, additional validation is required. Molecular imaging techniques, including magnetic resonance spectroscopy and positron emission tomography, are still not widely used in FGIDs research. Improvements in analytical techniques, especially machine learning algorithms, could improve neuroimaging by moving the focus from just mapping the brain to predicting clinical outcomes. Due to the intricate characteristics of FGIDs and the diversity of impacted populations, forthcoming research must implement an innovative model to evaluate the importance of different factors and brain functions that facilitate the attainment of optimal homeostasis.

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