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Microstructural white matter brain abnormalities in patients with idiopathic fecal incontinence
Author(s) -
Muthulingam J.,
Haas S.,
Hansen T. M.,
Laurberg S.,
Lundby L.,
Jørgensen H. S.,
Drewes A. M.,
Krogh K.,
Frøkjær J. B.
Publication year - 2018
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/nmo.13164
Subject(s) - white matter , fractional anisotropy , cingulum (brain) , diffusion mri , medicine , central nervous system , brain morphometry , magnetic resonance imaging , voxel based morphometry , neuroscience , pathology , psychology , radiology
Background Abnormal central nervous system processing of visceral sensation may be a part of the pathogenesis behind idiopathic fecal incontinence ( IFI ). Our aim was to characterize brain differences in patients with IFI and healthy controls by means of structural magnetic resonance imaging ( MRI ) and diffusion tensor imaging ( DTI ). Methods In 21 female patients with IFI and 15 female healthy controls, whole‐brain structural differences in gray matter volume (GMV), cortical thickness, and white matter tracts fractional anisotropy ( FA ) were quantified. For this purpose, we used voxel‐based morphometry, surface based morphometry and tract‐based spatial statistic, respectively. Furthermore, associations between structural brain characteristics and latencies of rectal sensory evoked electroencephalography potentials were determined. Key Results Compared to healthy controls, IFI patients had significantly reduced FA values, reflecting reduced white matter tract integrity, in the left hemisphere superior longitudinal fasciculus (SLF), posterior thalamic radiation, and middle frontal gyrus (MFG), all P <.05. No differences were observed in GMV or in cortical thickness. The reduced FA values in the SLF and MFG were correlated with prolonged latencies of cortical potentials evoked by rectal stimuli (all P <.05). Conclusions & Inferences This explorative study suggests that IFI patients have no macrostructural brain changes, but exhibit microstructural changes in white matter tracts relevant for sensory processing. The clinical relevance of this finding is supported by its correlations with prolonged latencies of cortical potentials evoked by rectal stimulation. This supports the theories of central nervous system changes as part of the pathogenesis in IFI patients.