Brain Imaging Helps Explain, Evaluate Behavioral IBS Treatments

The research may also lead to better treatment for millions suffering from this painful, often disabling, condition.

The work is funded by a $2.3 million grant from the National Institute of Diabetes and Digestive and Kidney Diseases awarded to the University of California, Los Angeles, the lead institution; Northwestern University; and UB.

Using functional and structural magnetic resonance imaging (MRI), “we’re going to look at biological mechanisms to discover what is going on in the brain that explains benefits achieved by teaching patients behavioral skills to control and reduce symptoms,” says Jeffrey M. Lackner, PsyD, associate professor of medicine and a principal investigator on the project.

The researchers are aiming to provide the first evidence for biological markers that correlate with symptom changes following treatment, Lackner notes.

“Such cutting-edge, translational research is going to help foster individualized, specific treatments for patients."

Scientists believe IBS symptoms result from dysregulation of brain-gut interactions that cause abnormal muscle contractions in the gut as well as heightened sensitivity to painful stimuli.

“Just as faulty wiring between the neural connection of the brain and gut can bring on symptoms, so learning new ways of thinking and behaving may 'rewire' brain-gut interactions, reducing pain and bowel symptoms," says Lackner.

The researchers will try to determine whether behavioral treatments work by targeting areas of the brain that directly affect gut function and sensation.

Irritable bowel syndrome is among the most common and intractable gastrointestinal disorders, affecting an estimated 25 million to 50 million Americans. Symptoms include pain, stomach cramps, bloating, diarrhea and constipation.

Often, these symptoms are unfairly perceived as not real or psychological.

Therefore, a critical part of the imaging study will involve demonstrating an ‘organic’ component to IBS by correlating structural brain changes with symptom relief.

The current study builds on the work of UCLA researchers as well as a pilot neuroimaging study conducted by Lackner and his UB colleagues.

UB researchers have pioneered successful behavioral treatments for IBS, including one that aims to change thought patterns and behaviors found to aggravate the condition. These treatments are regarded as some of the most powerful available for IBS sufferers.

Lackner also is leading an $8.9 million, seven-year, multi-site clinical trial at UB to test behavioral treatments for the syndrome. It is the largest IBS clinical trial conducted to date and one of the largest behavioral trials without a drug component funded by the NIH.

Other UB researchers working on the imaging study are Michael Sitrin, MD, professor, Christopher Radziwon, PhD, research assistant professor, Greg Gudleski, PhD, clinical research assistant professor, Leonard Katz, MD, professor emeritus and Rebecca Firth, senior research support specialist, all in the Department of Medicine, and Susan Krasner, PhD, clinical assistant professor of anesthesiology.