PMID- 31694124
OWN - NLM
STAT- MEDLINE
DCOM- 20191115
LR  - 20200108
IS  - 0376-2491 (Print)
IS  - 0376-2491 (Linking)
VI  - 99
IP  - 41
DP  - 2019 Nov 5
TI  - [A preliminary study of resting-state fMRI in patients with diarrhea-type 
      irritable bowel syndrome after pinaverium bromide combined treatment with 
      flupentixol-melitracen].
PG  - 3266-3272
LID - 10.3760/cma.j.issn.0376-2491.2019.41.013 [doi]
AB  - Objective: To observe the difference of brain activity in patients with 
      diarrhea-type irritable bowel syndrome (IBS-D) treated with pinaverium bromide 
      (PB) combined with flupentixol-melitracen (FM), and to explore the mechanism of 
      efficacy of combined with anxiolytic/antidepressant drugs in IBS-D patients at 
      the central level, using resting-state functional magnetic resonance imaging 
      (rs-fMRI). Methods: Forty-eight patients with IBS-D, including 28 males, 20 
      females, mean age 22-48 (33+/-7) years, were selected from the Affiliated Hospital 
      of Hangzhou Normal University from October 2015 to October 2018.All patients with 
      IBS-D underwent rs-fMRI scans before and after receiving either PB (basic 
      treatment group, n=16), PB combined with FM (combination therapy group, n=16), or 
      no medication (no treatment group, n=16). Rs-fMRI regional homogeneity (ReHo) 
      parameter among the three groups of patients were compared using One-way ANOVA 
      analysis and post analysis.Partial correlation and mediation analyses were 
      performed on ReHo values and the improvement of symptoms scores (gastrointestinal 
      symptom rating scale(GSRS) and hospital anxiety/depression scale (HAD)) in the 
      two medicated groups. Results: No significant differences in ReHo values were 
      observed among the three groups before treatment. Compared with patients on 
      no-medication, patients receiving either PB or PB-FM showed decreased ReHo in the 
      striatum, insular lobe, medial prefrontal cortex (MPFC) and subcallosal gyrus, 
      and increased ReHo in the occipital cortex. In particular, the combined treatment 
      group showed more extensive decreased ReHo in the left thalamus and left temporal 
      pole, and increased in the left precuneus. Compared with the basic treatment 
      group, the combined treatment group showed decreased ReHo in the right putamen, 
      right insula, right MPFC and subcallosal gyrus, and increased ReHo in the left 
      precuneus. In addition, the combined treatment group demonstrated a positive 
      correlation between ReHo values in the left thalamus and the improvement of HAD 
      score (r=0.653, P=0.011) , and a negative correlation between ReHo values in left 
      precuneus and the improvement of GSRS and HAD score (r=-0.771, P=0.001; r=-0.716, 
      P=0.004). ReHo values in the left precuneus were observed to mediate between 
      gastrointestinal symptoms and anxiety-depressive symptoms in the combined 
      treatment group. Conclusions: The efficacy of PB combined with FM is superior to 
      PB alone in the treatment of IBS. In addition to more extensive changes in 
      pain-related brain areas, IBS-D patients treated with anxiolytic/antidepressant 
      also show changes in default network and brain areas related to emotional 
      regulation, and are associated with improvement in gastrointestinal symptoms, 
      anxiety and depression.
FAU - Li, J
AU  - Li J
AD  - Department of Radiology, the Affiliated Hospital of Hangzhou Normal University, 
      Hangzhou 310015, China.
FAU - Guo, Y
AU  - Guo Y
AD  - Department of Gastroenterology, the Affiliated Hospital of Hangzhou Normal 
      University, Hangzhou 310015, China.
FAU - Lu, X Q
AU  - Lu XQ
AD  - Department of Radiology, the Affiliated Hospital of Hangzhou Normal University, 
      Hangzhou 310015, China.
FAU - Li, G X
AU  - Li GX
AD  - Department of Gastroenterology, the Affiliated Hospital of Hangzhou Normal 
      University, Hangzhou 310015, China.
FAU - Yang, Y
AU  - Yang Y
AD  - Department of Radiology, the Affiliated Hospital of Hangzhou Normal University, 
      Hangzhou 310015, China.
FAU - Li, L
AU  - Li L
AD  - Department of Gastroenterology, the Affiliated Hospital of Hangzhou Normal 
      University, Hangzhou 310015, China.
FAU - Ding, J P
AU  - Ding JP
AD  - Department of Radiology, the Affiliated Hospital of Hangzhou Normal University, 
      Hangzhou 310015, China.
LA  - chi
GR  - 2015C33292/Public Technology Research and Social Development Projects of Zhejiang 
      Province/
PT  - Journal Article
PL  - China
TA  - Zhonghua Yi Xue Za Zhi
JT  - Zhonghua yi xue za zhi
JID - 7511141
RN  - 0 (Drug Combinations)
RN  - 0 (Morpholines)
RN  - FA0UYH6QUO (Flupenthixol)
RN  - U2368VVE7O (pinaverium)
SB  - IM
MH  - Adult
MH  - Brain
MH  - Brain Mapping
MH  - Diarrhea/*drug therapy
MH  - Drug Combinations
MH  - Female
MH  - Flupenthixol/*therapeutic use
MH  - Humans
MH  - *Irritable Bowel Syndrome
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Morpholines/*therapeutic use
MH  - Young Adult
OTO - NOTNLM
OT  - Diarrhea
OT  - Flupenthixol
OT  - Irritable bowel syndrome
OT  - Magnetic resonance imaging
EDAT- 2019/11/07 06:00
MHDA- 2019/11/16 06:00
CRDT- 2019/11/07 06:00
PHST- 2019/11/07 06:00 [entrez]
PHST- 2019/11/07 06:00 [pubmed]
PHST- 2019/11/16 06:00 [medline]
AID - 10.3760/cma.j.issn.0376-2491.2019.41.013 [doi]
PST - ppublish
SO  - Zhonghua Yi Xue Za Zhi. 2019 Nov 5;99(41):3266-3272. doi: 
      10.3760/cma.j.issn.0376-2491.2019.41.013.