Primary Biliary Cholangitis Patients Exhibit MRI Changes in Structure and Function of Interoceptive Brain Regions

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2019 Feb 9

PMID 30735529

Citations 5

Authors

Victoria Mosher

Mark Swain

Jack Pang

Gilaad Kaplan

Keith Sharkey

Glenda MacQueen

Bradley Gordon Goodyear

Affiliations

Soon will be listed here.

Abstract

Background: Many patients with primary biliary cholangitis (PBC) experience non-hepatic symptoms that are possibly linked to altered interoception, the sense of the body's internal state. We used magnetic resonance imaging (MRI) to determine if PBC patients exhibit structural and functional changes of the thalamus and insula, brain regions that process signals related to interoception.

Methods: Fifteen PBC patients with mild disease and 17 controls underwent 3 Tesla T1-weighted MRI, resting-state functional MRI, and quantitative susceptibility mapping (QSM), to measure thalamic and insular volume, neuronal activity and iron deposition, respectively. Group differences were assessed using analysis of covariance, and stepwise linear regression was used to determine the predictive power of clinical indicators of disease.

Results: PBC patients exhibited reduced thalamic volume (p < 0.01), and ursodeoxycholic acid (UDCA) non-responders exhibited lower left thalamus activity (p = 0.05). PBC patients also exhibited reduced anterior insula activity (p = 0.012), and liver stiffness positively correlated with MRI indicators of anterior insula iron deposition (p < 0.02).

Conclusions: PBC affects structure and function of brain regions critically important to interoception. Moreover, these brain changes occur in patients with early, milder disease and thus may potentially be reversible.

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