title: Sex-related differences of cortical thickness in patients with chronic abdominal pain.
abstract: OBJECTIVE
  Regional reductions in gray matter (GM) have been reported in several chronic somatic and visceral pain conditions, including irritable bowel syndrome (IBS) and chronic pancreatitis. Reported GM reductions include insular and anterior cingulate cortices, even though subregions are generally not specified. The majority of published studies suffer from limited sample size, heterogeneity of populations, and lack of analyses for sex differences. We aimed to characterize regional changes in cortical thickness (CT) in a large number of well phenotyped IBS patients, taking into account the role of sex related differences.
  
  
  METHODS
  Cortical GM thickness was determined in 266 subjects (90 IBS [70 predominantly premenopausal female] and 176 healthy controls (HC) [155 predominantly premenopausal female]) using the Laboratory of Neuro Imaging (LONI) Pipeline. A combined region of interest (ROI) and whole brain approach was used to detect any sub-regional and vertex-level differences after removing effects of age and total GM volume. Correlation analyses were performed on behavioral data.
  
  
  RESULTS
  While IBS as a group did not show significant differences in CT compared to HCs, sex related differences were observed both within the IBS and the HC groups. When female IBS patients were compared to female HCs, whole brain analysis showed significant CT increase in somatosensory and primary motor cortex, as well as CT decrease in bilateral subgenual anterior cingulate cortex (sgACC). The ROI analysis showed significant regional CT decrease in bilateral subregions of insular cortex, while CT decrease in cingulate was limited to left sgACC, accounting for the effect of age and GM volume. Several measures of IBS symptom severity showed significant correlation with CT changes in female IBS patients.
  
  
  CONCLUSIONS
  Significant, sex related differences in CT are present in both HCs and in IBS patients. The biphasic neuroplastic changes in female IBS patients are related to symptom severity.
authors.affiliation: Gail and Gerald Oppenheimer Family Center for Neurobiology of Stress and Pain and Interoception Network (PAIN) Repository, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, United States of America ; Human Performance and Engineering Laboratory, Kessler Foundation Research Center, West Orange, New Jersey, United States of America ; Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, United States of America.
authors.forename: Zhiguo
authors.initials: Z
authors.lastname: Jiang
authors.forename: Ivo D
authors.initials: ID
authors.lastname: Dinov
authors.forename: Jennifer
authors.initials: J
authors.lastname: Labus
authors.forename: Yonggang
authors.initials: Y
authors.lastname: Shi
authors.forename: Alen
authors.initials: A
authors.lastname: Zamanyan
authors.forename: Arpana
authors.initials: A
authors.lastname: Gupta
authors.forename: Cody
authors.initials: C
authors.lastname: Ashe-McNalley
authors.forename: Jui-Yang
authors.initials: JY
authors.lastname: Hong
authors.forename: Kirsten
authors.initials: K
authors.lastname: Tillisch
authors.forename: Arthur W
authors.initials: AW
authors.lastname: Toga
authors.forename: Emeran A
authors.initials: EA
authors.lastname: Mayer
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D012737:Sex Factors; D014057:Tomography, X-Ray Computed
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