Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb;36(2):e14710.
doi: 10.1111/nmo.14710. Epub 2023 Nov 29.

Neural correlates of perceived and relative resilience in male and female patients with irritable bowel syndrome

Lisa A Kilpatrick  1   2 , Arpana Gupta  1   2 , Kirsten Tillisch  1   2 , Jennifer S Labus  1   2   3   4 , Bruce D Naliboff  1   2 , Emeran A Mayer  1   2 , Lin Chang  1   2
Affiliations

Neural correlates of perceived and relative resilience in male and female patients with irritable bowel syndrome

Lisa A Kilpatrick et al. Neurogastroenterol Motil. 2024 Feb.

Abstract

Background: Patients with irritable bowel syndrome (IBS) show lower resilience than healthy controls (HCs), associated with greater symptom severity and worse quality of life. However, little is known about affected markers of resilience or the influence of sex. Furthermore, as resilience is complex, a comprehensive assessment, with multiple resilience measures, is needed. Therefore, we aimed to evaluate perceived and relative resilience and their neural correlates in men and women with IBS.

Methods: In 402 individuals (232 IBS [73.3% women] and 170 HCs [61.2% women]), perceived resilience was assessed by the Connor-Davidson Resilience Scale (CDRISC) and Brief Resilience Scale (BRS); relative resilience was assessed by the standardized residual of the Short Form-12 mental component summary score predicted by the Adverse Childhood Experiences score. Non-rotated partial least squares analysis of region-to-region resting-state connectivity data was used to define resilience-related signatures in HCs. Disease and sex-related differences within these signatures were investigated.

Key results: Scores on all resilience measures were lower in IBS than in HCs (p's < 0.05). In all three resilience-related signatures, patients with IBS showed reduced connectivity largely involving the central autonomic network (p's < 0.001). Men with IBS showed lower CDRISC scores than women with IBS, and greater reductions in CDRISC-related connectivity, associated with worse symptom severity (p < 0.05).

Conclusions and inferences: Individuals with IBS show reduced perceived and relative resilience, with reduced connectivity suggesting impaired homeostasis maintenance. Men with IBS may show additional impairment in specific aspects of resilience. Treatments aimed at improving resilience may benefit patients with IBS, especially men with IBS.

Keywords: functional magnetic resonance imaging; irritable bowel syndrome; psychological resilience; sex differences.

PubMed Disclaimer

Conflict of interest statement

Disclosures: AG is a research consultant for YAMAHA. EAM is a member of the scientific advisory boards of Danone, Axial Therapeutics, Amare, Mahana Therapeutics, Pendulum, Bloom Biosciences, and APC Microbiome Ireland. LC serves as an advisory board member or consultant for Ardelyx, Arena Pharmaceuticals, Bausch Health, Immunic, Ironwood Pharmaceuticals, Inc., Mauna Kea Technologies, and Trellus; and receives grant support from AnX Robotica, Arena Pharmaceuticals, and Ironwood Pharmaceuticals. LAK, KT, BDN, and JSL declare no conflict of interest.

Figures

Figure 1.
Figure 1.
Group differences in scores on each resilience measure. Significant differences (p<0.05) are indicated by an *.
Figure 2.
Figure 2.
Neural correlates of each resilience measure in healthy controls at the connection-level (A and B) and network-level (C). (A) Lines represent connections positively correlated with each resilience measure (p<0.001). (B) Connections positively correlated with at least two resilience measures are shown (i.e. overlap between resilience measures). (C) The proportions of involved connections between networks are represented by line width to highlight main features of the neural correlates of each resilience measure.
Figure 3.
Figure 3.
Resilience-related brain connectivity affected by IBS and sex on non-rotated partial least squares analysis. (A) Connectivity showing a significant diagnosis main effect. Lines represent resilience-related connections with reduced strength in participants with IBS than in HCs (p<0.05). (B) Connectivity showing a significant sex main effect. Lines represent resilience-related connections with reduced strength in women than in men (p<0.05) (C) Connectivity showing a significant diagnosis*sex effect. Lines represent resilience-related connections reduced to a greater extent in men with IBS than in women with IBS relative to same-sex HCs (p<0.05). IBS, irritable bowel syndrome; HC, healthy control
Figure 4.
Figure 4.
Associations between affected connectivity and clinical measures. Lines represent resilience-related connections that are reduced in IBS (from Figure 3A,C) and show clinical relevance; that is, the reduction in connectivity is significantly correlated with worse symptom severity, assessed by the IBS-SSS, and/or worse disease-specific quality of life, assessed by the IBS-QOL (p<0.05). IBS-SSS, Irritable Bowel Syndrome Symptom Severity Scale; IBS-QOL, IBS- Quality of Life questionnaire
See this image and copyright information in PMC

References

    1. Drossman DA. Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features and Rome IV. Gastroenterology. 2016. - PubMed
    1. Mearin F, Lacy BE, Chang L, et al. Bowel Disorders. Gastroenterology. 2016. - PubMed
    1. Park SH, Naliboff BD, Shih W, et al. Resilience is decreased in irritable bowel syndrome and associated with symptoms and cortisol response. Neurogastroenterol Motil. 2018;30(1). - PMC - PubMed
    1. Parker CH, Naliboff BD, Shih W, et al. The Role of Resilience in Irritable Bowel Syndrome, Other Chronic Gastrointestinal Conditions, and the General Population. Clin Gastroenterol Hepatol. 2021;19(12):2541–2550 e2541. - PMC - PubMed
    1. Ben-Ezra M, Hamama-Raz Y, Palgi S, Palgi Y. Cognitive appraisal and psychological distress among patients with irritable bowel syndrome. Isr J Psychiatry Relat Sci. 2015;52(1):54–59. - PubMed

Supplementary concepts

LinkOut - more resources