ArticleBMC gastroenterology2026
Brain network correlates of fatigue, depression, and anxiety in patients with Crohn's Disease in different disease states.
Article in BMC gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSymptoms of fatigue, depression or anxiety are frequent in Crohn's Disease (CD) and may relate to disturbed brain-gut interactions. While more prevalent in active disease, these symptoms are also experienced by many individuals with CD during remission. Little is known about neural networks underlying such extraintestinal symptoms in CD and their relationship with the current disease state. Using a data fusion approach for functional MRI, this study investigated spatiotemporal markers of resting-state brain activity and associations with neurotransmitter systems and symptoms of fatigue, depression or anxiety in an active disease state or remission.
methodsWe examined n = 71 patients with CD in an active disease state (aCD; n = 47) or in remission (rCD; n = 24) and healthy controls (HC; n = 35). All participants underwent resting-state fMRI, completed symptom assessments for fatigue, depression and anxiety, and provided stool samples for analysis of faecal calprotectin (fCal; aCD and rCD only). Joint independent component analysis (jICA) of two resting-state brain activity parameters (temporal and spatial features) identified neural networks exhibiting disease-state-dependent alterations. Network connectivity strength was correlated with symptoms of fatigue, depression, and anxiety, as well as fecal calprotectin (fCal). We further explored associations of the networks with neurotransmitter receptor maps.
resultsJICA revealed three networks differentiating between disease states and/or between patients and controls. One network comprising affective orbitofrontal and temporal brain regions, exhibited reduced connectivity in active disease (HC vs. aCD: p = 0.003, p
conclusionsResting-state brain network connectivity in patients with CD differed between active disease and remission, and was associated with symptoms of fatigue, depression, and anxiety. Alterations in sensorimotor networks were linked to depressive and anxiety symptoms, whereas affect-related networks were associated with fatigue. These observations suggest that distinct brain networks may contribute to specific neuropsychiatric symptom clusters in Crohn's disease and underscore the role of brain-gut axis mechanisms in these manifestations.
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