Applicazione della neurodiagnostica avanzata allo studio dei disturbi psicologici nelle malattie infiammatorie croniche intestinali

Background and aim Ulcerative Colitis (UC) and Crohn’s Disease (CD), collectively labelled as inflammatory bowel disease (IBD), are idiopathic, chronic inflammatory disorder of the bowel with a remitting and relapsing course. IBD are associated to poor emotional functioning and psychological distress. We have investigated the brain involvement in patients with IBD using functional magnetic resonance imaging (fMRI). Materials and methods We developed an emotional visual task to investigate the emotional functioning in 10 UC patients and 10 healthy controls (HC). Furthermore, we have compared the brain stress response between a group of 20 CD patients and a group of 18 HC. Finally, we evaluated potential morphological differences between 18 CD patients and 18 HC in a voxel based morphometry (VBM) study. Results We found brain functional changes in UC patients characterized by decreased activity in the amygdala in response to positive emotional stimuli. Moreover, in CD patients, the brain stress response and habituation to stressful stimuli were significantly different in the medial temporal lobe (including the amygdala and hippocampus), the insula and cerebellum. Finally, in CD patients there were morphological abnormalities in the anterior mid cingulated cortex (aMCC). Conclusion IBD are associated to functional and morphological brain abnormalities. The previous intestinal inflammatory activity in IBD patients might have contributed to determine the functional and morphological changes we found. On the other hand, the dysfunctions of the brain structures we found may influence the course of the disease. Our findings might have clinical implications. The differences in the emotional processing may play a role in the development of psychological disorders in UC patients. Furthermore, in CD patients, the different habituation to stress might contribute to stress related inflammatory exacerbations. Finally, the structural changes in the aMCC might be involved in the pain symptoms associated to the bowel disorder.

Emotional engagement and brain potentials: repetition in affective picture processing

The present thesis addresses several experimental questions regarding the nature of the processes underlying the larger centro-parietal Late Positive Potential (LPP) measured during the viewing of emotional(both pleasant and unpleasant) compared to neutral pictures. During a passive viewing condition, this modulatory difference is significantly reduced with picture repetition, but it does not completely habituate even after a massive repetition of the same picture exemplar. In order to investigate the obligatory nature of the affective modulation of the LPP, in Study 1 we introduced a competing task during repetitive exposure of affective pictures. Picture repetition occurred in a passive viewing context or during a categorization task, in which pictures depicting any mean of transportation were presented as targets, and repeated pictures (affectively engaging images) served as distractor stimuli. Results indicated that the impact of repetition on the LPP affective modulation was very similar between the passive and the task contexts, indicating that the affective processing of visual stimuli reflects an obligatory process that occurs despite participants were engaged in a categorization task. In study 2 we assessed whether the decrease of the LPP affective modulation persists over time, by presenting in day 2 the same set of pictures that were massively repeated in day 1. Results indicated that the reduction of the emotional modulation of the LPP to repeated pictures persisted even after 1-day interval, suggesting a contribution of long-term memory processes on the affective habituation of the LPP. Taken together, the data provide new information regarding the processes underlying the affective modulation of the late positive potential.