| Part Ⅰ Clinical Survey of Symptom Spectrum,Emotion,Quality of Sleep and Life Quality in Functional dyspepsia patientsObjective:The objective of the present study was to observe the characteristic of the symptoms spectrum,emotion status,quality of sleep and life quality in FD patients,and to investigate the impact of emotional status and quality of sleep on FD symptoms and the quality of life.Methods:A total of 30 FD patients and 32 healthy subjects participated in this study and filled out of the questionnaire,including the demographics characteristic,dyspepsia assessment form,diet and life-style questionnaire,Pittsburgh sleep quality index questionnaire,Zung anxiety and depression scale,SF-36 quality of life survey questionnaire for FD patients.And the demographics characteristic,diet and life-style questionnaire,Pittsburgh sleep quality index questionnaire,Zung anxiety and depression scale,SF-36 quality of life survey questionnaire for healthy subjects.Results:The BMI value was significantly lower in FD patients than healthy controls.The most predominant dyspepsia symptoms in FD were postprandial discomfort,upper abdominal pain and belching.The ratio of abnormal SAS and SDS score was significantly higher in FD group compared to HC;There were a significantly higher scores in FD group than HC,including sleep quality,sleep time,sleep time,sleep efficiency,sleep disturbance,daytime dysfunction,and total sleep disorder scores,and there were about 64.5.%FD patients with sleep disorders.The SF-36 quality of life survey questionnaire of FD group was worse than HC,and there were statistically significant differences in physical function,physiological function,physical pain,general health,energy status,social function,emotional function,mental health.There was negative correlation between FD symptoms score and SF-36 score.SF-36 score negatively correlated with SAS and SDS scores,and SDS score positively correlated with PSQI score.Conclusion:1.FD patients had characteristic of lower body weight;2.Higher proportion of sleep disorder,and the severity of sleep disorder in FD patients was positively correlated with SDS score,and FD patients with sleep disorders had more serious gastrointestinal symptoms and higher anxiety scores;3.FD patients have more problems of anxiety and depression than the general healthy population.The quality of life in FD patients is significantly affected by the severity of symptoms and emotional factors.FD patients with anxiety and depression have worse quality of life and more sleep disorders.Part Ⅱ Different responses to a meal in functional connectivity density:an fMRI study in functional dyspepsia patients and healthy subjectsObjective:We aimed to observe the characteristics of brain functional connectivity changes in FD patients in response to the presence of normal digestion,and further to unravel the abnormal neurophysiological mechanisms in procession of visceral discomfort underlying meal tolerance in FD patients.Methods:A total of 30 FD patients and 32 healthy subjects participated in this study,the brain fMRI images of each subjects before and after the eating were collected respectively,and the raw data was preprocessed using the image data processing and analysis tool brain software DPABI based on the SPM8 software package.The whole brain functional connectivity was calculated.The independent sample t-test was used to compare the differences between the patients and the healthy subjects before and after eating using the generalized linear model.Secondly,the paired t-test was used to analyze the difference between before and after eating,which can help to understand the effect of eating on brain activity.Thirdly,the interaction of groups and eating was explored using interactive analysis.After the brain map analysis,post-analysis of the brain regions with differences was carried out.ROI was constructed according to these regions,and FCS value of each subject was extracted,and the FCS changes of these brain regions in different groups and states were compared.Results:1.There was no significant difference in the functional connectivity in the left posterior central gyrus between the FD group and the healthy control group before eating.The functional connectivity of the left posterior central gyrus after eating was significantly higher than that before eating in FD group,while no significant difference was found in the healthy control group.2.The functional connectivity of the right precuneus after eating was significantly higher than that before eating in the healthy control group,while no significant difference was found in FD group.3.The functional connectivity of the left middle frontal gyrus in FD group was significantly higher than that in the healthy control group before eating.The functional connectivity of the left middle frontal gyrus after eating was lower than that before eating in FD group.The functional connectivity of the left middle frontal gyrus after eating was higher than that before eating in the healthy control group.However,there was no statistically significant difference in the functional connectivity of two groups between before and after eating.4.The functional connectivity of the left medial frontal cortex in FD group was significantly higher than that in the healthy control group before eating,but it did not reach significant difference.The functional connectivity of the left medial frontal cortex decreased after eating in the FD group.There was an increasing trend of the functional connectivity of the left medial frontal cortex in the healthy control group after eating,but there was no significant difference.Changes of the functional connectivity of the left medial frontal cortex between before and after eating in FD group was significantly higher than that in the healthy control group.5.There was no significant difference in the functional connectivity of the anterior cingulate gyrus between FD group and the healthy control group before eating.The functional connectivity of the anterior cingulate gyrus in the healthy control group increased after eating,but there was no significant difference.The functional connectivity of the anterior cingulate gyrus was decreased after eating,and there was also no significant difference.However,the functional connectivity of the anterior cingulate gyrus in FD group was significantly lower than that in the healthy control group after eating.6.SAS score had a trend of negative correlation with the functional connectivity of left interior frontal gyrus after eating.SDS score had a trend of negative correlation with the functional connectivity of left interior frontal gyrus.PSQI score had a trend of negative correlation with the functional connectivity of left interior frontal gyrus.Conclusion:1.The FD patients activated the somatosensory cortex after visceral stimulation,had abnormal visceral sensory processing,and had visceral hypersensitization characteristics,supporting the presence of cortex in FD patients.Sensitization features support the FD cortical sensitization hypothesis.2.Eating results increased function of the precuneus,appetite and eating-related pleasure in healthy people,and decreased function of the precuneus in FD patients,which leads to decreased appetite and eating-related pleasure.3.FD patients have active attention adjustment and visceral expectation enhancement when responding to gastrointestinal discomfort,the healthy control group can mobilize the prefrontal cortex pain regulation mechanism driven by emotional arousal after eating,while the prefrontal cortex of FD patients has inhibited the regulation function after eating.4.FD has abnormal ACC function,which is presumed to be one of the important causes of central pain regulation dysfunction and visceral hypersensitivity reaction in FD patients. |
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