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Jinyu Wu, Wen Wang, Improving Brain–Gut Studies in Crohn’s Disease: Methodological Considerations, Inflammatory Bowel Diseases, 2025;, izaf055, https://doi.org/10.1093/ibd/izaf055
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To the Editors:
We recently read with great interest the study by Thomann et al.,1 which explores intrinsic brain function in Crohn’s disease (CD) and its association with neuropsychiatric symptoms. The authors’ findings on disease-state-dependent neural activity changes and their correlation with fatigue and depression in remission provide a critical foundation for understanding brain–gut interactions. To further advance this research, we propose methodological refinements to address key challenges and enhance clinical translation.
First, while resting-state functional magnetic resonance imaging (fMRI) captures baseline neural activity, incorporating task-evoked paradigms (eg, cognitive tasks or sensory challenges) could reveal dynamic neural vulnerabilities specific to CD. Recent studies in CD patients in remission suggest accelerated aging in brain responses to cognitive tasks.2 However, the mechanisms by which active CD impacts brain function and exacerbates neuropsychiatric symptoms remain poorly understood. This underscores the need for longitudinal studies combining advanced neuroimaging, inflammatory biomarker analysis, and symptom phenotyping to clarify these dynamics.