Sex Differences in Effectiveness of CBT on IBS Project 3

Degree of connectivity between brainstem nuclei and the salience, emotional arousal and sensorimotor networks brain networks.

Cognitive Behavioral Therapy (CBT) is the most well researched and most effective treatment
 for IBS targeting the brain-gut-microbiome (BGM) axis, and preliminary data show that this
 therapeutic effect is associated with a reduction of brainstem connectivity with other brain
 networks.
 
 The increased prevalence of IBS in women, the higher rate of comorbid non-GI pain conditions,
 as well as the higher prevalence in female IBS of increased sensitivity to a variety of
 internal and external stimuli (multisensory sensitivity) suggest the presence of important
 sex differences in some of these BGM mechanisms.
 
 Research performed by UCLA SCOR during previous funding has established an increased
 responsiveness of the CRF-Locus Coeruleus (LCC) system in female IBS subjects, suggesting
 that this central noradrenergic brainstem system plays an important role in IBS
 pathophysiology.
 
 In addition, the study team's earlier research has begun to identify clinical, functional and
 structural brain mechanisms that may underlie these sex effects. Based on the preliminary
 data, the overall goal of this project is to use CBT as a probe to study the relationship
 between specific disease-related alterations of the brain, the gut microbiome, and
 symptomatic outcome, and identify the role of sex differences in these relationships.
 Investigators will study male and female IBS patients before and after CBT using the advanced
 neuroimaging and microbiome technologies of the overall SCOR.