BUFFALO, NY – Patients who suffer from the painful, often
disabling, symptoms of irritable bowel syndrome (IBS) often are
surprised to find that behavioral changes, not drugs, provide
Now, researchers at the University at Buffalo who have pioneered
some of these behavioral treatments, along with colleagues at the
University of California, Los Angeles, and Northwestern University,
are using functional and structural magnetic resonance imaging
(MRI) to reveal the biological basis for the relief. The research
could help doctors choose the best treatment method for individual
patients and could improve the quality of life for millions of
people with IBS.
“We’re going to look at biological mechanisms that
underlie these non-drug treatments, to discover what is going on in
the brain that explains treatment benefits achieved by teaching
patients specific skills to control and reduce their
symptoms,” says Jeffrey M. Lackner, PhD, associate professor
of medicine at the UB School of Medicine and Biomedical Sciences
and a project principal investigator. “By using a brain scan
to compare brain activity before and after treatment, we expect to
get a picture of changes in the brain that correspond to
improvements in gastrointestinal symptoms.”
The work is funded by a $2.3 million grant to UCLA, the lead
institution; Northwestern; and UB by the National Institute of
Diabetes and Digestive and Kidney Diseases. It builds on the work
of UCLA researchers at its Oppenheimer Family Center for
Neurobiology of Stress and a pilot neuroimaging study conducted by
Lackner and colleagues at UB.
The brain imaging study came about partly as a result of a
major, $8.9 million, seven-year, multi-site clinical trial Lackner
is leading at UB to test behavioral treatments in IBS patients. It
is the largest IBS clinical trial conducted to date and one of the
largest behavioral trials ever funded by the NIH without a drug
component. Developed at UB, these treatments are regarded as some
of the most powerful treatments available to IBS sufferers.
Lackner is currently recruiting IBS patients for the behavioral
and imaging studies at the Behavioral Medicine Clinic of the UB
Department of Medicine at Erie County Medical Center. For more
information on participating in one of the studies, call
716-898-4458 and leave a name, telephone number and convenient
times to be contacted.
IBS is among the most common, disabling and intractable
gastrointestinal disorders. Twice as common among women as men, it
is estimated to affect between 25 million and 50 million Americans.
Symptoms include pain, stomach cramps, bloating, diarrhea and/or
“We're excited about the possibility of providing the
first evidence for biological markers that correlate with
treatment-induced symptom changes, and developing a better
understanding of the mechanism behind IBS,” says Lackner.
“Such cutting-edge translational research is going to help
foster individualized, specific treatments for patients."
One treatment developed at UB aims to control symptoms by
changing specific thinking patterns and behaviors found to
aggravate IBS. Using state-of-the-art brain-imaging methods, UCLA
researchers, under the leadership of Emeran Mayer, MD, hope to
identify the biological mechanisms underlying their effectiveness.
Mayer is a professor of medicine and psychiatry at UCLA, director
of the Oppenheimer Center for Neurobiology of Stress and principal
investigator of the imaging study.
Scientists believe that IBS symptoms are the result of
dysregulation of brain-gut interactions, resulting in abnormal
muscle contractions in the gut and heightened sensitivity to
“Just as faulty wiring between the neural connection of
the brain and gut can bring on symptoms, so learning new ways of
thinking and behaving may 'rewire' brain-gut interactions,
resulting in reduced pain and bowel symptoms that otherwise take a
major toll on patients," says Lackner. "Determining whether
behavioral treatments work by targeting specific areas of the brain
that have a direct effect on gut function and sensation is a major
goal of this study.”
Correlating structural brain changes with symptom reduction is,
for both Lackner and Mayer, a primary goal that they say will
demonstrate an ‘organic’ component to IBS, which is
critical. “IBS is often unfairly dismissed as a psychosomatic
condition,” says Mayer. “These findings will be
important in dispelling the notion once and for all that IBS
symptoms are not real and are ‘only
Lackner’s UB’s colleagues on the study include
Michael Sitrin, MD, professor; Christopher Radziwon, PhD, research
assistant professor; Greg Gudleski, PhD, clinical research
assistant professor; Leonard Katz, MD, professor emeritus; and
Rebecca Firth, senior research support specialist; all in the
Department of Medicine, and Susan Krasner, PhD, clinical assistant
professor of anesthesiology.