Cognitive performance in irritable bowel syndrome: Evidence of a stress-related impairment in visuospatial memory

Kennedy, P. J.; Clarke, G.; O'Neill, A.; Groeger, J. A.; Quigley, E. M. M.; Shanahan, F.; Cryan, J. F.; Dinan, T. G.

Abstract

Background Central nervous system (CNS) dysfunction is a prominent feature of the functional gastrointestinal (GI) disorder, irritable bowel syndrome (IBS). However, the neurobiological and cognitive consequences of key pathophysiological features of IBS, such as stress-induced changes in hypothalamic-pituitary-adrenal (HPA)-axis functioning, is unknown. Our aim was to determine whether IBS is associated with cognitive impairment, independently of psychiatric co-morbidity, and whether cognitive performance is related to HPA-axis function. Method A cross-sectional sample of 39 patients with IBS, a disease control group of 18 patients with Crohn's disease (CD) in clinical remission and 40 healthy age- and IQ-matched control participants were assessed using the Paired Associates Learning (PAL), Intra-Extra Dimensional Set Shift (IED) and Spatial Working Memory (SWM) tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB) and a computerized Stroop test. HPA-axis function was determined by measuring the cortisol awakening response (CAR). Results IBS patients exhibited a subtle visuospatial memory deficit at the PAL six- pattern stage (p = 0.03), which remained after psychiatric co-morbidity was controlled for (p = 0.04). Morning cortisol levels were lower in IBS (p = 0.04) and significantly associated with visuospatial memory performance within IBS only (p = 0.02). Conclusions For the first time, altered cognitive function on a hippocampal-mediated test of visuospatial memory, which was related to cortisol levels and independent of psychiatric co-morbidity, has been identified in IBS. Visuospatial memory impairment may be a common, but currently neglected, component of IBS. Further elucidation of the nature of this impairment may lead to a greater understanding of the underlying pathophysiology of IBS, and may provide novel therapeutic approaches. © Cambridge University Press 2013.

Citation

Kennedy, P. J., Clarke, G., O'Neill, A., Groeger, J. A., Quigley, E. M. . M., Shanahan, F., …Dinan, T. G. (2014). Cognitive performance in irritable bowel syndrome: Evidence of a stress-related impairment in visuospatial memory. Psychological Medicine, 44(7), 1553-1566. https://doi.org/10.1017/S0033291713002171

• Journal Article Type: Article
• Acceptance Date: Aug 4, 2013
• Online Publication Date: Aug 29, 2013
• Publication Date: 2014-05
• Deposit Date: Apr 20, 2016
• Publicly Available Date: Nov 23, 2020
• Journal: Psychological medicine
• Print ISSN: 0033-2917
• Electronic ISSN: 1469-8978
• Publisher: Cambridge University Press
• Peer Reviewed: Peer Reviewed
• Volume: 44
• Issue: 7
• Pages: 1553-1566
• DOI: https://doi.org/10.1017/S0033291713002171
• Keywords: Irritable bowel syndrome (IBS), CANTAB, Cognition, Cortisol, Stress
• Public URL: https://hull-repository.worktribe.com/output/436566