There is a potential connection between a diagnosis of certain gastrointestinal (GI) syndromes, and the formation and rupture of intracranial aneurysms, according to research presented this week at the Society of NeuroInterventional Surgery (SNIS) annual meeting (22–26 July, Colorado Springs, USA).
It has previously been questioned whether GI syndromes may be connected to the formation and rupture of brain aneurysms and, in a study titled “The gut-brain axis: a nationwide database analysis of gastrointestinal syndromes preceding a diagnosis of intracranial aneurysms”, researchers from the University of Pennsylvania (Philadelphia, USA) found that certain digestive symptoms and diagnoses may precede the formation and rupture of these aneurysms.
The team analysed data from 72,545 individuals with ruptured intracranial aneurysms, 46,748 individuals with unruptured aneurysms, and matched controls, looking for patients who had been diagnosed with GI disorders like gastro-oesophageal reflux disease, irritable bowel syndrome (IBS) and diarrhoea before their intracranial aneurysm diagnosis. Then, they validated their findings in a cohort study with a five-year timeframe.
The researchers found that GI syndromes and appendectomy were associated with both ruptured and unruptured intracranial aneurysm cases. Specifically, patients with intracranial aneurysms who had been previously diagnosed with difficulty swallowing (dysphagia), diarrhoea and constipation were more likely to experience both aneurysm formation and rupture—leading to haemorrhagic stroke. Separately, they found that patients with intracranial aneurysms who had been diagnosed with reflux disease, chronic stomach pain and bloating (known as functional dyspepsia), and IBS without diarrhoea, were more likely to only experience intracranial aneurysm formation without rupture.
“There is evidence from animal studies suggesting a relationship between the gut microbiome and various inflammatory diseases, including the development and rupture of intracranial aneurysms,” said Georgios Sioutas (University of Pennsylvania, Philadelphia, USA), the primary author of the study. “Therefore, validating this new potential connection in humans has been enlightening.”
“Now that we have found more evidence for a link between intracranial aneurysms and GI disorders, we are eager to explore them further, hoping that early detection of GI syndromes might help identify patients at risk of intracranial aneurysms,” commented Jan-Karl Burkhardt (University of Pennsylvania, Philadelphia, USA), the lead author of the study.
In addition, Sioutas emphasised the need for further studies to elucidate these associations and explore the intricate interplay among GI syndromes, the gut microbiome, and intracranial aneurysm pathogenesis.
