Abstract Background Emerging evidence underscores psychological distress as a potential modifier of clinical outcomes in Crohn’s disease (CD), though its etiological basis remains undetermined. This study investigated associations between psychological distress and intestinal abnormalities identified by magnetic resonance enterography (MRE) through serum neurotransmitter analysis. Methods In this prospective study, 105 patients with CD and 46 healthy controls (HCs) completed State-Trait Anxiety Inventory (including STAI-Trait and State score), Beck Depression Inventory, and Perceived Stress Scale questionnaires to assess psychological distress. CD patients underwent MRE and serum neurotransmitter profiling. 79 patients received repeat MRE and psychological evaluations during follow-up. Statistical analyses included correlation analysis, multivariable logistic regression, and Cox proportional hazards modeling. Results CD patients exhibited higher psychological distress scores versus HCs (all P 0.001). Anxiety severity (STAI-Trait score) correlated with CD bowel stricture, perienteric effusion, mural T2WI hyperintensity and hyperenhancement (|r| = 0.454-0.606; all P 0.05). Multivariable analysis showed that STAI-Trait score influenced the odds of perienteric effusion (OR = 1.124, 95% CI 1.007, 1.255, P = 0.036). Longitudinal follow-up demonstrated significantly higher incidence of new-onset perienteric effusion in patients with elevated baseline STAI-Trait scores compared to those with low scores (62.1% vs.15.4%, P 0.001), with STAI-Trait being the strongest predictor (HR = 6.986, 95% CI 2.274, 21.465, P 0.001). Both STAI-Trait score and perienteric effusion showed consistent associations with serum tryptophan and histidine levels (|r| = 0.203-0.255; all P 0.05). Conclusion CD patients’ psychological state is associated with intestinal morphological changes on MRE. The associations of serum tryptophan and histidine levels with both psychological distress and MRE features provide preliminary support for gut-brain interaction in CD. Conflict of interest: Dr. Ke, Yaoqi: No conflict of interest Zhang, Ruonan: No conflict of interest Wang, Yangdi: No conflict of interest Huang, Lili: No conflict of interest Shen, Xiaodi: No conflict of interest Zheng, Qingzhu: No conflict of interest Wu, Luyao: No conflict of interest Zheng, Weikai: No conflict of interest Zhao, Qiaochu: No conflict of interest Li, Xuehua: No conflict of interest Peng, Zhenpeng: No conflict of interest
Ke et al. (Thu,) studied this question.