Abstract
BACKGROUND: Irritable bowel syndrome (IBS) is a disorder characterized by signaling dysregulation between the brain and gut, leading to gastrointestinal dysfunction. Symptoms such as abdominal pain and constipation can manifest periodically or persistently, and negative emotions may exacerbate the symptoms. Previous studies have shown that the pathogenesis of IBS is closely related to the brain-gut axis and brain function, but there are still difficulties in disease diagnosis. Therefore, this study applied a machine-learning approach based on resting-state functional magnetic resonance imaging (rs-fMRI) whole-brain functional connectivity (FC) to distinguish IBS patients from healthy controls (HCs). METHODS: A total of 176 subjects, comprising 88 consecutive patients with IBS and 88 age-, sex- and education-matched HCs, were enrolled in this study between January 2020 and January 2024 at the First Affiliated Hospital of Shantou University Medical College. All the subjects underwent rs-fMRI and high-resolution anatomical T1-weighted imaging (T1WI) examinations. Following the preprocessing of the rs-fMRI image data, FC matrices between all regions of interest (ROIs) were extracted using automated anatomical labeling (AAL). Subsequently, supervised machine learning was performed using whole-brain FC for classification features to identify the best-performing model. Finally, weights of the optimal model's features were exported to confirm the neuroanatomical regions significantly influencing model establishment. RESULTS: Compared with other supervised learning models, the support vector machine (SVM) model had significantly higher classification accuracy and performed significantly better than the other models (P<0.05) with a classification accuracy of 75% and an area under the curve (AUC) of 0.7788 (95% confidence interval [CI]: 0.6861-0.8715) (P<0.01). In addition, the FC features from the Rolandic operculum (ROL) to the anterior cingulate gyrus (ACG), the calcarine sulcus (CAL) to the triangular part of the inferior frontal gyrus (IFG), the gyrus rectus (REC) to the inferior occipital gyrus (IOG), the lingual gyrus (LING) to the putamen (PUT), and the IOG to the angular gyrus (ANG) were relatively important in the construction of the machine-learning models. CONCLUSIONS: The SVM was the optimal machine-learning model for effectively classifying IBS patients and HCs based on whole-brain resting-state FC matrices. The FC features between the emotion-related brain regions significantly affected the construction of the machine-learning models. As a classification feature in machine learning, whole-brain resting-state FC holds the potential to achieve precision medicine in IBS and enhance disease diagnostic efficacy.