IBD-related neuroimaging shows brain alterations in emotional networks with distinguishable phenotypes for Crohn's and ulcerative colitis

BackgroundInflammatory bowel disease (IBD) is recognized as a prototypical disorder of brain-gut interaction. Although neuroimaging research in this field has advanced rapidly in recent years, the findings remain fragmented across multiple disciplines, and a systematic integration of the literature is lacking.ObjectiveThis study presents the first integrated bibliometric analysis and literature review to map the landscape and evolving trends of neuroimaging research in IBD over the past two decades and to identify the knowledge base and research frontiers.MethodsWe conducted a systematic search of the Web of Science Core Collection and Scopus databases for IBD-related neuroimaging literature published between January 2000 and January 2026. Following the PRISMA guidelines, two independent reviewers screened titles, abstracts, and full texts. A total of 175 articles met the inclusion criteria. Data were extracted on study characteristics, neuroimaging modalities, and clinical findings. For the synthesis, we employed a dual approach: (1) a bibliometric analysis using VOSviewer, Biblioshiny, and CiteSpace to map publication trends, collaboration networks, and research hotspots; and (2) a structured literature review across five predefined dimensions: technical modalities, brain region–symptom associations, subtype differences, mechanistic pathways, and clinical translation.ResultsThe systematic search and selection process identified 175 articles for final synthesis. The field has entered a phase of rapid expansion since 2021, with China and the United States as core contributing countries. Emerging frontiers include the “brain-gut axis” and the “default mode network.” The literature synthesis indicates that: (1) brain alterations are predominantly localized within an emotional and interoceptive network (anterior cingulate cortex, insula, and amygdala), with abnormalities generally associated with abdominal pain, anxiety, and depression; and (2) Crohn’s disease and ulcerative colitis appear to exhibit distinguishable neuroimaging phenotypes, though direct comparative studies remain limited.ConclusionThis study systematically clarifies the knowledge structure of the IBD neuroimaging field, demonstrates that the available neuroimaging evidence is consistent with the brain-gut axis as a central theoretical framework, and identifies subtype-specific neural characteristics. Future efforts should prioritize large-sample multicenter validation, longitudinal designs capable of testing mechanistic hypotheses, and multimodal data integration to transition the field from descriptive observations toward clinically meaningful applications,though substantial barriers—including small sample sizes, methodological heterogeneity, and lack of standardization—must first be overcome.