Deconditioning in quiescent Crohn's Disease patients with heightened fatigue perception

Jordan J McGing; Sébastien Serres; Rosemary Nicholas; Ayushman Gupta; Shellie J Radford; Aline V Nixon; Joanne Mallinson; Christopher Bradley; Stephen Bawden; Susan T Francis; Paul L Greenhaff; Gordon W Moran

doi:10.1093/ecco-jcc/jjae194

Deconditioning in quiescent Crohn's Disease patients with heightened fatigue perception

J Crohns Colitis. 2025 Jan 9:jjae194. doi: 10.1093/ecco-jcc/jjae194. Online ahead of print.

Authors

Affiliations

¹ Postdoctoral Researcher, Sir Peter Mansfield Imaging Centre, University of Nottingham.
² Assistant Professor of Metabolic Biochemistry, Faculty of Medicine and Health Sciences, University of Nottingham.
³ Research Fellow, Sir Peter Mansfield Imaging Centre, University of Nottingham.
⁴ Clinical Fellow, Faculty of Medicine and Health Sciences, University of Nottingham.
⁵ Senior Research Fellow in Gastroenterology, Faculty of Medicine and Health Sciences, University of Nottingham; NIHR Nottingham Biomedical Research Centre, Nottingham.
⁶ Senior Technical Specialist/Research Nurse, David Greenfield Human Physiology Unit, Faculty of Medicine and Health Sciences, University of Nottingham.
⁷ Human Studies Technician, David Greenfield Human Physiology Unit, Faculty of Medicine and Health Sciences, University of Nottingham.
⁸ Research Fellow, Sir Peter Mansfield Imaging Centre, University of Nottingham; NIHR Nottingham Biomedical Research Centre, Nottingham.
⁹ Research Fellow, Sir Peter Mansfield Imaging Centre, University of Nottingham; NIHR Nottingham Biomedical Research Centre, Nottingham. MRI Physics Group, Department of Medical Physics and Clinical Engineering, Singleton Hospital, Swansea.
¹⁰ Professor of Physics, Sir Peter Mansfield Imaging Centre, University of Nottingham; NIHR Nottingham Biomedical Research Centre, Nottingham.
¹¹ Professor of Muscle Metabolism, David Greenfield Human Physiology Unit, MRC/Versus Arthritis Centre for Musculoskeletal Ageing Research, NIHR Nottingham Biomedical Research Centre, Faculty of Medicine and Health Sciences, University of Nottingham.
¹² Professor of Gastroenterology, Translational Medical Sciences, School of Medicine, Faculty of Medicine and Health Sciences, University of Nottingham; NIHR Nottingham Biomedical Research Centre, Nottingham.

PMID: 39787044
DOI: 10.1093/ecco-jcc/jjae194

Abstract

Background & objective: IBD fatigue aetiology is poorly understood. This study quantified body composition and physical function alongside proton magnetic resonance imaging (1H MRI) and spectroscopy (31P MRS) measures of organ structure and function in quiescent Crohn's Disease patients (CD) and healthy volunteers (HV), to identify a physiological basis for IBD fatigue.

Methods: Body composition was determined using DEXA and 1H MRI. Knee extensor isometric strength and isokinetic fatigue were measured using dynamometry. 1H MRI was used to quantify cardiac output, cerebral blood flow (gmCBF) and brain oxygen extraction fraction (OEF) at rest, and during supine, steady-state exercise and recovery. 31P MRS was used to quantify post-exercise muscle phosphocreatine (PCr) resynthesis.

Results: 16 CD and 12 HV (age, sex and BMI matched) were recruited. Fatigue perception was greater (13.9 ± 1 vs 8.3 ± 0.9, P=0.001) and daily step-count was less (5482 ± 684 vs 8168 ± 1123, P=0.04) in CD. During steady-state exercise, gmCBF was less in CD (653 ± 30 vs 823 ± 40 mL/min, P = 0.003). Cardiac output and brain OEF were no different. Post-exercise PCr resynthesis was less in CD (17.2 ± 2.0 vs 25.3 ± 2.4 mM min-1, P=0.02). Body composition, isometric strength and isokinetic fatigueability were no different.

Conclusion: CD self-reported increased fatigue perception and exhibited a slower rate of post-exercise PCr resynthesis compared to HV. This occurred independently of changes in body composition, muscle strength and fatigueability. IBD fatigue may be linked to peripheral muscle deconditioning and lower gmCBF during submaximal exercise.