Patients with ulcerative colitis (UC) often exhibit affective disorders, such as depression and anxiety. The underlying neurological mechanisms of these symptoms, however, remain poorly understood. This study aimed to explore alterations in functional connectivity (FC) both within and between resting-state networks (RSNs) in individuals with ulcerative colitis. Twelve meaningful RSNs were identified from 22 ulcerative colitis patients and 23 healthy controls using independent component analysis of functional magnetic resonance imaging data. Correlation analyses were performed between clinical indices, neuropsychological assessments and neuroimaging data. Compared with healthy controls, UC patients showed increased intranetwork FC, mainly located in the right temporal pole, orbitofrontal cortex, and left superior temporal and Rolandic opercular cortices within the auditory network. Increased intranetwork FC in the Rolandic opercular cortex was also observed in UC patients during remission phase, while no significant alterations were detected in patients with active-phase UC. In addition, UC patients exhibited increased connectivity between the dorsal attention and the left frontoparietal network, as well as between the anterior default mode network and the posterior default mode network, with distinct patterns of internetwork connectivity observed across different clinical phases. No significant correlations were found between altered brain regions and psychological scales in UC patients. These findings imply that UC patients may undergo functional network alterations, affecting both intranetwork connectivity within RSNs and internetwork connectivity between RSNs.

To compare audiological profiling and association of hearing loss in different types of IBD and evaluate the degree of hearing impairment based on duration of illness and age parameters.

120 subjects evaluated at a tertiary centre were divided into 2 groups- Controls and Cases. Cases were sub grouped into Ulcerative colitis (UC) and Crohn's disease based on biopsy. Hearing evaluation was done using PTA and DPOAE. Results were compared between the groups with analysis including duration of illness and age at presentation.

Mild hearing loss at 8000 Hz was noted in both the subgroups, more so in UC. The median dB loss on PTA was more in the UC group at all the frequencies but was significant only at 1000, 2000, 4000 and 8000 Hz. 53(44.1%) of the 120 ears, showed mild hearing loss at 8000 Hz on PTA. The median SNR was lower in both subgroups at 8000 Hz. At 8000 Hz on DPOAE, 80 ears (66.6%) showed absent response which was much higher as compared to PTA findings at this frequency. At 8000 Hz, patients with > 5 years duration of illness and those with age > 30 years, showed higher absent DPOAE responses namely 25 ears (83.4%) out of 30 ears and 56 ears (80%) of 70, respectively.

UC cases are more susceptible to hearing loss compared to Crohn's disease especially at 8000 Hz. DPOAE supersedes PTA as a diagnostic tool for subclinical hearing loss.

Disorders such as inflammatory bowel disease (IBD) and celiac disease (CeD) result in intestinal hyperpermeability or 'leaky' gut. The increased permeability of the intestinal barrier allows microbial metabolites, toxins, and pathogens to infiltrate the bloodstream and extraintestinal tissues, causing systemic inflammation. Despite differences in aetiology and pathophysiology, IBD and CeD share several extraintestinal manifestations such as neuroinflammation, neurological and psychiatric manifestations, and sensorineural hearing loss (SNHL). This narrative review focuses on the association between intestinal hyperpermeability with the brain and inner ear diseases. We postulate that the microbial metabolites and pathogens released from the gut increase the permeability of natural barriers, such as the blood-brain barrier (BBB) and blood-labyrinth barrier (BLB). The barrier breakdown allows the spreading of inflammatory processes to the brain and inner ear, leading to disease.