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It is often comorbid with anxiety, depression, and cognitive dysfunction. Understanding the neural mechanisms underlying these comorbidities is crucial for identifying IBS pathology and developing targeted treatments. Functional magnetic resonance imaging (fMRI) offers valuable insights into brain connectivity and psychopathology. This review evaluates research on the link between functional connectivity, mood, and cognition in IBS. We systematically searched Embase, PubMed, and PsycINFO for studies published between 2010 and 2024, identifying 49 studies using both resting-state and task-based fMRI. Of these, 12 studies meeting inclusion criteria were reviewed. Across studies, IBS was associated with altered connectivity in the salience (SN), sensorimotor (SMN), default mode (DMN), and executive control (ECN) networks. Reported cognitive findings largely reflected executive and attentional control processes occurring in the context of pain anticipation, salience detection, and interoceptive awareness rather than domain-general cognitive impairment. Alterations in the SN, particularly involving the pregenual anterior cingulate cortex and anterior midcingulate cortex, were linked to increased visceral sensitivity and affective symptoms. Disrupted DMN connectivity was associated with altered self-referential processing and emotional regulation, while changes in the SMN and ECN suggested differences in sensory integration and top-down control. Notably, several studies showed that group differences in functional connectivity were reduced or no longer significant after accounting for anxiety and depression, suggesting that mood symptoms may play a mediating role in brain network alterations in IBS. While the literature is limited by small samples and sex imbalance, this review highlights a multi-network model of IBS that emphasizes emotional\u2013cognitive\u2013visceral interactions and points to important directions for future longitudinal research.<\/jats:p>","DOI":"10.1007\/s11682-026-01135-9","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T14:58:13Z","timestamp":1775573893000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A systematic review of associations between functional connectivity, mood and cognition in patients with irritable bowel syndrome"],"prefix":"10.1007","volume":"20","author":[{"given":"Mahnaz","family":"Reisian","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Toben","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liliana G.","family":"Ciobanu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalene C.","family":"Jawahar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"Eldeghaidy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott R.","family":"Clark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"issue":"5","key":"1135_CR1","doi-asserted-by":"publisher","first-page":"1188","DOI":"10.1053\/j.gastro.2012.07.104","volume":"143","author":"E Aizawa","year":"2012","unstructured":"Aizawa, E., Sato, Y., Kochiyama, T., Saito, N., Izumiyama, M., Morishita, J., Kanazawa, M., Shima, K., Mushiake, H., & Hongo, M. 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