{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T22:41:42Z","timestamp":1793227302011,"version":"4.5.0"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T00:00:00Z","timestamp":1722297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Disorders of gut\u2010brain interaction (DGBI) are symptom\u2010based disorders categorized by anatomic location but have high overlap and heterogeneity. Viewing DGBI symptoms on a spectrum (i.e. dimensionally) rather than categorically may better inform interventions to accommodate complex clinical presentations. We aimed to evaluate symptom networks to identify how DGBI symptoms interact.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used the Rome IV Diagnostic Questionnaire continuously\/ordinally scored items collected from the Rome Foundation Global Epidemiology Study. We excluded participants who reported \u22651 organic\/structural gastrointestinal disorder(s). We sought to (1) identify core symptoms in the DGBI symptom networks, (2) identify bridge pathways between Rome IV diagnostic categories (esophageal, bowel, gastroduodenal, anorectal), and (3) explore how symptoms group together into communities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 54,127 adults, 20,229 met criteria for at least one DGBI (age mean\u2009=\u200942.2\u2009\u00b1\u200915.5; 57% female). General abdominal pain and epigastric pain were the core symptoms in the DGBI symptom network (i.e., had the strongest connections to other symptoms). Pain symptoms emerged as bridge pathways across existing DGBI diagnostic anatomic location (i.e., abdominal pain connected to chest pain, epigastric pain, rectal pain). Without a priori category definitions, exploratory network community analysis showed that symptoms grouped together into \u201cpain,\u201d \u201cgastroduodenal,\u201d and \u201cconstipation,\u201d rather than into groups by anatomic location.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings suggest pain symptoms are central and serve as a key connection to other symptoms, crosscutting anatomic location. Future longitudinal research is needed to test symptom network relations longitudinally and investigate whether targeting pain symptoms (rather than anatomic\u2010 or disorder\u2010specific symptoms) has clinical impact.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nmo.14877","type":"journal-article","created":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T07:00:33Z","timestamp":1722322833000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Pain is a cardinal symptom cutting across Rome\n                    <scp>IV<\/scp>\n                    anatomical categories in disorders of gut\u2010brain interaction: A network\u2010based approach"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2059-3256","authenticated-orcid":false,"given":"Helen","family":"Burton\u2010Murray","sequence":"first","affiliation":[{"name":"Department of Psychiatry Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Medicine Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Gastroenterology, Department of Medicine Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2925-3955","authenticated-orcid":false,"given":"Livia","family":"Guadagnoli","sequence":"additional","affiliation":[{"name":"Laboratory for Brain\u2010Gut Axis Studies (LaBGAS), Translational Research in Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism (CHROMETA) KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina A.","family":"Vanzhula","sequence":"additional","affiliation":[{"name":"Department of Psychological and Brain Sciences University of Louisville  Louisville Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany A.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Psychological Sciences Auburn University  Auburn Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7634-3689","authenticated-orcid":false,"given":"Ami D.","family":"Sperber","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences Ben\u2010Gurion University of the Negev  Beer\u2010Sheva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olafur","family":"Palsson","sequence":"additional","affiliation":[{"name":"Center for Functional GI &amp; Motility Disorders University of North Carolina\u2010Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3111-0689","authenticated-orcid":false,"given":"Shrikant I.","family":"Bangdiwala","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence, and Impact McMaster University  Hamilton Ontario Canada"},{"name":"Population Health Research Institute McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Van\u00a0Oudenhove","sequence":"additional","affiliation":[{"name":"Laboratory for Brain\u2010Gut Axis Studies (LaBGAS), Translational Research in Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism (CHROMETA) KU Leuven  Leuven Belgium"},{"name":"Leuven Brain Institute KU Leuven  Leuven Belgium"},{"name":"Consultation\u2010Liaison Psychiatry University Psychiatric Centre KU Leuven, Campus Gasthuisberg  Leuven Belgium"},{"name":"Cognitive and Affective Neuroscience Lab, Department of Psychological and Brain Sciences Dartmouth College  Hanover New Hampshire USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4925-4290","authenticated-orcid":false,"given":"Kyle","family":"Staller","sequence":"additional","affiliation":[{"name":"Department of Medicine Harvard Medical School  Boston Massachusetts USA"},{"name":"Division of Gastroenterology, Department of Medicine Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,30]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"ROME IV: Functional Gastrointestinal Disorders\u2014Disorders of Gut\u2010Brain Interaction","author":"Drossman D","year":"2016"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.04.014"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2002.32978"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1586\/egh.10.19"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.20503"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(23)00102-4"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2015.2079"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20375"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-clinpsy-050212-185608"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.11.279"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2468-1253(23)00144-9"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.014"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.psy.50.6.613"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.21105\/joss.03210"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2023.02.033"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.02.042"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365521.2017.1395908"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000975"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14391"},{"key":"e_1_2_10_21_1","volume-title":"Multidimensional Clinical Profile for Disorders of Gut\u2010Brain Interaction (MDCP)","author":"Drossman DATJ","year":"2021"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnaa473"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2018.02.027"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.12.034"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2015-310683"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2005.077503"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.027"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/sga.0000000000000178"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/psy.0000000000000257"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2021.05.042"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2021.04.005"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2021.09.015"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002280"},{"key":"e_1_2_10_34_1","unstructured":"United States Census Bureau American Community Survey. 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