JMIR Publications

ABSTRACT

Background:

Inflammatory bowel disease (IBD) is a chronic gastrointestinal disease characterized by continuous relapsing remission, mainly including Crohn's disease and ulcerative colitis, which causes a huge global health and so-cio-economic burden

Objective:

This study aimed to develop and validate an innovative multidimensional integrative analysis framework to characterize the time-varying interaction between stress and inflammatory bowel disease (IBD) symptoms via in-tensive longitudinal monitoring, identify core regulatory modules and intervention targets, and support personal-ized IBD management.

Methods:

A prospective longitudinal design was conducted in 74 IBD patients with 90-day continuous monitoring. Daily high-density data of 12 core variables across 4 dimensions were collected via a customized mobile health appli-cation, constructing a micro-dynamic dataset with 79,920 standardized data points. Systematic analyses were performed using the PCMCI algorithm, module control network analysis, causal emergence metrics, and time-varying effect model (TVEM)

Results:

IBD symptom fluctuations were significantly synchronized with end-of-month stress rhythms, with an individu-al-specific bidirectional response pattern. The group-level causal network structure was stable, while symp-tom-emotion association strength showed linear continuous enhancement. Four functional modules were identi-fied, among which the central sensitization (CS) module exhibited the optimal micro-macro information integra-tion efficiency and strongest macro causal control effect. Causal emergence was first demonstrated in IBD, with macro modules showing significantly better causal specificity and information transmission efficiency than micro symptom levels (all P<0.01). Baseline disease activity significantly moderated the treatment gain pattern of caus-al emergence and module control strength.

Conclusions:

This study first reveals the time-varying causal emergence process of stress-symptom interaction in IBD, and identifies the CS module as the core regulatory target. The established framework provides a new strategy for disease dynamic mechanism analysis and precise intervention optimization, laying a foundation for individual-ized time-series targeted IBD therapy. Clinical Trial: This study was reviewed by the Ethics Committee of the The First Affiliated Hospital of Xinjiang Medical Universi-ty(K202412-86).