Identification of human brain loci processing esophageal sensation using positron emission tomography
Identification of human brain loci processing esophageal sensation using positron emission tomography
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DOI：
10.1016/s0016-5085(97)70079-9
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发表时间：
1997-07-01
期刊：
影响因子：
29.4
通讯作者：
Thompson, DG
中科院分区：
文献类型：
--
作者：
Aziz, Q;Andersson, JLR;Thompson, DG
背景与目的：人类食管感觉的脑定位仍不清楚。本研究的目的是确定大脑的位置，处理无痛和疼痛的人类食管的感觉。研究方法：在8名健康受试者（7名男性;年龄范围，24-47岁）中，通过以产生无感觉、明确感觉或疼痛的体积重复充盈球囊进行远端食管刺激。使用（H2O）-O-15对每种感觉进行两次正电子发射断层扫描。同时对每例受试者进行脑部磁共振扫描，并将正电子发射断层扫描数据与磁共振扫描数据进行配准，对显示对比明确感觉基线、疼痛基线和疼痛明确感觉的协方差校正t图像进行分析。结果：非痛性刺激引起双侧中央沟、岛叶皮质和额/顶叶岛盖的沿着激活（P < 0.01）。疼痛刺激产生更强烈的激活相同的地区和额外的激活右前岛叶皮层和前扣带回。还观察到多个区域的激活减少;其中最突出的是右前额叶皮层，在非疼痛和疼痛刺激期间都受到抑制。结论：食管感觉激活双侧的延髓、初级躯体感觉皮层和鳃盖。右前岛叶皮层和前扣带回处理食管疼痛。
Background & Aims: Brain loci that process human esophageal sensation remain unidentified. The aim of this study was to identify the brain loci that process nonpainful and painful human esophageal sensation. Methods: In 8 healthy subjects (7 men; age range, 24-47 years), distal esophageal stimulation was performed by repeatedly inflating a balloon at volumes that produced either no sensation, definite sensation, or pain. Two positron emission tomography scans were performed for each sensation using (H2O)-O-15. Magnetic resonance brain scans were also performed in each subject, and the positron emission tomography data were coregistered with magnetic resonance scans, Analysis of covariance-corrected t images showing the contrasts definite sensation-baseline, pain-baseline, and pain-definite sensation were created. Results: Nonpainful stimulation elicited bilateral activations along the central sulcus, insular cortex, and frontal/parietal operculum (P < 0.01). Painful stimulation produced more intense activations of the same areas and additional activation of the right anterior insular cortex and the anterior cingulate gyrus. Multiple areas of decreased activation were also observed; prominent among these was the right prefrontal cortex, which was inhibited during both nonpainful and painful stimulation. Conclusions: Esophageal sensation activates bilaterally the insula, primary somatosensory cortex, and operculum. The right anterior insular cortex and anterior cingulate gyrus process esophageal pain.