Site-specific differences in central processing of visceral stimuli from the rectum and the descending colon in men
Site-specific differences in central processing of visceral stimuli from the rectum and the descending colon in men
复制标题
DOI：
10.1111/j.1365-2982.2009.01417.x
复制
发表时间：
2010-02-01
影响因子：
3.5
通讯作者：
Fukudo, S.
中科院分区：
文献类型：
--
作者：
Kanazawa, M.;Hamaguchi, T.;Fukudo, S.
背景研究表明，躯体感觉刺激和内脏刺激可激活不同的脑区。然而，到目前为止，还没有研究调查人类大脑中的激活模式在消化道不同部位的内脏刺激期间如何不同。本研究的目的是确定在两个不同的部位，直肠和降结肠的管腔内扩张内脏刺激时，大脑反应和感知的可能的部位特异性差异。方法在32名健康右利手男性受试者中，使用H（2）15 O正电子发射断层扫描在直肠扩张期间评估局部脑血流量（R组，n = 16）或降结肠（DC组，n = 16）在40或20 mmHg。关键结果R组报告的腹痛评分显着较高与DC组相比，40 mmHg刺激时，大鼠的排便次数（P < 0.05）和排便欲望（P < 0.001）明显增加，但腹胀和焦虑症状无明显变化。在对40-mmHg刺激的反应的比较中，R组在后中扣带皮层（MCC）和右前扣带皮层和右后扣带皮层中显示出显著更大的激活，而DC组在膝下前扣带皮层（ACC）中显示出更大的激活，膝周前扣带回和左眶额皮质和上级颞叶皮质。这些发现表明，来自直肠和降结肠的疼痛内脏刺激的中枢投射在大脑的情感、认知和伤害性处理中是不同的，这可能导致对来自不同部位的内脏刺激的不同感知。
BackgroundIt has been reported that different brain activation areas are demonstrated during somatosensory and visceral stimulation. However, no study thus far has investigated how activated patterns in the human brain differ during visceral stimulation of different sites of the digestive tracts. The aim of this study was to determine possible site-specific differences in brain responses and perceptions during visceral stimulation of two different sites, the intraluminal distentions of the rectum and descending colon.MethodsRegional cerebral blood flow was assessed in 32 healthy right-handed male subjects using H(2)15O positron emission tomography during distention of the rectum (R group, n = 16) or descending colon (DC group, n = 16) at 40 or 20 mmHg.Key ResultsR group reported significantly higher scores of abdominal pain (P < 0.05) and urge to defecate (P < 0.001) during the application of stimulus at 40 mmHg compared with DC group but not of abdominal bloating or anxiety. In comparisons of response to the 40-mmHg stimulus, R group showed significantly greater activation in posterior midcingulate cortex (MCC) and right anterior and posterior insula, whereas DC group showed greater activation in subgenual anterior cingulate cortex (ACC), perigenual ACC and left orbitofrontal and superior temporal cortices.Conclusions & InferencesThese findings suggest that central projections of painful visceral stimulation from the rectum and descending colon differ in affective, cognitive and nociceptive processing in the brain, which may result in different perceptions of visceral stimulation from different sites.