Correlation between alexithymia and hypersensitivity to visceral stimulation in human
Correlation between alexithymia and hypersensitivity to visceral stimulation in human
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DOI：
10.1016/j.pain.2007.01.032
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发表时间：
2007-12-05
期刊：
影响因子：
7.4
通讯作者：
Fukudo, Shin
中科院分区：
文献类型：
--
作者：
Kano, Michiko;Hamaguchi, Toyohiro;Fukudo, Shin
实证研究表明，述情障碍加重身体疾病。然而，尚未提供直接证据来解释这种恶化的机制。一种假设是，述情障碍放大了令人不快的内部信号。本研究旨在探讨述情障碍对内脏刺激敏感性的影响。在45名非临床健康受试者（34名男性和12名女性）中，使用（H2O）-O-15正电子发射断层扫描（PET）检查了结肠扩张引起的内脏感觉的脑处理。主观感觉评价纵坐标尺度和神经内分泌反应的刺激也进行了测量。采用多伦多述情障碍量表（TAS-20）的20个条目评定患者的述情障碍程度，并评价TAS-20及其3个分量表[情感识别困难（DIF）、情感描述困难（DDF）和外向性思维（EOT）]评分与刺激反应的相关性。在TAS-20评分大于61的10例（共45例）被确定为述情障碍的受试者中，在结肠扩张期间观察到膝前扣带皮层、右脑和中脑的更大激活。TAS-20评分与右颞回和眶回的活动以及刺激后血液中的肾上腺素水平呈正相关。DIF得分高的受试者感觉到强烈的疼痛，排便的紧迫性，压力，焦虑和轻微的困倦。本研究表明述情障碍与内脏刺激超敏反应有关。这一发现支持了述情障碍中的躯体感觉放大假设，并且对于阐明述情障碍对脑肠功能的影响，特别是理解FGIDs（功能性胃肠道疾病）的病理生理学具有重要意义。(c)2007年国际疼痛研究协会。出版社：Elsevier B. V. All rights reserved.
Empirical studies indicate that alexithymia exacerbates physical illness. However, direct evidence to explain the mechanism of this exacerbation has not been provided. One hypothesis is that alexithymics amplify unpleasant internal signals. In the present study, we investigated how alexithymia influences sensitivity to visceral stimulation in human. In 45 non-clinical healthy subjects (34 males and II females), brain processing of visceral sensation induced by colonic distension was examined using (H2O)-O-15 positron emission tomography (PET). Subjective feeling evaluated on an ordinate scale and neuroendocrine response to stimuli were also measured. The degree of alexithymia was determined using the 20-item of Toronto alexithymia scale (TAS-20), and the correlation between reaction to stimuli and the scores of TAS-20 and its three subscales [difficulty to identify feelings (DIF), difficulty to describe feelings (DDF) and external oriented thinking (EOT)] was evaluated. Greater activation was observed during colonic distension in the pregenual anterior cingulate cortex, right insula and midbrain in the 10 (out of 45) subjects that were identified as alexithymic by TAS-20 scores larger than 61. TAS-20 scores positively correlated with both activity in the right insula and orbital gyrus and adrenaline levels in the blood in response to stimulation. Subjects with high scores of DIF perceived strong pain, urgency for defecation, stress, anxiety, and slight sleepiness. The present study demonstrates that alexithymia is associated with hypersensitivity to visceral stimulation. This finding supports the somatosensory amplification hypothesized in alexithymics and is important to elucidate the influence of alexithymia on brain-gut function, particularly to understand the pathophysiology of FGIDs (functional gastrointestinal disorders). (c) 2007 International Association for the Study of Pain. Published by Elsevier B.V.. All rights reserved.