Identification and characterization of cerebral cortical response to esophageal mucosal acid exposure and distention
Identification and characterization of cerebral cortical response to esophageal mucosal acid exposure and distention
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DOI：
10.1016/s0016-5085(98)70013-7
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发表时间：
1998-12-01
期刊：
影响因子：
29.4
通讯作者：
Shaker, R
中科院分区：
文献类型：
--
作者：
Kern, MK;Birn, RM;Shaker, R
背景与目的：食管酸暴露在健康个体和食管炎患者中很常见。临床上，对这种暴露的感知范围从没有感知到严重的胃灼热和胸痛。大脑皮层对食管粘膜接触酸的反应尚未进行系统研究。本研究旨在通过功能磁共振成像（FMRI）研究正常人大脑皮层对食管酸暴露的反应。方法：10名正常健康志愿者。皮层功能磁共振成像反应的0.1N盐酸（1毫升/分钟）的食管内灌注10分钟，并与生理盐水灌注和球囊扩张的结果进行了比较。结果：酸灌注没有引起烧心或胸痛，但FMRI信号强度比灌注前增加6.7% +/- 2.0%。生理盐水输注未检测到增加。球囊扩张与酸灌注的FMRI信号强度相似，酸灌注的激活潜伏期、激活达峰期和失活期均显著长于球囊扩张（P < 0.05）。结论：食管粘膜与酸接触;在诱发胃灼热之前，引起大脑皮层反应，可通过功能磁共振成像检测。这种反应的时间特征与食管球囊扩张引起的反应明显不同。
Background & Aims: Esophageal acid exposure is a common occurrence in healthy individuals and patients with esophagitis. Clinically, perception of this exposure ranges from no perception to severe heartburn and chest pain. Cerebral cortical response to esophageal mucosal contact to acid has not been systematically studied. The aim of this study was to elucidate cerebral cortical response to esophageal acid exposure in normal individuals by functional magnetic resonance imaging (FMRI). Methods: We studied 10 normal healthy volunteers. Cortical FMRI response to 10 minutes of intraesophageal perfusion of 0.1N HCl (1 mL/min) was determined, and the results were compared with those of saline infusion and balloon distention. Results: Acid perfusion did not induce heartburn or chest pain but increased FMRI signal intensity by 6.7% +/- 2.0% over the preperfusion values. No increase was detected for saline infusion. FMRI signal intensity to balloon distention was similar to that of acid perfusion; Activation latency, activation to peak, and the deactivation periods for response to acid perfusion were significantly longer than those of balloon distention (P < 0.05). Conclusions: Contact of esophageal mucosa with acid; before inducing heartburn, evokes a cerebral cortical response detectable by FMRI. Temporal characteristics of this response are significantly different from those induced by esophageal balloon distention.