Regional cerebral activity in normal and pathological perception of visceral pain
Regional cerebral activity in normal and pathological perception of visceral pain
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DOI：
10.1016/s0016-5085(97)70220-8
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发表时间：
1997-01-01
期刊：
影响因子：
29.4
通讯作者：
Mayer, EA
中科院分区：
文献类型：
--
作者：
Silverman, DHS;Munakata, JA;Mayer, EA
背景和目标：为了描述伤害性内脏事件的大脑处理，检查了与肠痛感知相关的局部脑血流量的变化。在12名受试者中，使用O-15-水正电子发射断层扫描（PET）评估直肠压力刺激对局部脑血流的影响，其中一半患有肠易激综合征（IBS），在基线以及实际和模拟输送预期刺激期间获得PET扫描，使用统计参数映射和感兴趣区域分析方法解释局部脑血流量的变化，结果：在健康受试者中，在实际或模拟传递疼痛刺激期间的疼痛感知显著相关，（P < 0.01）与前扣带皮层活动有关（行政协调会; Brodmann区24和32），而没有观察到ACC对非疼痛刺激的感知反应。在IBS患者中，ACC对相同的刺激没有反应，而显著激活左前额叶皮层（P < 0.01）（在Brodmann区10最大），结论：在健康受试者中，急性直肠疼痛的感知与ACC的激活相关，肠易激综合征患者在有害性直肠扩张和预期直肠疼痛时均表现出异常的脑激活模式。
Background & Aims: To characterize the cerebral processing of noxious visceral events, changes in regional cerebral blood flow associated with perception of intestinal pain were examined, Methods: The effects of rectal pressure stimuli on regional cerebral blood flow were assessed with O-15-water positron emission tomography (PET) in 12 subjects, half with irritable bowel syndrome (IBS), PET scans were obtained at baseline and during both actual and simulated delivery of anticipated stimuli, Changes in regional cerebral blood flow were interpreted using statistical parametric mapping and region of interest methods of analysis, Results: in healthy subjects, perception of pain during actual or simulated delivery of painful stimuli was significantly associated (P < 0.01) with activity of the anterior cingulate cortex (ACC; Brodmann's areas 24 and 32), whereas no ACC response to perception of nonpainful stimuli was observed, In patients with IBS, the ACC failed to respond to the same stimuli, whereas significant activation (P < 0.01) of the left prefrontal cortex (maximal in Brodmann's area 10) was seen, Conclusions: The perception of acute rectal pain is associated with activation of the ACC in healthy subjects, and patients with IBS show an aberrant brain activation pattern both during noxious rectal distention and during the anticipation of rectal pain.