Brain responses to visceral stimuli reflect visceral sensitivity thresholds in patients with irritable bowel syndrome.
Brain responses to visceral stimuli reflect visceral sensitivity thresholds in patients with irritable bowel syndrome.
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DOI：
10.1053/j.gastro.2011.11.022
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发表时间：
2012-03
期刊：
影响因子：
29.4
通讯作者：
Walter SA
中科院分区：
文献类型：
--
作者：
Larsson MB;Tillisch K;Craig AD;Engström M;Labus J;Naliboff B;Lundberg P;Ström M;Mayer EA;Walter SA
只有一小部分IBS患者表现出对直肠扩张的感知敏感性增加，这表明该组内内脏传入信号的处理和/或调制可能存在差异。其目的是确定可能导致这些感知差异的大脑机制。44例IBS患者和20例女性健康对照者（HC）。IBS症状严重程度采用IBS严重程度评分系统（IBS-SSS）评定。使用医院焦虑和抑郁评分（HAD）评估焦虑和抑郁症状。在高强度（45 mmHg）和低强度（15 mmHg）直肠扩张的预期和输送期间，通过功能性磁共振成像（fMRI）测量血氧水平依赖（BOLD）信号。在扫描仪中确定直肠扩张的感知阈值。比较了18例正常敏感、15例过敏性IBS患者和18例HC的脑成像数据。如果峰值p值≤ 0.05，则报告结果具有显著性，并且在感兴趣区域中进行了族间误差校正。两个IBS亚组在年龄、症状持续时间、心理症状和IBS症状严重程度方面相似。虽然大脑对扩张的反应在正常敏感的患者和HC中相似，但与HC和正常敏感的IBS相比，过敏性IBS在有害的直肠扩张过程中表现出更大的激活，减少了膝前扣带皮层的失活。在直肠扩张的预期，正常敏感IBS有更多的激活在右侧海马比HC。尽管症状相似，高敏感性和正常敏感性IBS患者在标准化直肠扩张的大脑反应和他们的期望方面存在很大差异，这与上行内脏传入输入的差异一致。
Only a fraction of IBS patients show increased perceptual sensitivity to rectal distension, suggesting possible differences in processing and/or modulation of visceral afferent signals within this group. The aim was to identify brain mechanisms which may underlie these perceptual differences. 44 women with IBS and 20 female healthy control subjects (HCs) were included. Symptom severity in IBS was determined by Severity Scoring System (IBS-SSS). Anxiety and depression symptoms were assessed using the Hospital anxiety & depression score (HAD). Blood oxygen level dependent (BOLD) signals were measured by functional Magnetic Resonance Imaging (fMRI) during expectation and delivery of high (45mmHg) and low (15mmHg) intensity rectal distensions. Perception thresholds to rectal distension were determined in the scanner. Brain imaging data from 18 normosensitive, 15 hypersensitive IBS patients and 18 HCs were compared. Results were reported significant if peak p-value ≤ 0.05 with family wise error correction in regions of interest. The two IBS subgroups were similar in age, symptom duration, psychological symptoms and IBS symptom severity. While brain responses to distension were similar in normosensitive patients and HCs, hypersensitive IBS demonstrated greater activation of insula and reduced deactivation in pregenual anterior cingulate cortex during noxious rectal distensions, compared to both HCs and normosensitive IBS. During expectation of rectal distension, normosensitive IBS had more activation in right hippocampus than HCs. Despite similarities in symptoms, hyper- and normosensitive IBS patients differed substantially in cerebral response to standardized rectal distensions and their expectation, consistent with differences in ascending visceral afferent input.
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DOI：
10.1097/ajp.0b013e3181bff800
发表时间：
2010-02
期刊：
The Clinical journal of pain
影响因子：
--
作者：
Heymen S;Maixner W;Whitehead WE;Klatzkin RR;Mechlin B;Light KC
通讯作者：
Light KC
影响因子：
24.5
作者：
Dorn, Spencer D.;Palsson, Olafur S.;Whitehead, William E.
通讯作者：
Whitehead, William E.
影响因子：
24.5
作者：
Elsenbruch, S.;Rosenberger, C.;Gizewski, E. R.
通讯作者：
Gizewski, E. R.
影响因子：
7.6
作者：
Labus, JS;Bolus, R;Naliboff, BD
通讯作者：
Naliboff, BD
影响因子：
29.4
作者：
Bouin, M;Plourde, V;Poitras, P
通讯作者：
Poitras, P