Brain mechanisms underlying selective attention in IBS

IBS 选择性注意的脑机制

• 批准号: 7712329
• 负责人: JENNIFER S LABUS
• 金额: $ 7.7万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-01 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7712329
• 关键词: Abdominal Pain; Affective; Amygdaloid structure; Anterior; Applications Grants; Arousal; Arts; Attention; Award; Behavior; Behavioral; Biological; Biological Neural Networks; Brain; Brain region; Chronic; Cognitive; Data; Development; Disease; Disinhibition; Emotional; Emotions; Esthesia; Evaluation; Fright; Functional Gastrointestinal Disorders; Functional Magnetic Resonance Imaging; Functional disorder; Habits; Impairment; Intestines; Irritable Bowel Syndrome; Lateral; Lesion; Medial; Methods; Network-based; Organism; Pain Disorder; Parietal Lobe; Participant; Patients; Performance; Pharmacological Treatment; Physiological; Pilot Projects; Play; Process; Public Health; Reaction Time; Research; Role; Sensory; Stimulus; Symptoms; System; Testing; Thalamic structure; Transcranial magnetic stimulation; Work; central pain; cingulate cortex; cognitive behavior therapy; cognitive control; executive function; gastrointestinal; health care service utilization; health related quality of life; indexing; interest; neuromechanism; novel; public health relevance; response; selective attention; tool

DESCRIPTION (provided by applicant): Symptom-related fears and associated hypervigilance toward disease-related stimuli (gastrointestinal [GI] sensations, symptoms or contexts) may play an important role in triggering central pain amplification systems in irritable bowel syndrome (IBS). This R03 tests the general hypothesis that central pain amplification in IBS is in part related to impairment in brain mechanisms responsible for regulating attention. Attention is a process involving the selection of competing sensory information to optimize current behavioral responses to specific stimuli relevant for the organism. I hypothesize that central pain amplification in IBS is related to impairment in attention processes responsible for filtering distracting information, i.e., symptom-related stimuli. I will test the specific hypothesis that decreased engagement of prefrontal cortical (PFC) control mechanisms will result in diminished PFC control over threat-related distracters and disinhibition of emotional arousal circuits (amygdala-centered pre-attentive threat mechanisms). Functional magnetic resonance imaging will be used to evaluate differences in the engagement of selective attention networks during emotional and threat-related stimuli in IBS patients versus healthy control subjects. Brain responses and behavioral performance on tasks indexing general attention (alerting, orienting, executive) and selective attention to disease-relevant GI words and threatening stimuli are compared between IBS and control subjects. To make valid causal inferences regarding the brain regions/networks and behavior, transcranial magnetic stimulation will be applied to produce temporary and fully reversible inactivation of the dorsolateral PFC in controls. The proposed studies are an extension of my K08 award that aims to identify the neuroanatomical substrates of the cognitive, behavioral, affective and physiologic alterations in IBS patients. This research will provide preliminary data for a planned R01 grant proposal focused on delineating the mechanism of PFC dysfunction in IBS. More complete understanding of cognitive mechanisms involved in central pain amplification will provide a better understanding of non-pharmacological treatment approaches such as cognitive behavioral therapy. PUBLIC HEALTH RELEVANCE: Irritable bowel syndrome is a common, chronic functional gastrointestinal disorder, characterized by abdominal pain and altered bowel habits, with significant impact on health-related quality of life and health care utilization. A better understanding of the biological mechanisms underlying central amplification of abdominal pain may increase progress in the development of more effective pharmacological therapies. The current research evaluates the attentional mechanisms and underlying brain circuits necessary to filter non-relevant information from the gut, and will test whether these functions are impaired in IBS.

描述（由申请人提供）： 症状相关的恐惧和对疾病相关刺激（胃肠道[GI]感觉，症状或背景）的相关过度警惕可能在触发肠易激综合征（IBS）的中枢疼痛放大系统中发挥重要作用。这R 03测试的一般假设，在IBS的中枢疼痛放大是部分相关的负责调节注意力的大脑机制的损害。注意是一个过程，涉及选择竞争的感官信息，以优化当前的行为反应，以特定的刺激相关的有机体。我假设IBS的中枢疼痛放大与负责过滤分心信息的注意力过程受损有关，即，与刺激有关的。我将测试的具体假设，减少参与的前额叶皮层（PFC）控制机制将导致减少PFC控制威胁相关的干扰和情绪唤醒电路的去抑制（杏仁核为中心的前注意力威胁机制）。功能性磁共振成像将用于评价IBS患者与健康对照受试者在情绪和威胁相关刺激期间选择性注意网络参与的差异。脑反应和行为表现的任务索引一般注意力（警觉，定向，执行）和选择性注意疾病相关的GI词和威胁性刺激IBS和对照组之间进行了比较。为了对大脑区域/网络和行为进行有效的因果推断，将应用经颅磁刺激以使对照组的背外侧PFC暂时和完全可逆失活。拟议的研究是我的K 08奖的延伸，旨在确定IBS患者认知，行为，情感和生理变化的神经解剖学基础。这项研究将为计划中的R 01拨款提案提供初步数据，该提案的重点是描述IBS中PFC功能障碍的机制。更全面地了解中枢性疼痛放大的认知机制将有助于更好地了解非药物治疗方法，如认知行为治疗。 公共卫生关系：肠易激综合征是一种常见的慢性功能性胃肠道疾病，以腹痛和排便习惯改变为特征，对健康相关的生活质量和卫生保健利用有显著影响。更好地了解腹痛中枢放大的生物学机制可能会增加更有效的药物治疗的发展。目前的研究评估了从肠道过滤非相关信息所需的注意力机制和潜在的大脑回路，并将测试这些功能是否在IBS中受损。