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）： 与症状有关的恐惧和对疾病相关刺激（胃肠道[GI]感觉，症状或环境）的相关过度维护可能在触发肠易激综合征（IBS）中触发中心疼痛放大系统中起重要作用。该R03检验了一个普遍的假设，即IBS中的中枢疼痛放大部分与负责调节注意力的脑机制的损害有关。注意是一个涉及选择竞争感官信息的过程，以优化对与生物体相关的特定刺激的当前行为反应。我假设IBS中的中枢疼痛扩增与负责过滤分散信息的注意力过程中的损害有关，即与症状相关的刺激。我将测试以下特定假设：前额叶皮质（PFC）控制机制的参与度降低将导致PFC控制与威胁相关的干扰物和情绪唤醒回路（以amygdala为中心的预处理前牵引的威胁机制）的控制减少。功能磁共振成像将用于评估IBS患者与健康对照组受试者情绪和威胁相关刺激期间选择性注意网络参与的差异。在IBS和控制受试者之间，比较了对任务的大脑反应和行为表现，以征服一般关注（警报，定向，执行）以及对与疾病相关的GI单词和威胁性刺激的选择性关注。为了对大脑区域/网络和行为进行有效的因果推断，将应用经颅磁刺激来产生对照中背侧PFC的暂时和完全可逆的失活。拟议的研究是我的K08奖的扩展，该奖项旨在确定IBS患者认知，行为，情感和生理改变的神经解剖底物。这项研究将为计划的R01赠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。对中央疼痛扩增所涉及的认知机制的更完整了解将更好地理解非药物治疗方法，例如认知行为疗法。 公共卫生相关性：肠易激综合征是一种常见的慢性功能性胃肠道疾病，其特征是腹痛和肠习惯改变，对与健康相关的生活质量和医疗保健利用产生了重大影响。更好地了解腹痛中心扩增的生物学机制可能会增加更有效的药理学疗法的发展。当前的研究评估了从肠道中过滤非相关信息所需的注意机制和潜在的脑电路，并将测试这些功能是否在IBS中受损。