Cerebral activation in patients with irritable bowel syndrome and control subjects during rectosigmoid stimulation

被引:236
作者
Naliboff, BD
Derbyshire, SWG
Munakata, J
Berman, S
Mandelkern, M
Chang, L
Mayer, EA
机构
[1] Univ Calif Los Angeles, CURE, Neuroenter Dis Program,Sch Med, Digest Dis Res Ctr,VA Greater Los Angeles Healthc, Los Angeles, CA 90073 USA
[2] Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA
[3] Univ Calif Los Angeles, Sch Med, Dept Physiol, Los Angeles, CA 90024 USA
[4] Univ Calif Irvine, Irvine, CA USA
[5] Greater Los Angeles Healthcare Syst, Dept Psychol, Irvine, CA USA
[6] Greater Los Angeles Healthcare Syst, Dept Nucl Med, Irvine, CA USA
来源
PSYCHOSOMATIC MEDICINE | 2001年 / 63卷 / 03期
关键词
irritable bowel syndrome; limbic system; conditioned fear; antinociception;
D O I
10.1097/00006842-200105000-00006
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Objective: Patients with irritable bowel syndrome (IBS) show evidence of altered perceptual responses to visceral stimuli, consistent with altered processing of visceral afferent information by the brain. In the current study, brain responses to anticipated and delivered rectal balloon distension were assessed, Methods: Changes in regional cerebral blood flow were measured using (H2O)-O-15-water positron emission tomography in 12 nonconstipated IBS patients and 12 healthy control subjects. Regional cerebral blood flow responses to moderate rectal distension (45 mm Hg) and anticipated but undelivered distension were assessed before and after a series of repetitive noxious (60-mm Hg) sigmoid distensions. Results: Brain regions activated by actual and simulated distensions were similar in both groups. Compared with control subjects, patients with IBS showed lateralized activation of right prefrontal cortex: reduced activation of perigenual cortex, temporal lobe, and brain stem; but enhanced activation of rostral anterior cingulate and posterior cingulate cortices. Conclusions: IBS patients show altered brain responses to rectal stimuli, regardless of whether these stimuli are actually delivered or simply anticipated. These alterations are consistent with reported alterations in autonomic and perceptual responses and may be related to altered central noradrenergic modulation.
引用
收藏
页码:365 / 375
页数:11
相关论文
共 76 条
  • [1] An X, 1998, J COMP NEUROL, V401, P455
  • [2] [Anonymous], [No title captured]
  • [3] Identification of human brain loci processing esophageal sensation using positron emission tomography
    Aziz, Q
    Andersson, JLR
    Valind, S
    Sundin, A
    Hamdy, S
    Jones, AKP
    Foster, ER
    Langstrom, B
    Thompson, DG
    [J]. GASTROENTEROLOGY, 1997, 113 (01) : 50 - 59
  • [4] Aziz Q, 2000, J NEUROSCI, V20, P2657
  • [5] Bakshi VP, 2000, PROG BRAIN RES, V122, P105
  • [6] Bandler R, 2000, PROG BRAIN RES, V122, P333
  • [7] THE ANATOMY OF MELANCHOLIA - FOCAL ABNORMALITIES OF CEREBRAL BLOOD-FLOW IN MAJOR DEPRESSION
    BENCH, CJ
    FRISTON, KJ
    BROWN, RG
    SCOTT, LC
    FRACKOWIAK, RSJ
    DOLAN, RJ
    [J]. PSYCHOLOGICAL MEDICINE, 1992, 22 (03) : 607 - 615
  • [8] Gender differences in regional brain response to visceral pressure in IBS patients
    Berman, S
    Munakata, J
    Naliboff, BD
    Chang, L
    Mandelkern, M
    Silverman, D
    Kovalik, E
    Mayer, EA
    [J]. EUROPEAN JOURNAL OF PAIN-LONDON, 2000, 4 (02): : 157 - 172
  • [9] Central processing of rectal pain in IBS patients: An fMRI study.
    Bonaz, BL
    Papillon, E
    Baciu, M
    Segebarth, C
    Bost, R
    Le Bas, JF
    Fournet, J
    [J]. GASTROENTEROLOGY, 2000, 118 (04) : A615 - A615
  • [10] Bremner JD, 1997, ARCH GEN PSYCHIAT, V54, P246