Cerebral Activation in Patients With Irritable Bowel Syndrome and Control Subjects During Rectosigmoid Stimulation
作者:
Bruce,
Naliboff Stuart,
Derbyshire Julie,
Munakata Steve,
Berman Mark,
Mandelkern Lin,
Chang Emeran,
期刊:
Psychosomatic Medicine
(OVID Available online 2001)
卷期:
Volume 63,
issue 3
页码: 365-375
ISSN:0033-3174
年代: 2001
出版商: OVID
关键词: irritable bowel syndrome,;limbic system,;conditioned fear,;antinociception.
数据来源: OVID
摘要:
ObjectivePatients 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.MethodsChanges in regional cerebral blood flow were measured using H215O-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.ResultsBrain 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.ConclusionsIBS 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.
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