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Cortical effects of anticipation and endogenous modulation of visceral pain assessed by functional brain MRI in irritable bowel syndrome patients and healthy controls.
Pain. 2006 Dec 15; 126(1-3):79-90.PAIN

Abstract

Visceral pain processing is abnormal in a majority of irritable bowel syndrome (IBS) patients. Aberrant endogenous nociceptive modulation and anticipation are possible underlying mechanisms investigated in the current study. Twelve IBS patients and 12 matched healthy controls underwent brain fMRI scanning during the following randomised stimuli: sham and painful rectal distensions by barostat without and with simultaneous activation of endogenous descending nociceptive inhibition using ice water immersion of the foot for heterotopic stimulation. Heterotopic stimulation decreased rectal pain scores from 3.7+/-0.2 to 3.1+/-0.3 (mean+/-SE, scale 0-5) in controls (p<0.01), but not significantly in IBS. Controls differed from IBS patients in showing significantly greater activation bilaterally in the anterior insula, SII and putamen during rectal stimulation alone compared to rectal plus heterotopic stimulation. Greater activation during rectal plus heterotopic versus rectal stimulation was seen bilaterally in SI and the right superior temporal gyrus in controls and in the right inferior lobule and bilaterally in the superior temporal gyrus in IBS. Rectal pain scores were similarly low during sham stimulation in both groups, but brain activation patterns differed. In conclusion, IBS patients showed dysfunctional endogenous inhibition of pain and concomitant aberrant activation of brain areas involved in pain processing and integration. Anticipation of rectal pain was associated with different brain activation patterns in IBS involving multiple interoceptive, homeostatic, associative and emotional areas, even though pain scores were similar during sham distension. The aberrant activation of endogenous pain inhibition appears to involve circuitry relating to anticipation as well as pain processing itself.

Authors+Show Affiliations

Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16846694

Citation

Song, Guang Hui, et al. "Cortical Effects of Anticipation and Endogenous Modulation of Visceral Pain Assessed By Functional Brain MRI in Irritable Bowel Syndrome Patients and Healthy Controls." Pain, vol. 126, no. 1-3, 2006, pp. 79-90.
Song GH, Venkatraman V, Ho KY, et al. Cortical effects of anticipation and endogenous modulation of visceral pain assessed by functional brain MRI in irritable bowel syndrome patients and healthy controls. Pain. 2006;126(1-3):79-90.
Song, G. H., Venkatraman, V., Ho, K. Y., Chee, M. W., Yeoh, K. G., & Wilder-Smith, C. H. (2006). Cortical effects of anticipation and endogenous modulation of visceral pain assessed by functional brain MRI in irritable bowel syndrome patients and healthy controls. Pain, 126(1-3), 79-90.
Song GH, et al. Cortical Effects of Anticipation and Endogenous Modulation of Visceral Pain Assessed By Functional Brain MRI in Irritable Bowel Syndrome Patients and Healthy Controls. Pain. 2006 Dec 15;126(1-3):79-90. PubMed PMID: 16846694.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cortical effects of anticipation and endogenous modulation of visceral pain assessed by functional brain MRI in irritable bowel syndrome patients and healthy controls. AU - Song,Guang Hui, AU - Venkatraman,Vinod, AU - Ho,Khek Yu, AU - Chee,Michael W L, AU - Yeoh,Khay Guan, AU - Wilder-Smith,Clive H, Y1 - 2006/07/18/ PY - 2005/10/03/received PY - 2006/05/12/revised PY - 2006/06/12/accepted PY - 2006/7/19/pubmed PY - 2006/12/27/medline PY - 2006/7/19/entrez SP - 79 EP - 90 JF - Pain JO - Pain VL - 126 IS - 1-3 N2 - Visceral pain processing is abnormal in a majority of irritable bowel syndrome (IBS) patients. Aberrant endogenous nociceptive modulation and anticipation are possible underlying mechanisms investigated in the current study. Twelve IBS patients and 12 matched healthy controls underwent brain fMRI scanning during the following randomised stimuli: sham and painful rectal distensions by barostat without and with simultaneous activation of endogenous descending nociceptive inhibition using ice water immersion of the foot for heterotopic stimulation. Heterotopic stimulation decreased rectal pain scores from 3.7+/-0.2 to 3.1+/-0.3 (mean+/-SE, scale 0-5) in controls (p<0.01), but not significantly in IBS. Controls differed from IBS patients in showing significantly greater activation bilaterally in the anterior insula, SII and putamen during rectal stimulation alone compared to rectal plus heterotopic stimulation. Greater activation during rectal plus heterotopic versus rectal stimulation was seen bilaterally in SI and the right superior temporal gyrus in controls and in the right inferior lobule and bilaterally in the superior temporal gyrus in IBS. Rectal pain scores were similarly low during sham stimulation in both groups, but brain activation patterns differed. In conclusion, IBS patients showed dysfunctional endogenous inhibition of pain and concomitant aberrant activation of brain areas involved in pain processing and integration. Anticipation of rectal pain was associated with different brain activation patterns in IBS involving multiple interoceptive, homeostatic, associative and emotional areas, even though pain scores were similar during sham distension. The aberrant activation of endogenous pain inhibition appears to involve circuitry relating to anticipation as well as pain processing itself. SN - 1872-6623 UR - https://www.unboundmedicine.com/medline/citation/16846694/Cortical_effects_of_anticipation_and_endogenous_modulation_of_visceral_pain_assessed_by_functional_brain_MRI_in_irritable_bowel_syndrome_patients_and_healthy_controls_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0304-3959(06)00340-X DB - PRIME DP - Unbound Medicine ER -