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Affective disturbances modulate the neural processing of visceral pain stimuli in irritable bowel syndrome: an fMRI study.
Gut. 2010 Apr; 59(4):489-95.Gut

Abstract

OBJECTIVE

To address the role of anxiety and depression symptoms in altered pain processing in irritable bowel syndrome (IBS).

DESIGN

In this functional magnetic resonance imaging study, the blood oxygen level-dependent (BOLD) response to rectal distensions delivered at previously determined individual discomfort thresholds was assessed.

PATIENTS

15 female patients with irritable bowel syndrome (IBS) and with normal rectal pain thresholds, and 12 healthy women.

MEASURES

The correlation of anxiety and depression symptoms, measured with the Hospital Anxiety and Depression Scale (HADS), with subjective pain ratings and the BOLD response during distension-induced brain activation were analysed within IBS. Group differences in pain-induced brain activation with and without controlling for HADS scores were evaluated.

RESULTS

Patients with IBS experienced significantly more pain and discomfort upon rectal distensions in the scanner, despite unaltered rectal sensory thresholds. Anxiety and depression scores were associated with these subjective stimulus ratings, but not with rectal sensory thresholds. Anxiety symptoms in IBS were significantly associated with pain-induced activation of the anterior midcingulate cortex and pregenual anterior cingulate cortex. Depression scores correlated with activation of the prefrontal cortex (PFC) and cerebellar areas within IBS. Group comparisons with the two-sample t test revealed significant activation in the IBS versus controls contrast in the anterior insular cortex and PFC. Inclusion of anxiety and depression scores, respectively, as confounding variables led to a loss of significant group differences.

CONCLUSIONS

Altered central processing of visceral stimuli in IBS is at least in part mediated by symptoms of anxiety and depression, which may modulate the affective-motivational aspects of the pain response.

Authors+Show Affiliations

Institute of Medical Psychology and Behavioral Immunobiology, University Clinic of Essen, University of Duisburg-Essen, Germany. sigrid.elsenbruch@uk-essen.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19651629

Citation

Elsenbruch, S, et al. "Affective Disturbances Modulate the Neural Processing of Visceral Pain Stimuli in Irritable Bowel Syndrome: an fMRI Study." Gut, vol. 59, no. 4, 2010, pp. 489-95.
Elsenbruch S, Rosenberger C, Enck P, et al. Affective disturbances modulate the neural processing of visceral pain stimuli in irritable bowel syndrome: an fMRI study. Gut. 2010;59(4):489-95.
Elsenbruch, S., Rosenberger, C., Enck, P., Forsting, M., Schedlowski, M., & Gizewski, E. R. (2010). Affective disturbances modulate the neural processing of visceral pain stimuli in irritable bowel syndrome: an fMRI study. Gut, 59(4), 489-95. https://doi.org/10.1136/gut.2008.175000
Elsenbruch S, et al. Affective Disturbances Modulate the Neural Processing of Visceral Pain Stimuli in Irritable Bowel Syndrome: an fMRI Study. Gut. 2010;59(4):489-95. PubMed PMID: 19651629.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Affective disturbances modulate the neural processing of visceral pain stimuli in irritable bowel syndrome: an fMRI study. AU - Elsenbruch,S, AU - Rosenberger,C, AU - Enck,P, AU - Forsting,M, AU - Schedlowski,M, AU - Gizewski,E R, Y1 - 2009/08/02/ PY - 2009/8/5/entrez PY - 2009/8/5/pubmed PY - 2010/4/28/medline SP - 489 EP - 95 JF - Gut JO - Gut VL - 59 IS - 4 N2 - OBJECTIVE: To address the role of anxiety and depression symptoms in altered pain processing in irritable bowel syndrome (IBS). DESIGN: In this functional magnetic resonance imaging study, the blood oxygen level-dependent (BOLD) response to rectal distensions delivered at previously determined individual discomfort thresholds was assessed. PATIENTS: 15 female patients with irritable bowel syndrome (IBS) and with normal rectal pain thresholds, and 12 healthy women. MEASURES: The correlation of anxiety and depression symptoms, measured with the Hospital Anxiety and Depression Scale (HADS), with subjective pain ratings and the BOLD response during distension-induced brain activation were analysed within IBS. Group differences in pain-induced brain activation with and without controlling for HADS scores were evaluated. RESULTS: Patients with IBS experienced significantly more pain and discomfort upon rectal distensions in the scanner, despite unaltered rectal sensory thresholds. Anxiety and depression scores were associated with these subjective stimulus ratings, but not with rectal sensory thresholds. Anxiety symptoms in IBS were significantly associated with pain-induced activation of the anterior midcingulate cortex and pregenual anterior cingulate cortex. Depression scores correlated with activation of the prefrontal cortex (PFC) and cerebellar areas within IBS. Group comparisons with the two-sample t test revealed significant activation in the IBS versus controls contrast in the anterior insular cortex and PFC. Inclusion of anxiety and depression scores, respectively, as confounding variables led to a loss of significant group differences. CONCLUSIONS: Altered central processing of visceral stimuli in IBS is at least in part mediated by symptoms of anxiety and depression, which may modulate the affective-motivational aspects of the pain response. SN - 1468-3288 UR - https://www.unboundmedicine.com/medline/citation/19651629/Affective_disturbances_modulate_the_neural_processing_of_visceral_pain_stimuli_in_irritable_bowel_syndrome:_an_fMRI_study_ L2 - https://gut.bmj.com/lookup/pmidlookup?view=long&pmid=19651629 DB - PRIME DP - Unbound Medicine ER -