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Brain responses to visceral stimuli reflect visceral sensitivity thresholds in patients with irritable bowel syndrome.
Gastroenterology. 2012 Mar; 142(3):463-472.e3.G

Abstract

BACKGROUND & AIMS

Only a fraction of patients with irritable bowel syndrome (IBS) have increased perceptual sensitivity to rectal distension, indicating differences in processing and/or modulation of visceral afferent signals. We investigated the brain mechanisms of these perceptual differences.

METHODS

We analyzed data from 44 women with IBS and 20 female healthy subjects (controls). IBS symptom severity was determined by a severity scoring system. Anxiety and depression symptoms were assessed using the hospital anxiety and depression score. Blood oxygen level-dependent signals were measured by functional magnetic resonance imaging during expectation and delivery of high (45 mmHg) and low (15 mmHg) intensity rectal distensions. Perception thresholds to rectal distension were determined in the scanner. Brain imaging data were compared among 18 normosensitive and 15 hypersensitive patients with IBS and 18 controls. Results were reported significant if peak P-values were ≤.05, with family-wise error correction in regions of interest.

RESULTS

The subgroups of patients with IBS were similar in age, symptom duration, psychological symptoms, and IBS symptom severity. Although brain responses to distension were similar between normosensitive patients and controls, hypersensitive patients with IBS had greater activation of insula and reduced deactivation in pregenual anterior cingulate cortex during noxious rectal distensions, compared to controls and normosensitive patients with IBS. During expectation of rectal distension, normosensitive patients with IBS had more activation in right hippocampus than controls.

CONCLUSIONS

Despite similarities in symptoms, hyper- and normosensitive patients with IBS differ in cerebral responses to standardized rectal distensions and their expectation, consistent with differences in ascending visceral afferent input.

Authors+Show Affiliations

Department of Clinical and Experimental Medicine/Gastroenterology, Linköping University, Linköping, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22108191

Citation

Larsson, Mats B O., et al. "Brain Responses to Visceral Stimuli Reflect Visceral Sensitivity Thresholds in Patients With Irritable Bowel Syndrome." Gastroenterology, vol. 142, no. 3, 2012, pp. 463-472.e3.
Larsson MB, Tillisch K, Craig AD, et al. Brain responses to visceral stimuli reflect visceral sensitivity thresholds in patients with irritable bowel syndrome. Gastroenterology. 2012;142(3):463-472.e3.
Larsson, M. B., Tillisch, K., Craig, A. D., Engström, M., Labus, J., Naliboff, B., Lundberg, P., Ström, M., Mayer, E. A., & Walter, S. A. (2012). Brain responses to visceral stimuli reflect visceral sensitivity thresholds in patients with irritable bowel syndrome. Gastroenterology, 142(3), 463-e3. https://doi.org/10.1053/j.gastro.2011.11.022
Larsson MB, et al. Brain Responses to Visceral Stimuli Reflect Visceral Sensitivity Thresholds in Patients With Irritable Bowel Syndrome. Gastroenterology. 2012;142(3):463-472.e3. PubMed PMID: 22108191.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Brain responses to visceral stimuli reflect visceral sensitivity thresholds in patients with irritable bowel syndrome. AU - Larsson,Mats B O, AU - Tillisch,Kirsten, AU - Craig,A D, AU - Engström,Maria, AU - Labus,Jennifer, AU - Naliboff,Bruce, AU - Lundberg,Peter, AU - Ström,Magnus, AU - Mayer,Emeran A, AU - Walter,Susanna A, Y1 - 2011/11/19/ PY - 2011/07/20/received PY - 2011/10/31/revised PY - 2011/11/02/accepted PY - 2011/11/24/entrez PY - 2011/11/24/pubmed PY - 2012/5/10/medline SP - 463 EP - 472.e3 JF - Gastroenterology JO - Gastroenterology VL - 142 IS - 3 N2 - BACKGROUND & AIMS: Only a fraction of patients with irritable bowel syndrome (IBS) have increased perceptual sensitivity to rectal distension, indicating differences in processing and/or modulation of visceral afferent signals. We investigated the brain mechanisms of these perceptual differences. METHODS: We analyzed data from 44 women with IBS and 20 female healthy subjects (controls). IBS symptom severity was determined by a severity scoring system. Anxiety and depression symptoms were assessed using the hospital anxiety and depression score. Blood oxygen level-dependent signals were measured by functional magnetic resonance imaging during expectation and delivery of high (45 mmHg) and low (15 mmHg) intensity rectal distensions. Perception thresholds to rectal distension were determined in the scanner. Brain imaging data were compared among 18 normosensitive and 15 hypersensitive patients with IBS and 18 controls. Results were reported significant if peak P-values were ≤.05, with family-wise error correction in regions of interest. RESULTS: The subgroups of patients with IBS were similar in age, symptom duration, psychological symptoms, and IBS symptom severity. Although brain responses to distension were similar between normosensitive patients and controls, hypersensitive patients with IBS had greater activation of insula and reduced deactivation in pregenual anterior cingulate cortex during noxious rectal distensions, compared to controls and normosensitive patients with IBS. During expectation of rectal distension, normosensitive patients with IBS had more activation in right hippocampus than controls. CONCLUSIONS: Despite similarities in symptoms, hyper- and normosensitive patients with IBS differ in cerebral responses to standardized rectal distensions and their expectation, consistent with differences in ascending visceral afferent input. SN - 1528-0012 UR - https://www.unboundmedicine.com/medline/citation/22108191/Brain_responses_to_visceral_stimuli_reflect_visceral_sensitivity_thresholds_in_patients_with_irritable_bowel_syndrome_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(11)01583-6 DB - PRIME DP - Unbound Medicine ER -