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Deficient habituation to repeated rectal distensions in irritable bowel syndrome patients with visceral hypersensitivity.
Neurogastroenterol Motil. 2015 May; 27(5):646-55.NM

Abstract

BACKGROUND

Irritable bowel syndrome (IBS) patients show evidence of altered central processing of visceral signals. One of the proposed alterations in sensory processing is an altered engagement of endogenous pain modulation mechanisms. The aim was to test the hypothesis that IBS patients with (IBS-S) and without visceral hypersensitivity (IBS-N) differ in their ability to engage endogenous pain modulation mechanism during habituation to repeated visceral stimuli.

METHODS

Brain blood oxygen level dependent (BOLD) response was measured during repeated rectal distension and its anticipation in 33 IBS patients with and without visceral hypersensitivity and 18 healthy controls (HCs). BOLD response to early and late phase of the distension series was compared within and between groups.

KEY RESULTS

While BOLD response was similar during the early phase of the experiment, IBS-S showed greater BOLD response than IBS-N and HCs during the late phase of the distension series. IBS-S showed increasing BOLD response both to the anticipation and delivery of low intensity rectal distensions in brain regions including insula, anterior and mid cingulate cortex. IBS-N showed decreasing BOLD response to repeated rectal distensions in brain regions including insula, prefrontal cortex and amygdala.

CONCLUSIONS & INFERENCES

These findings are consistent with compromised ability of IBS-S to respond to repeated delivery of rectal stimuli, both in terms of sensitization of sensory pathways and habituation of emotional arousal. The fact that both IBS subgroups met Rome criteria, and did not differ in terms of reported symptom severity demonstrates that similar symptom patterns can result from different underlying neurobiological mechanisms.

Authors+Show Affiliations

Department of Gastroenterology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Center for Medical Image Science and Visualization (CMIV), 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

25777251

Citation

Lowén, M B O., et al. "Deficient Habituation to Repeated Rectal Distensions in Irritable Bowel Syndrome Patients With Visceral Hypersensitivity." Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society, vol. 27, no. 5, 2015, pp. 646-55.
Lowén MB, Mayer E, Tillisch K, et al. Deficient habituation to repeated rectal distensions in irritable bowel syndrome patients with visceral hypersensitivity. Neurogastroenterol Motil. 2015;27(5):646-55.
Lowén, M. B., Mayer, E., Tillisch, K., Labus, J., Naliboff, B., Lundberg, P., Thorell, L. H., Ström, M., Engström, M., & Walter, S. (2015). Deficient habituation to repeated rectal distensions in irritable bowel syndrome patients with visceral hypersensitivity. Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society, 27(5), 646-55. https://doi.org/10.1111/nmo.12537
Lowén MB, et al. Deficient Habituation to Repeated Rectal Distensions in Irritable Bowel Syndrome Patients With Visceral Hypersensitivity. Neurogastroenterol Motil. 2015;27(5):646-55. PubMed PMID: 25777251.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Deficient habituation to repeated rectal distensions in irritable bowel syndrome patients with visceral hypersensitivity. AU - Lowén,M B O, AU - Mayer,E, AU - Tillisch,K, AU - Labus,J, AU - Naliboff,B, AU - Lundberg,P, AU - Thorell,L-H, AU - Ström,M, AU - Engström,M, AU - Walter,S, Y1 - 2015/03/17/ PY - 2014/09/17/received PY - 2015/02/03/accepted PY - 2015/3/18/entrez PY - 2015/3/18/pubmed PY - 2016/1/16/medline KW - brain-gut interaction KW - fMRI KW - irritable bowel syndrome KW - visceral sensitivity SP - 646 EP - 55 JF - Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society JO - Neurogastroenterol Motil VL - 27 IS - 5 N2 - BACKGROUND: Irritable bowel syndrome (IBS) patients show evidence of altered central processing of visceral signals. One of the proposed alterations in sensory processing is an altered engagement of endogenous pain modulation mechanisms. The aim was to test the hypothesis that IBS patients with (IBS-S) and without visceral hypersensitivity (IBS-N) differ in their ability to engage endogenous pain modulation mechanism during habituation to repeated visceral stimuli. METHODS: Brain blood oxygen level dependent (BOLD) response was measured during repeated rectal distension and its anticipation in 33 IBS patients with and without visceral hypersensitivity and 18 healthy controls (HCs). BOLD response to early and late phase of the distension series was compared within and between groups. KEY RESULTS: While BOLD response was similar during the early phase of the experiment, IBS-S showed greater BOLD response than IBS-N and HCs during the late phase of the distension series. IBS-S showed increasing BOLD response both to the anticipation and delivery of low intensity rectal distensions in brain regions including insula, anterior and mid cingulate cortex. IBS-N showed decreasing BOLD response to repeated rectal distensions in brain regions including insula, prefrontal cortex and amygdala. CONCLUSIONS & INFERENCES: These findings are consistent with compromised ability of IBS-S to respond to repeated delivery of rectal stimuli, both in terms of sensitization of sensory pathways and habituation of emotional arousal. The fact that both IBS subgroups met Rome criteria, and did not differ in terms of reported symptom severity demonstrates that similar symptom patterns can result from different underlying neurobiological mechanisms. SN - 1365-2982 UR - https://www.unboundmedicine.com/medline/citation/25777251/Deficient_habituation_to_repeated_rectal_distensions_in_irritable_bowel_syndrome_patients_with_visceral_hypersensitivity_ L2 - https://doi.org/10.1111/nmo.12537 DB - PRIME DP - Unbound Medicine ER -