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Altered Cerebellar Activity in Visceral Pain-Related Fear Conditioning in Irritable Bowel Syndrome.
Cerebellum. 2017 04; 16(2):508-517.C

Abstract

There is evidence to support a role of the cerebellum in emotional learning processes, which are demonstrably altered in patients with chronic pain. We tested if cerebellar activation is altered during visceral pain-related fear conditioning and extinction in irritable bowel syndrome (IBS). Cerebellar blood oxygenation level-dependent (BOLD) data from N = 17 IBS patients and N = 21 healthy controls, collected as part of a previous fMRI study, was reanalyzed utilizing an advanced normalizing method of the cerebellum. The differential fear conditioning paradigm consisted of acquisition, extinction, and reinstatement phases. During acquisition, two visual conditioned stimuli (CS) were presented either paired (CS+) or unpaired (CS-) with painful rectal distension as unconditioned stimulus (US). In the extinction phase, the CS+ and CS- were presented without US. For reinstatement, unpaired US presentations were followed by unpaired CS+ and CS- presentations. Group differences in cerebellar activation were analyzed for the contrasts CS+ > CS- and CS- > CS+. During acquisition, IBS patients revealed significantly enhanced cerebellar BOLD responses to pain-predictive (CS+) and safety (CS-) cues compared to controls (p < 0.05, family-wise error corrected). Increased activation was found in three main clusters, including the vermis (maximum in vermal lobule VI), intermediate cerebellum (maximum in lobule VIII), and the posterolateral cerebellar hemisphere (maximum in lobule VI). Areas overlapped for the contrasts CS+ > CS- and CS- > CS+. Group differences were most prominent in the contrast CS- > CS+. During extinction and reinstatement, no significant group differences were found. During visceral pain-related fear conditioning, IBS patients showed increased activations in circumscribed areas of the medial, intermediate, and lateral cerebellum. These areas are involved in autonomic, somatosensory, and cognitive functions and likely contribute to the different aspects of pain-related fear. The cerebellum contributes to altered pain-related fear learning in IBS.

Authors+Show Affiliations

Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.Integrative Gastroenterology, Clinic for Internal and Integrative Medicine, Kliniken Essen-Mitte, Essen, Germany.Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany. sigrid.elsenbruch@uk-essen.de.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27797090

Citation

Claassen, J, et al. "Altered Cerebellar Activity in Visceral Pain-Related Fear Conditioning in Irritable Bowel Syndrome." Cerebellum (London, England), vol. 16, no. 2, 2017, pp. 508-517.
Claassen J, Labrenz F, Ernst TM, et al. Altered Cerebellar Activity in Visceral Pain-Related Fear Conditioning in Irritable Bowel Syndrome. Cerebellum. 2017;16(2):508-517.
Claassen, J., Labrenz, F., Ernst, T. M., Icenhour, A., Langhorst, J., Forsting, M., Timmann, D., & Elsenbruch, S. (2017). Altered Cerebellar Activity in Visceral Pain-Related Fear Conditioning in Irritable Bowel Syndrome. Cerebellum (London, England), 16(2), 508-517. https://doi.org/10.1007/s12311-016-0832-7
Claassen J, et al. Altered Cerebellar Activity in Visceral Pain-Related Fear Conditioning in Irritable Bowel Syndrome. Cerebellum. 2017;16(2):508-517. PubMed PMID: 27797090.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Altered Cerebellar Activity in Visceral Pain-Related Fear Conditioning in Irritable Bowel Syndrome. AU - Claassen,J, AU - Labrenz,F, AU - Ernst,T M, AU - Icenhour,A, AU - Langhorst,J, AU - Forsting,M, AU - Timmann,D, AU - Elsenbruch,S, PY - 2016/11/1/pubmed PY - 2017/9/25/medline PY - 2016/11/1/entrez KW - Anticipation KW - Cerebellum KW - Extinction KW - Fear conditioning KW - Irritable bowel syndrome KW - Visceral pain SP - 508 EP - 517 JF - Cerebellum (London, England) JO - Cerebellum VL - 16 IS - 2 N2 - There is evidence to support a role of the cerebellum in emotional learning processes, which are demonstrably altered in patients with chronic pain. We tested if cerebellar activation is altered during visceral pain-related fear conditioning and extinction in irritable bowel syndrome (IBS). Cerebellar blood oxygenation level-dependent (BOLD) data from N = 17 IBS patients and N = 21 healthy controls, collected as part of a previous fMRI study, was reanalyzed utilizing an advanced normalizing method of the cerebellum. The differential fear conditioning paradigm consisted of acquisition, extinction, and reinstatement phases. During acquisition, two visual conditioned stimuli (CS) were presented either paired (CS+) or unpaired (CS-) with painful rectal distension as unconditioned stimulus (US). In the extinction phase, the CS+ and CS- were presented without US. For reinstatement, unpaired US presentations were followed by unpaired CS+ and CS- presentations. Group differences in cerebellar activation were analyzed for the contrasts CS+ > CS- and CS- > CS+. During acquisition, IBS patients revealed significantly enhanced cerebellar BOLD responses to pain-predictive (CS+) and safety (CS-) cues compared to controls (p < 0.05, family-wise error corrected). Increased activation was found in three main clusters, including the vermis (maximum in vermal lobule VI), intermediate cerebellum (maximum in lobule VIII), and the posterolateral cerebellar hemisphere (maximum in lobule VI). Areas overlapped for the contrasts CS+ > CS- and CS- > CS+. Group differences were most prominent in the contrast CS- > CS+. During extinction and reinstatement, no significant group differences were found. During visceral pain-related fear conditioning, IBS patients showed increased activations in circumscribed areas of the medial, intermediate, and lateral cerebellum. These areas are involved in autonomic, somatosensory, and cognitive functions and likely contribute to the different aspects of pain-related fear. The cerebellum contributes to altered pain-related fear learning in IBS. SN - 1473-4230 UR - https://www.unboundmedicine.com/medline/citation/27797090/Altered_Cerebellar_Activity_in_Visceral_Pain_Related_Fear_Conditioning_in_Irritable_Bowel_Syndrome_ L2 - https://dx.doi.org/10.1007/s12311-016-0832-7 DB - PRIME DP - Unbound Medicine ER -