Cerebral activation in patients with irritable bowel syndrome and control subjects during rectosigmoid stimulation

BD Naliboff, SWG Derbyshire, J Munakata… - Psychosomatic …, 2001 - journals.lww.com
BD Naliboff, SWG Derbyshire, J Munakata, S Berman, M Mandelkern, L Chang, EA Mayer
Psychosomatic medicine, 2001journals.lww.com
Objective Patients with irritable bowel syndrome (IBS) show evidence of altered perceptual
responses to visceral stimuli, consistent with altered processing of visceral afferent
information by the brain. In the current study, brain responses to anticipated and delivered
rectal balloon distension were assessed. Methods Changes in regional cerebral blood flow
were measured using H 2 15 O-water positron emission tomography in 12 nonconstipated
IBS patients and 12 healthy control subjects. Regional cerebral blood flow responses to …
Abstract
Objective
Patients with irritable bowel syndrome (IBS) show evidence of altered perceptual responses to visceral stimuli, consistent with altered processing of visceral afferent information by the brain. In the current study, brain responses to anticipated and delivered rectal balloon distension were assessed.
Methods
Changes in regional cerebral blood flow were measured using H 2 15 O-water positron emission tomography in 12 nonconstipated IBS patients and 12 healthy control subjects. Regional cerebral blood flow responses to moderate rectal distension (45 mm Hg) and anticipated but undelivered distension were assessed before and after a series of repetitive noxious (60-mm Hg) sigmoid distensions.
Results
Brain regions activated by actual and simulated distensions were similar in both groups. Compared with control subjects, patients with IBS showed lateralized activation of right prefrontal cortex; reduced activation of perigenual cortex, temporal lobe, and brain stem; but enhanced activation of rostral anterior cingulate and posterior cingulate cortices.
Conclusions
IBS patients show altered brain responses to rectal stimuli, regardless of whether these stimuli are actually delivered or simply anticipated. These alterations are consistent with reported alterations in autonomic and perceptual responses and may be related to altered central noradrenergic modulation.
Lippincott Williams & Wilkins