Document Detail


Central representation of visceral and cutaneous hypersensitivity in the irritable bowel syndrome.
MedLine Citation:
PMID:  12749964     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We have previously shown that irritable bowel syndrome (IBS) patients have both visceral and cutaneous hyperalgesia. The neural mechanisms of these forms of hyperalgesia were further characterized by comparing cortical processing of both rectal distension (35, 55mmHg) and cutaneous heat nociceptive stimuli (foot immersion in 45 and 47 degrees C water bath) in IBS patients and in a group of healthy age/sex-matched controls. Our approach relied on functional magnetic resonance imaging neuroimaging analyses in which brain activation in age/sex-matched control subjects was subtracted from that found in IBS patients. These analyses revealed that both rectal distension and cutaneous heat stimuli evoked greater neural activity in several brain regions of IBS patients in comparison to age/sex-matched control subjects. These include those related to early stages of somatosensory processing (e.g. thalamus, somatosensory cortex) as well as those more related to cognitive and affective processing (insular, anterior cingulate, posterior cingulate, prefrontal cortex). Thus, our results support the hypothesis that hyperalgesia of IBS is manifested by increased somatosensory processing at all cortical levels. This was found to be the case not only for visceral hyperalgesia but also for cutaneous heat hyperalgesia, a likely form of secondary hyperalgesia. Furthermore, visceral and heat hyperalgesia were accompanied by increased neural activity within the same brain structures. These results support the hypothesis that visceral and cutaneous hyperalgesia in IBS patients is related to increased afferent processing in pathways ascending to the brain rather than to selectively increased activity at higher cortical levels (e.g. limbic and frontal cortical areas).
Authors:
G Nicholas Verne; Nathan C Himes; Michael E Robinson; Kaundinya S Gopinath; Richard W Briggs; Bruce Crosson; Donald D Price
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Pain     Volume:  103     ISSN:  0304-3959     ISO Abbreviation:  Pain     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-05-16     Completed Date:  2003-07-21     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7508686     Medline TA:  Pain     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  99-110     Citation Subset:  IM    
Affiliation:
Research Service (151), Malcom Randall VAMC, Gainesville, FL 32608, USA. vernegn@medicine.ufl.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Anxiety
Brain Mapping
Case-Control Studies
Colonic Diseases, Functional / physiopathology*
Fear
Female
Foot
Hot Temperature / adverse effects
Humans
Hyperalgesia / etiology*
Magnetic Resonance Imaging / methods
Male
Pain / etiology,  psychology
Pain Measurement
Physical Stimulation
Psychological Tests
Skin Diseases / etiology*
Viscera / physiopathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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