Enhanced Auditory Brainstem Response and Parental Bonding Style in Children with Gastrointestinal Symptoms

Abstract

BackgroundThe electrophysiological properties of the brain and influence of parental bonding in childhood irritable bowel syndrome (IBS) are unclear. We hypothesized that children with chronic gastrointestinal (GI) symptoms like IBS may show exaggerated brainstem auditory evoked potential (BAEP) responses and receive more inadequate parental bonding.Methodology/Principal FindingsChildren aged seven and their mothers (141 pairs) participated. BAEP was measured by summation of 1,000 waves of the electroencephalogram triggered by 75 dB click sounds. The mothers completed their Children's Somatization Inventory (CSI) and Parental Bonding Instrument (PBI). CSI results revealed 66 (42%) children without GI symptoms (controls) and 75 (58%) children with one or more GI symptoms (GI group). The III wave in the GI group (median 4.10 interquartile range [3.95–4.24] ms right, 4.04 [3.90–4.18] ms left) had a significantly shorter peak latency than controls (4.18 [4.06–4.34] ms right, p = 0.032, 4.13 [4.02–4.24] ms left, p = 0.018). The female GI group showed a significantly shorter peak latency of the III wave (4.00 [3.90–4.18] ms) than controls (4.18 [3.97–4.31] ms, p = 0.034) in the right side. BAEP in the male GI group did not significantly differ from that in controls. GI scores showed a significant correlation with the peak latency of the III wave in the left side (rho = −0.192, p = 0.025). The maternal care PBI scores in the GI group (29 [26]–[33]) were significantly lower than controls (31 [28.5–33], p = 0.010), while the maternal over-protection PBI scores were significantly higher in the GI group (16 [12]–[17]) than controls (13 [10.5–16], p = 0.024). Multiple regression analysis in females also supported these findings.ConclusionsIt is suggested that children with chronic GI symptoms have exaggerated brainstem responses to environmental stimuli and inadequate parental behaviors aggravate these symptoms.

A brief version of the Pediatric Inventory for Parents (PIP) in Spanish population: Stress of main family carers of chronic paediatric patients

“…The predictive capacity of PIP with respect to anxiety and depression has been demonstrated, and these are the most common conditions in these caregivers. This is relevant because they can affect the quality of life and well-being of caregivers, can lead to other pathologies in the caregiver, can worsen their health [ 12 ], can deteriorate their children's adjustment to the disease [ 11 ] and, as a consequence of all of the above, can lead to increased health expenditure [ 1 – 3 ]. According to the World Health Organization (WHO), health is the interaction of multiple social, political, economic, cultural, and scientific factors, making this concept a complex reality that requires an interdisciplinary approach to address [ 65 ].…”

“…It is important to pay attention to the caregiver's adjustment to his or her child's diagnosis, as inappropriate parental behaviors have been observed to influence the patient's symptoms. [ 11 ].…”

Corticotropin-Releasing Hormone Receptor 1 Gene Variants in Irritable Bowel Syndrome

“…The variability of genes that encode the proteins which play a pivotal role in regulating the HPA axis influence the inter-individual clinical response to antidepressants [26], [27]. Previous study from our laboratory reported that less maternal care and maternal overprotection form risk for IBS-like symptoms in 7-year old children [28]. Earlier studies have reported moderation of the effects of maltreatment on depression and neuroticism by a three-allele haplotype of CRH-R1 involving the single-nucleotide polymorphisms (SNPs) rs7209436 , rs110402 , and rs242924 [22], [23], [29].…”

The role of psychological factors in pediatric functional abdominal pain disorders

“…In children, there is no direct evidence. Two studies reported that inadequate care by parents, which could be a proxy for insecure attachment, resulted in increased odds of FAPDs . Furthermore, children with FAPDs were more likely than their healthy peers to suffer from separation anxiety disorder which could be a sign of insecure attachment .…”

“…Two studies reported that inadequate care by parents, which could be a proxy for insecure attachment, resulted in increased odds of FAPDs. 26,125 Furthermore, children with FAPDs were more likely than their healthy peers to suffer from separation anxiety disorder which could be a sign of insecure attachment. 14 However, the authors did find that family functioning (ranging from healthy to unhealthy and could be another proxy for attachment) did not differ between families with and without pain.…”