Gastric distention correlates with activation of multiple cortical and subcortical regions

Ladabaum, Uri; Minoshima, Shinsei; Hasler, William L.; Cross, Donna; Chey, William D.; Owyang, Chung

doi:10.1053/gast.2001.21201

Cited by 144 publications

(102 citation statements)

References 35 publications

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“…Several human studies also showed activation in the striatum in response to CRD [5,52,63] or gastric distention [37] in normal subjects. Neuroanatomical evidence suggests that nociceptive information may reach the basal ganglia through several afferent sources including the medial and posterior thalamus, amygdala, PBN area, dorsal raphe nucleus, as well as cortical regions.…”

Section: Discussionmentioning

confidence: 95%

“…To date, the majority of human studies in this field have used distension of the rectosigmoid colon [4,5,8,41,44,48,52,62], stomach [37,69], and esophagus [2,3,9,73]. Activation of the insular and dorsal anterior cingulate cortex (dACC) has been most consistently reported, with other brain regions, including the prefrontal cortex, thalamus and brainstem being reported in some, but not in other studies.…”

Section: Introductionmentioning

confidence: 99%

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Regional brain activation in conscious, nonrestrained rats in response to noxious visceral stimulation

Wang

Bradesi

Maarek³

et al. 2008

Pain

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Preclinical drug development for visceral pain has largely relied on quantifying pseudoaffective responses to colorectal distension (CRD) in restrained rodents. However, the predictive value of changes in simple reflex responses in rodents for the complex human pain experience is not known. Male rats were implanted with venous cannulas and with telemetry transmitters for abdominal electromyographic (EMG) recordings. [ 14 C]-iodoantipyrine was injected during noxious CRD (60 mmHg) in the awake, nonrestrained animal. Regional cerebral blood flow (rCBF)-related tissue radioactivity was quantified by autoradiography and analyzed in the threedimensionally reconstructed brain by statistical parametric mapping. 60-mmHg CRD, compared with controls (0 mmHg) evoked significant increases in EMG activity (267 ± 24% vs. 103 ± 8%), as well as in behavioral pain score (77 ± 6% vs. 3 ± 3%). CRD elicited significant increases in rCBF as expected in sensory (insula, somatosensory cortex), and limbic and paralimbic regions (including anterior cingulate cortex and amygdala). Significant decreases in rCBF were seen in the thalamus, parabrachial nucleus, periaqueductal gray, hypothalamus and pons. Correlations of rCBF with EMG and with behavioral pain score were noted in the cingulate, insula, lateral amygdala, dorsal striatum, somatosensory and motor regions. Our findings support the validity of measurements of cerebral perfusion during CRD in the freely moving rat as a model of functional brain changes in human visceral pain. However, not all regions demonstrating significant group differences correlated with EMG or behavioral measures. This suggests that functional brain imaging captures more extensive responses of the central nervous system to noxious visceral distension than those identified by traditional measures.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Regional brain activation in conscious, nonrestrained rats in response to noxious visceral stimulation

Wang

Bradesi

Maarek³

et al. 2008

Pain

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“…Recently, neuroimaging studies [10,11] on the central processing of gastric pain revealed activation of a wide range of cortical and subcortical structures (bilateral thalamus, bilateral insula, anterior cingulated cortex, caudate nuclei, brainstem, amygdala, periaqueductal grey matter, cerebellum and occipital cortex). These results support the hypothesis of a possible common cerebral pain network for both somatic and visceral pain.…”

Section: Discussionmentioning

confidence: 99%

Patients with headache and functional dyspepsia present meal–induced hypersensitivity of the stomach

Pucci

Miceli

et al. 2005

J Headache Pain

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IntroductionFunctional gastrointestinal disorders are frequently characterised by the presence of extra-intestinal symptoms. A survey on irritable bowel syndrome showed that gynaecological, urinary, psychological, dermatological and neurological symptoms were significantly more prevalent in patients than in controls [1]. Headache, in particular, was present in more than 30% of patients suffering from this condition. Although there is no similar evaluation for functional dyspepsia, the presence of headache also in patients suffering from this functional disorder is a common finding in day-today clinical practice. To our knowledge no data are available on the responsible pathophysiological mechanism.A new instrument recently became available, the barostat, which allows the evaluation of both tone modifications of large viscera, such as the stomach and colon, and the evaluation of visceral sensitivity, by the study of sensitivity thresholds to mechanical distention [2]. The application of this new technology to the study of the pathophysiology of functional dyspepsia has made it possible to identify several mechanisms at the basis of the onset of dyspeptic symptoms: for example, it was shown that the onset of post-prandial epigastric pain, belching and weight loss is due to gastric hypersensitivity to distention Abstract Headache is a frequent feature of functional gastrointestinal disorders but there is no data on the responsible pathophysiological mechanism. The aim of this study was to verify whether alteration of post-prandial gastric tone or sensitivity might explain this association. Fourteen patients affected by functional dyspepsia (7 migraine without aura) and 7 healthy volunteers (HV) underwent gastric tone measurement in fasting condition and after the administration of a liquid meal by barostat. Gastric volume (GV) and accommodation were calculated as difference between mean post-prandial and mean fasting volume. Mean postprandial GV increase and fasting perception and discomfort threshold (DTh) were similar among the 3 groups. DTh after meal was lower in dyspeptic headache patients than in HV and dyspeptic without headache patients. Patients with migraine and functional dyspepsia may be characterised by mealinduced hypersensitivity of the stomach.

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“…Methods of brain imaging offer another investigative modality for addressing questions related to abnormal processing of sensory information in the cerebral cortex of IBS patients [84,[94][95][96] . Functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) are now commonly used to study information processing in the higher brain centers that underlie an individual's experience of conscious sensations.…”

Section: Sensory Processing In the Cerebral Cortexmentioning

confidence: 99%

“…Results from imaging studies suggest that unlike somatic sensation, which has a main homuncular representation in the primary somatosensory cortex, visceral sensation is mainly represented in the secondary somatosensory cortex [96,97] . Differences in processing in these specialized regions might account for the vagueness of an individual's ability to localize visceral sensation in relation to somatic sensation.…”

Section: Sensory Processing In the Cerebral Cortexmentioning

confidence: 99%

Neuropathophysiology of functional gastrointestinal disorders

Wood

2007

WJG

100

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The investigative evidence and emerging concepts in neurogastroenterology implicate dysfunctions at the levels of the enteric and central nervous systems as underlying causes of the prominent symptoms of many of the functional gastrointestinal disorders. Neurogastroenterological research aims for improved understanding of the physiology and pathophysiology of the digestive subsystems from which the arrays of functional symptoms emerge. The key subsystems for defecation-related symptoms and visceral hypersensitivity are the intestinal secretory glands, the musculature and the nervous system that controls and integrates their activity. Abdominal pain and discomfort arising from these systems adds the dimension of sensory neurophysiology. This review details current concepts for the underlying pathophysiology in terms of the physiology of intestinal secretion, motility, nervous control, sensing function, immuno-neural communication and the brain-gut axis.

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Gastric distention correlates with activation of multiple cortical and subcortical regions

Cited by 144 publications

References 35 publications

Regional brain activation in conscious, nonrestrained rats in response to noxious visceral stimulation

Regional brain activation in conscious, nonrestrained rats in response to noxious visceral stimulation

Patients with headache and functional dyspepsia present meal–induced hypersensitivity of the stomach

Neuropathophysiology of functional gastrointestinal disorders

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