Sex-related differences in IBS patients: central processing of visceral stimuli

Naliboff, Bruce D.; Berman, Steven M.; Chang, Lin; Derbyshire, Stuart; Suyenobu, Brandall Y.; Vogt, Brent A.; Mandelkern, M.; Mayer, Emeran A.

doi:10.1016/s0016-5085(03)00400-1

Cited by 260 publications

(197 citation statements)

References 54 publications

Supporting

Mentioning

180

Contrasting

Unclassified

Order By: Relevance

“…Compared with men, women usually reported more frequent, severe, and persisting pain 36 . A study reported differences in central pain processing, including the magnitudes and locations of μ-opioid system activation, between men and women 37 . Men have higher activation in the right dorsolateral prefrontal cortex, insula, and dorsal pons, whereas women have higher activation in the ventromedial prefrontal cortex, right anterior cingulate cortex, and left amygdala 37 .…”

Section: Discussionmentioning

confidence: 99%

“…A study reported differences in central pain processing, including the magnitudes and locations of μ-opioid system activation, between men and women 37 . Men have higher activation in the right dorsolateral prefrontal cortex, insula, and dorsal pons, whereas women have higher activation in the ventromedial prefrontal cortex, right anterior cingulate cortex, and left amygdala 37 . Additional studies should investigate whether these sex differences in central pain processing account for the sex difference in pain-related QOL found in this study.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pain-related quality of life related to mental health and sociodemographic indicators in adolescents

Lee

Yeh

Hsiao

et al. 2017

Arch. Clin. Psychiatry (São Paulo)

View full text Add to dashboard Cite

Background: A total of 6150 junior and senior high school students aged 11-18 years participated in this study. Their level of pain-related QOL was assessed using the pain subscale of the Taiwanese QOL Questionnaire for Adolescents. The severities of depression, suicidality, anxiety, and alcohol abuse were also examined. Objectives: This study examined the associations between pain-related quality of life (QOL) and sociodemographic characteristics and those between pain-related QOL and mental health problems such as depression, suicidality, anxiety, and alcohol abuse. Methods: The association of sociodemographic factors with pain-related QOL was examined through multiple regression analysis. The association of pain-related QOL with mental health problems was examined through logistic regression analysis. Results: The boys exhibited a higher level of satisfaction with pain-related QOL than did the girls. Older age was significantly associated with a lower level of satisfaction with pain-related QOL. Residential background, parental marital status, and parental education levels were not significantly associated with the level of satisfaction with pain-related QOL. Increased risks of depression, suicidality, anxiety, and alcohol abuse were significantly associated with a low level of satisfaction with pain-related QOL. Discussion: A low level of satisfaction with pain-related QOL is significantly associated with the risk of poor mental health. Adolescents with the correlates of low satisfaction with pain-related QOL should be monitored for the risk of mental health problems.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pain-related quality of life related to mental health and sociodemographic indicators in adolescents

Lee

Yeh

Hsiao

et al. 2017

Arch. Clin. Psychiatry (São Paulo)

View full text Add to dashboard Cite

show abstract

“…8 While peripheral mediators likely affect GI motility, gender-associated differences in visceral pain perception in IBS patients have been demonstrated using brain imaging techniques such as positron emission tomography. 84 A study by Naliboff et al 85 has shown that compared to men with IBS, women with IBS utilized different areas of their brain, such as the amygdala, while experiencing a rectal distension they perceived as aversive. Moreover, other clinical studies have provided evidence that women's perception of visceral pain can be influenced by their cyclical changes in gonadal hormones.…”

Section: Sex Linked Differences In Visceral Sensitivitymentioning

confidence: 99%

Mechanisms of Stress-induced Visceral Pain

Meerveld

Johnson

2018

J Neurogastroenterol Motil

View full text Add to dashboard Cite

Evidence suggests that long-term stress facilitates visceral pain through sensitization of pain pathways and promotes chronic visceral pain disorders such as the irritable bowel syndrome (IBS). This review will describe the importance of stress in exacerbating IBS-induced abdominal pain. Additionally, we will briefly review our understanding of the activation of the hypothalamic-pituitary-adrenal axis by both chronic adult stress and following early life stress in the pathogenesis of IBS. The review will focus on the glucocorticoid receptor and corticotropin-releasing hormone-mediated mechanisms in the amygdala involved in stress-induced visceral hypersensitivity. One potential mechanism underlying persistent effects of stress on visceral sensitivity could be epigenetic modulation of gene expression. While there are relatively few studies examining epigenetically mediated mechanisms involved in stress-induced visceral nociception, alterations in DNA methylation and histone acetylation patterns within the brain, have been linked to alterations in nociceptive signaling via increased expression of pro-nociceptive neurotransmitters. This review will discuss the latest studies investigating the long-term effects of stress on visceral sensitivity. Additionally, we will critically review the importance of experimental models of adult stress and early life stress in enhancing our understanding of the basic molecular mechanisms of nociceptive processing. Taken together, the complex clinical phenotype makes recapitulating IBS in rodent models extremely challenging. However, an aim of this review will be to describe how the use of rodent models of adult stress, early life stress (ELS), and a dysregulated HPA axis has improved our understanding of stress in the pathophysiology of IBS. Pathophysiology of Irritable Bowel Syndrome: Activation of the Brain-Gut AxisEvidence from clinical and basic research points to dysregulation of the bidirectional communication between the brain-gut axis in IBS. 21 The brain-gut axis represents a dynamic interplay between central circuits and peripheral mechanisms. The messengers of this complex circuit include neural, endocrine, metabolic, and immune mediators that are activated by central factors such as stress (Fig. 1). Although IBS is not an inflammatory disorder, the immune system plays a role in the pathogenesis of IBS in at least a subset of patients and likely contributes to the etiology of IBS symptoms. 22,23 A subset of IBS patients display a low grade chronic inflammation, and there is also evidence that following an enteric infection and combined with stressful life events, there is an increased risk of developed post-infectious IBS. [24][25][26][27] Clearly, the immune system and inflammatory processes are modulated by the HPA and autonomic nervous systems. In support, IBS patients also show increased number and reactivity of mast cells. 28,29 Data from peripheral blood mononuclear cells, as well as in mucosal biopsies, from IBS patients show that cytokines levels including TNF-α...

show abstract

“…Female-to-male prevalence ratios for IBS vary from 1 : 1 to > 2 : 1 across a variety of studies, and women are more likely to develop IBS-like symptoms following an episode of infectious gastroenteritis (9). In population-based studies, there are no large differences in the prevalence of IBS symptoms between men and women or among the three major symptom subtypes of IBS (diarrhea-or constipationpredominant or alternating).…”

Section: Gender Differencesmentioning

confidence: 99%

“…Sex-related differences in brain responses to a visceral and a psychological stressor in IBS were studied (9). Regional cerebral blood flow measurements using positron emission tomography were compared.…”

Section: Gender Differencesmentioning

confidence: 99%