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Toussaint B, Heinzle J, Stephan KE. A computationally informed distinction of interoception and exteroception. Neurosci Biobehav Rev 2024; 159:105608. [PMID: 38432449 DOI: 10.1016/j.neubiorev.2024.105608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/23/2024] [Accepted: 02/26/2024] [Indexed: 03/05/2024]
Abstract
While interoception is of major neuroscientific interest, its precise definition and delineation from exteroception continue to be debated. Here, we propose a functional distinction between interoception and exteroception based on computational concepts of sensor-effector loops. Under this view, the classification of sensory inputs as serving interoception or exteroception depends on the sensor-effector loop they feed into, for the control of either bodily (physiological and biochemical) or environmental states. We explain the utility of this perspective by examining the perception of skin temperature, one of the most challenging cases for distinguishing between interoception and exteroception. Specifically, we propose conceptualising thermoception as inference about the thermal state of the body (including the skin), which is directly coupled to thermoregulatory processes. This functional view emphasises the coupling to regulation (control) as a defining property of perception (inference) and connects the definition of interoception to contemporary computational theories of brain-body interactions.
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Affiliation(s)
- Birte Toussaint
- Translational Neuromodeling Unit (TNU), Institute for Biomedical Engineering, University of Zurich & ETH Zurich, Zurich, Switzerland.
| | - Jakob Heinzle
- Translational Neuromodeling Unit (TNU), Institute for Biomedical Engineering, University of Zurich & ETH Zurich, Zurich, Switzerland
| | - Klaas Enno Stephan
- Translational Neuromodeling Unit (TNU), Institute for Biomedical Engineering, University of Zurich & ETH Zurich, Zurich, Switzerland; Max Planck Institute for Metabolism Research, Cologne, Germany
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2
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Engelen T, Solcà M, Tallon-Baudry C. Interoceptive rhythms in the brain. Nat Neurosci 2023; 26:1670-1684. [PMID: 37697110 DOI: 10.1038/s41593-023-01425-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 08/08/2023] [Indexed: 09/13/2023]
Abstract
Sensing internal bodily signals, or interoception, is fundamental to maintain life. However, interoception should not be viewed as an isolated domain, as it interacts with exteroception, cognition and action to ensure the integrity of the organism. Focusing on cardiac, respiratory and gastric rhythms, we review evidence that interoception is anatomically and functionally intertwined with the processing of signals from the external environment. Interactions arise at all stages, from the peripheral transduction of interoceptive signals to sensory processing and cortical integration, in a network that extends beyond core interoceptive regions. Interoceptive rhythms contribute to functions ranging from perceptual detection up to sense of self, or conversely compete with external inputs. Renewed interest in interoception revives long-standing issues on how the brain integrates and coordinates information in distributed regions, by means of oscillatory synchrony, predictive coding or multisensory integration. Considering interoception and exteroception in the same framework paves the way for biological modes of information processing specific to living organisms.
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Affiliation(s)
- Tahnée Engelen
- Cognitive and Computational Neuroscience Laboratory, Inserm, Ecole Normale Supérieure PSL University, Paris, France
| | - Marco Solcà
- Cognitive and Computational Neuroscience Laboratory, Inserm, Ecole Normale Supérieure PSL University, Paris, France
| | - Catherine Tallon-Baudry
- Cognitive and Computational Neuroscience Laboratory, Inserm, Ecole Normale Supérieure PSL University, Paris, France.
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3
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Desmedt O, Luminet O, Walentynowicz M, Corneille O. The new measures of interoceptive accuracy: A systematic review and assessment. Neurosci Biobehav Rev 2023; 153:105388. [PMID: 37708919 DOI: 10.1016/j.neubiorev.2023.105388] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 08/10/2023] [Accepted: 09/07/2023] [Indexed: 09/16/2023]
Abstract
Conscious interoception, the perception of internal bodily states, is thought to contribute to fundamental human abilities (e.g., decision-making and emotional regulation). One of its most studied dimensions is interoceptive accuracy: the objective capacity to detect internal bodily signals. In the past few years, several labs across the world have started developing new tasks aimed at overcoming limitations inherent in classical measures of interoceptive accuracy. In this systematic review, we identified these tasks (since 2015) for the cardiac, respiratory, and gastrointestinal domains. For each identified task, we discuss their strengths and weaknesses, and make constructive suggestions for further improvement. In the general discussion, we discuss the (potentially elusive) possibility of reaching high validity in the measurement of interoceptive accuracy. We also point out that interoceptive accuracy may not be the most critical dimension for informing current theories, and we encourage researchers to investigate other dimensions of conscious interoception.
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Affiliation(s)
- Olivier Desmedt
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland; Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium; Fund for Scientific Research (FRS-FNRS), Belgium.
| | - Olivier Luminet
- Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium; Fund for Scientific Research (FRS-FNRS), Belgium
| | - Marta Walentynowicz
- Centre for the Psychology of Learning and Experimental Psychopathology, KULeuven, Belgium
| | - Olivier Corneille
- Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium
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4
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Mayeli A, Al Zoubi O, White EJ, Chappelle S, Kuplicki R, Morton A, Bruce J, Smith R, Feinstein JS, Bodurka J, Paulus MP, Khalsa SS. Parieto-occipital ERP indicators of gut mechanosensation in humans. Nat Commun 2023; 14:3398. [PMID: 37311748 PMCID: PMC10264354 DOI: 10.1038/s41467-023-39058-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 05/24/2023] [Indexed: 06/15/2023] Open
Abstract
Understanding the neural processes governing the human gut-brain connection has been challenging due to the inaccessibility of the body's interior. Here, we investigated neural responses to gastrointestinal sensation using a minimally invasive mechanosensory probe by quantifying brain, stomach, and perceptual responses following the ingestion of a vibrating capsule. Participants successfully perceived capsule stimulation under two vibration conditions (normal and enhanced), as evidenced by above chance accuracy scores. Perceptual accuracy improved significantly during the enhanced relative to normal stimulation, which was associated with faster stimulation detection and reduced reaction time variability. Capsule stimulation induced late neural responses in parieto-occipital electrodes near the midline. Moreover, these 'gastric evoked potentials' showed intensity-dependent increases in amplitude and were significantly correlated with perceptual accuracy. Our results replicated in a separate experiment, and abdominal X-ray imaging localized most capsule stimulations to the gastroduodenal segments. Combined with our prior observation that a Bayesian model is capable of estimating computational parameters of gut-brain mechanosensation, these findings highlight a unique form of enterically-focused sensory monitoring within the human brain, with implications for understanding gut feelings and gut-brain interactions in healthy and clinical populations.
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Affiliation(s)
- Ahmad Mayeli
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Obada Al Zoubi
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Harvard Medical School/McLean Hospital, Boston, MA, USA
| | - Evan J White
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | | | | | - Alexa Morton
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Jaimee Bruce
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Ryan Smith
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | | | - Jerzy Bodurka
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Stephenson School of Biomedical Engineering, University of Oklahoma, Tulsa, OK, USA
| | - Martin P Paulus
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Oxley College of Health Sciences, University of Tulsa, Tulsa, OK, USA
| | - Sahib S Khalsa
- Laureate Institute for Brain Research, Tulsa, OK, USA.
- Oxley College of Health Sciences, University of Tulsa, Tulsa, OK, USA.
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5
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Vardar-Yagli N, Saglam M, Dasgin H, Karli-Oguz K. The Effects of Respiratory Muscle Training on Resting-State Brain Activity and Thoracic Mobility in Healthy Subjects: A Randomized Controlled Trial. J Magn Reson Imaging 2023; 57:403-417. [PMID: 35762913 DOI: 10.1002/jmri.28322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Although inspiratory muscle training (IMT) is an effective intervention for improving breath perception, brain mechanisms have not been studied yet. PURPOSE To examine the effects of IMT on insula and default mode network (DMN) using resting-state functional MRI (RS-fMRI). STUDY TYPE Prospective. POPULATION A total of 26 healthy participants were randomly assigned to two groups as IMT group (n = 14) and sham IMT groups (n = 12). FIELD STRENGTH/SEQUENCE A 3-T, three-dimensional T2* gradient-echo echo planar imaging sequence for RS-fMRI was obtained. ASSESSMENT The intervention group received IMT at 60% and sham group received at 15% of maximal inspiratory pressure (MIP) for 8 weeks. Pulmonary and respiratory muscle function, and breathing patterns were measured. Groups underwent RS-fMRI before and after the treatment. STATISTICAL TESTS Statistical tests were two-tailed P < 0.05 was considered statistically significant. Student's t test was used to compare the groups. One-sample t-test for each group was used to reveal pattern of functional connectivity. A statistical threshold of P < 0.001 uncorrected value was set at voxel level. We used False discovery rate (FDR)-corrected P < 0.05 cluster level. RESULTS The IMT group showed more prominent alterations in insula and DMN connectivity than sham group. The MIP was significantly different after IMT. Respiratory rate (P = 0.344), inspiratory time (P = 0.222), expiratory time (P = 1.000), and inspiratory time/total breath time (P = 0.572) of respiratory patterns showed no significant change after IMT. All DMN components showed decreased, while insula showed increased activation significantly. DATA CONCLUSION Differences in brain activity and connectivity may reflect improved ventilatory perception with IMT with a possible role in regulating breathing pattern by processing interoceptive signals. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 4.
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Affiliation(s)
- Naciye Vardar-Yagli
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Department of Cardiorespiratory Physiotherapy and Rehabilitation, Ankara, Turkey
| | - Melda Saglam
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Department of Cardiorespiratory Physiotherapy and Rehabilitation, Ankara, Turkey
| | - Hacer Dasgin
- National Magnetic Resonance Research Center (UMRAM) Bilkent University, Ankara, Turkey
| | - Kader Karli-Oguz
- National Magnetic Resonance Research Center (UMRAM) Bilkent University, Ankara, Turkey.,Hacettepe University, Faculty of Medicine, Department of Radiology, Ankara, Turkey
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Choi JC, Park HJ, Park JA, Kang DR, Choi YS, Choi S, Lee HG, Choi JH, Choi IH, Yoon MW, Lee JM, Kim J. The increased analgesic efficacy of cold therapy after an unsuccessful analgesic experience is associated with inferior parietal lobule activation. Sci Rep 2022; 12:14687. [PMID: 36038625 PMCID: PMC9424269 DOI: 10.1038/s41598-022-18181-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 08/08/2022] [Indexed: 11/09/2022] Open
Abstract
Prior experiences of successful and failed treatments are known to influence the efficacy of a newly applied treatment. However, whether that carry-over effect applies to non-pharmacological treatments is unknown. This study investigated how a failed treatment history with placebo analgesic cream affected the therapeutic outcomes of cold-pack treatment. The neural correlates underlying those effects were also explored using functional magnetic resonance imaging. The effect of the placebo analgesic cream was induced using placebo conditioning with small (44.5 °C to 43.7 °C, negative experience) and large (44.5 °C to 40.0 °C, positive experience) thermal stimuli changes. After the placebo conditioning, brain responses and self-reported evaluations of the effect of subsequent treatment with a cold-pack were contrasted between the two groups. The negative experience group reported less pain and lower anxiety scores in the cold-pack condition than the positive experience group and exhibited significantly greater activation in the right inferior parietal lobule (IPL), which is known to be involved in pain relief. These findings suggest that an unsatisfying experience with an initial pain-relief treatment could increase the expectations for the complementary treatment outcome and improve the analgesic effect of the subsequent treatment. The IPL could be associated with this expectation-induced pain relief process.
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Affiliation(s)
- Jae Chan Choi
- Department of Anesthesiology and Pain Medicine, Yonsei University Wonju College of Medicine, Wonju, 26426, Republic of Korea.,Cham Brain Health Institute, 08807, Seoul, Republic of Korea
| | - Hae-Jeong Park
- Department of Nuclear Medicine, Graduate School of Medical Science, BrainKorea21Project, Yonsei University College of Medicine, Seoul, 3722, Republic of Korea
| | - Jeong A Park
- Alzza Health Institute, Seoul, Republic of Korea
| | - Dae Ryong Kang
- Department of Precision Medicine & Biostatistics, Yonsei University Wonju College of Medicine, Wonju-si, 26426, Republic of Korea
| | - Young-Seok Choi
- Department of Electronics and Communications Engineering, Kwangwoon University, Seoul, 01897, Republic of Korea
| | - SoHyun Choi
- Department of Precision Medicine & Biostatistics, Yonsei University Wonju College of Medicine, Wonju-si, 26426, Republic of Korea
| | - Hong Gyu Lee
- Department of Radiology, Yonsei University Wonju College of Medicine, Wonju-si, 26426, Republic of Korea
| | - Jun-Ho Choi
- Department of Practical Arts Education, Chinju National University of Education, Jinju-si, 52673, Republic of Korea
| | - In-Ho Choi
- Department of Architectural Design, Kaywon University of Art and Design, Uiwang-si, 16038, Republic of Korea
| | - Min Woo Yoon
- Department of Anesthesiology and Pain Medicine, Yonsei University Wonju College of Medicine, Wonju, 26426, Republic of Korea
| | - Jong-Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, 4763, Republic of Korea
| | - Jinhee Kim
- School of Psychology, Korea University, Seoul, 2841, Republic of Korea.
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Taytard J, Gand C, Niérat MC, Barthes R, Lavault S, Adler D, Morélot Panzini C, Gatignol P, Campion S, Serresse L, Wattiez N, Straus C, Similowski T. Impact of inspiratory threshold loading on brain activity and cognitive performances in healthy humans. J Appl Physiol (1985) 2021; 132:95-105. [PMID: 34818073 DOI: 10.1152/japplphysiol.00994.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
In healthy humans, inspiratory threshold loading deteriorates cognitive performances. This can result from motor-cognitive interference (activation of motor respiratory-related cortical networks vs. executive resources allocation), sensory-cognitive interference (dyspnea vs. shift in attentional focus), or both. We hypothesized that inspiratory loading would concomitantly induce dyspnea, activate motor respiratory-related cortical networks, and deteriorate cognitive performance. We reasoned that a concomitant activation of cortical networks and cognitive deterioration would be compatible with motor-cognitive interference, particularly in case of a predominant alteration of executive cognitive performances. Symmetrically, we reasoned that a predominant alteration of attention-depending performances would suggest sensory-cognitive interference. Twenty-five volunteers (12 men; 19.5-51.5 years) performed the Paced Auditory Serial Addition test (PASAT-A and B; calculation capacity, working memory, attention), the Trail Making Test (TMT-A, visuospatial exploration capacity; TMT-B, visuospatial exploration capacity and attention), and the Corsi block-tapping test (visuospatial memory, short-term and working memory) during unloaded breathing and inspiratory threshold loading in random order. Loading consistently induced dyspnea and respiratory-related brain activation. It was associated with deteriorations inPASAT A (52 [45.5;55.5] (median [interquartile range]) to 48 [41;54.5], p=0.01), PASAT B (55 [47.5;58] to 51 [44.5;57.5], p=0.01), and TMT B (44s [36;54.5] to 53s [42;64], p=0.01), but did not affect TMT-A and Corsi. The concomitance of cortical activation and cognitive performance deterioration is compatible with competition for cortical resources (motor-cognitive interference), while the profile of cognitive impairment (PASAT and TMT-B but not TMT-A and Corsi) is compatible with a contribution of attentional distraction (sensory-cognitive interference). Both mechanisms are therefore likely at play.
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Affiliation(s)
- Jessica Taytard
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.,AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Armand-Trousseau, Service de Pneumologie Pédiatrique, F-75012 Paris, France
| | - Camille Gand
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
| | - Marie-Cécile Niérat
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
| | - Romain Barthes
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
| | - Sophie Lavault
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.,AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service de Pneumologie, Médecine Intensive et Réanimation (Département R3S), Paris, France
| | - Dan Adler
- Division of Pulmonary Disease, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Capucine Morélot Panzini
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.,AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service de Pneumologie, Médecine Intensive et Réanimation (Département R3S), Paris, France
| | - Peggy Gatignol
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.,AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service d'ORL et d'oto-neurochirurgie, Paris, France
| | - Sebastien Campion
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.,AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Département d'Anesthésie-Réanimation, Paris, France
| | - Laure Serresse
- AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Unité Mobile de Soins Palliatifs, Paris, France
| | - Nicolas Wattiez
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
| | - Christian Straus
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.,AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié31 Salpêtrière, Service d'Exploration Fonctionnelles de la Respiration, de l'Exercice et de la Dyspnée (Département R3S), Paris, France
| | - Thomas Similowski
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.,AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service de Pneumologie, Médecine Intensive et Réanimation (Département R3S), Paris, France
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Roelofs TJM, Luijendijk MCM, van der Toorn A, Camps G, Smeets PAM, Dijkhuizen RM, Adan RAH. Good taste or gut feeling? A new method in rats shows oro-sensory stimulation and gastric distention generate distinct and overlapping brain activation patterns. Int J Eat Disord 2021; 54:1116-1126. [PMID: 32671875 PMCID: PMC8359261 DOI: 10.1002/eat.23354] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 06/09/2020] [Accepted: 06/29/2020] [Indexed: 12/13/2022]
Abstract
Satiation is influenced by a variety of signals including gastric distention and oro-sensory stimulation. Here we developed a high-field (9.4 T) functional magnetic resonance imaging (fMRI) protocol to test how oro-sensory stimulation and gastric distention, as induced with a block-design paradigm, affect brain activation under different states of energy balance in rats. Repeated tasting of sucrose induced positive and negative fMRI responses in the ventral tegmental area and septum, respectively, and gradual neural activation in the anterior insula and the brain stem nucleus of the solitary tract (NTS), as revealed using a two-level generalized linear model-based analysis. These unique findings align with comparable human experiments, and are now for the first time identified in rats, thereby allowing for comparison between species. Gastric distention induced more extensive brain activation, involving the insular cortex and NTS. Our findings are largely in line with human studies that have shown that the NTS is involved in processing both visceral information and taste, and anterior insula in processing sweet taste oro-sensory signals. Gastric distention and sucrose tasting induced responses in mesolimbic areas, to our knowledge not previously detected in humans, which may reflect the rewarding effects of a full stomach and sweet taste, thereby giving more insight into the processing of sensory signals leading to satiation. The similarities of these data to human neuroimaging data demonstrate the translational value of the approach and offer a new avenue to deepen our understanding of the process of satiation in healthy people and those with eating disorders.
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Affiliation(s)
- Theresia J. M. Roelofs
- Department of Translational Neuroscience, Brain Center Rudolf MagnusUniversity Medical Center Utrecht and Utrecht UniversityUtrechtThe Netherlands,Biomedical MR Imaging and Spectroscopy Group, Center for Image SciencesUniversity Medical Center Utrecht and Utrecht UniversityUtrechtThe Netherlands
| | - Mieneke C. M. Luijendijk
- Department of Translational Neuroscience, Brain Center Rudolf MagnusUniversity Medical Center Utrecht and Utrecht UniversityUtrechtThe Netherlands
| | - Annette van der Toorn
- Biomedical MR Imaging and Spectroscopy Group, Center for Image SciencesUniversity Medical Center Utrecht and Utrecht UniversityUtrechtThe Netherlands
| | - Guido Camps
- Division of Human Nutrition and HealthWageningen University and ResearchWageningenThe Netherlands
| | - Paul A. M. Smeets
- Division of Human Nutrition and HealthWageningen University and ResearchWageningenThe Netherlands,Image Sciences Institute, Brain Center Rudolf MagnusUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Rick M. Dijkhuizen
- Biomedical MR Imaging and Spectroscopy Group, Center for Image SciencesUniversity Medical Center Utrecht and Utrecht UniversityUtrechtThe Netherlands
| | - Roger A. H. Adan
- Department of Translational Neuroscience, Brain Center Rudolf MagnusUniversity Medical Center Utrecht and Utrecht UniversityUtrechtThe Netherlands,Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of GothenburgSweden
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9
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Brain–stomach coupling: Anatomy, functions, and future avenues of research. CURRENT OPINION IN BIOMEDICAL ENGINEERING 2021. [DOI: 10.1016/j.cobme.2021.100270] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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10
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Neural correlates of future weight loss reveal a possible role for brain-gastric interactions. Neuroimage 2020; 224:117403. [PMID: 32979521 DOI: 10.1016/j.neuroimage.2020.117403] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 08/19/2020] [Accepted: 08/25/2020] [Indexed: 12/19/2022] Open
Abstract
Lifestyle dietary interventions are an essential practice in treating obesity, hence neural factors that may assist in predicting individual treatment success are of great significance. Here, in a prospective, open-label, three arms study, we examined the correlation between brain resting-state functional connectivity measured at baseline and weight loss following 6 months of lifestyle intervention in 92 overweight participants. We report a robust subnetwork composed mainly of sensory and motor cortical regions, whose edges correlated with future weight loss. This effect was found regardless of intervention group. Importantly, this main finding was further corroborated using a stringent connectivity-based prediction model assessed with cross-validation thus attesting to its robustness. The engagement of senso-motor regions in this subnetwork is consistent with the over-sensitivity to food cues theory of weight regulation. Finally, we tested an additional hypothesis regarding the role of brain-gastric interaction in this subnetwork, considering recent findings of a cortical network synchronized with gastric activity. Accordingly, we found a significant spatial overlap with the subnetwork reported in the present study. Moreover, power in the gastric basal electric frequency within our reported subnetwork negatively correlated with future weight loss. This finding was specific to the weight loss related subnetwork and to the gastric basal frequency. These findings should be further corroborated by combining direct recordings of gastric activity in future studies. Taken together, these intriguing results may have important implications for our understanding of the etiology of obesity and the mechanism of response to dietary intervention.
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11
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Wolpert N, Rebollo I, Tallon‐Baudry C. Electrogastrography for psychophysiological research: Practical considerations, analysis pipeline, and normative data in a large sample. Psychophysiology 2020; 57:e13599. [PMID: 32449806 PMCID: PMC7507207 DOI: 10.1111/psyp.13599] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 03/12/2020] [Accepted: 04/14/2020] [Indexed: 12/14/2022]
Abstract
Electrogastrography (EGG) is the noninvasive electrophysiological technique used to record gastric electrical activity by means of cutaneous electrodes placed on the abdomen. EGG has been so far mostly used in clinical studies in gastroenterology, but it represents an attractive method to study brain-viscera interactions in psychophysiology. Compared to the literature on electrocardiography for instance, where practical recommendations and normative data are abundant, the literature on EGG in humans remains scarce. The aim of this article is threefold. First, we review the existing literature on the physiological basis of the EGG, pathways of brain-stomach interactions, and experimental findings in the cognitive neuroscience and psychophysiology literature. We then describe practical issues faced when recording the EGG in young healthy participants, from data acquisition to data analysis, and propose a semi-automated analysis pipeline together with associated MATLAB code. The analysis pipeline aims at identifying a regular rhythm that can be safely attributed to the stomach, through multiple steps. Finally, we apply these recording and analysis procedures in a large sample (N = 117) of healthy young adult male and female participants in a moderate (<5 hr) to prolonged (>10 hr) fasting state to establish the normative distribution of several EGG parameters. Our results are overall congruent with the clinical gastroenterology literature, but suggest using an electrode coverage extending to lower abdominal locations than current clinical guidelines. Our results indicate a marginal difference in EGG peak frequency between male and female participants, and that the gastric rhythm becomes more irregular after prolonged fasting.
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Affiliation(s)
- Nicolai Wolpert
- Laboratoire de Neurosciences Cognitives et ComputationnellesEcole Normale SupérieurePSL UniversityParisFrance
| | - Ignacio Rebollo
- Laboratoire de Neurosciences Cognitives et ComputationnellesEcole Normale SupérieurePSL UniversityParisFrance
| | - Catherine Tallon‐Baudry
- Laboratoire de Neurosciences Cognitives et ComputationnellesEcole Normale SupérieurePSL UniversityParisFrance
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12
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Visceral Signals Shape Brain Dynamics and Cognition. Trends Cogn Sci 2019; 23:488-509. [DOI: 10.1016/j.tics.2019.03.007] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 03/22/2019] [Accepted: 03/27/2019] [Indexed: 01/17/2023]
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13
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Liu P, Wang G, Zeng F, Liu Y, Fan Y, Wei Y, Qin W, Calhoun VD. Abnormal brain structure implicated in patients with functional dyspepsia. Brain Imaging Behav 2019; 12:459-466. [PMID: 28353135 DOI: 10.1007/s11682-017-9705-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Recent studies suggest dysfunctional brain-gut interactions are involved in the pathophysiology of functional dyspepsia (FD). However, limited studies have investigated brain structural abnormalities in FD patients. This study aimed to identify potential differences in both cortical thickness and subcortical volume in FD patients compared to healthy controls (HCs) and to explore relationships of structural abnormalities with clinical symptoms. Sixty-nine patients and forty-nine HCs underwent 3T structural magnetic resonance imaging scans. Cortical thickness and subcortical volume were compared between the groups across the cortical and subcortical regions, respectively. Regression analysis was then performed to examine relationships between the structure alternations and clinical symptoms in FD patients. Our results showed that FD patients had decreased cortical thickness compared to HCs in the distributed brain regions including the dorsolateral prefrontal cortex (dlPFC), ventrolateral prefrontal cortex (vlPFC), medial prefrontal cortex (mPFC), anterior/posterior cingulate cortex (ACC/PCC), insula, superior parietal cortex (SPC), supramarginal gyrus and lingual gyrus. Significantly negative correlations were observed between the Nepean Dyspepsia Index (NDI) and cortical thickness in the mPFC, second somatosensory cortex (SII), ACC and parahippocampus (paraHIPP). And significantly negative correlations were found between disease duration and the cortical thickness in the vlPFC, first somatosensory cortex (SI) and insula in FD patients. These findings suggest that FD patients have structural abnormalities in brain regions involved in sensory perception, sensorimotor integration, pain modulation, affective and cognitive controls. The relationships between the brain structural changes and clinical symptoms indicate that the alternations may be a consequence of living with FD.
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Affiliation(s)
- Peng Liu
- Life Sciences Research Center, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, China. .,Engineering Research Center of Molecular and Neuroimaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, 710071, China.
| | - Geliang Wang
- Life Sciences Research Center, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, China.,Engineering Research Center of Molecular and Neuroimaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, 710071, China
| | - Fang Zeng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Yanfei Liu
- Life Sciences Research Center, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, China.,Engineering Research Center of Molecular and Neuroimaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, 710071, China
| | - Yingying Fan
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Ying Wei
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China
| | - Wei Qin
- Life Sciences Research Center, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, China.,Engineering Research Center of Molecular and Neuroimaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, 710071, China
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14
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Liu P, Li G, Zhang A, Sun N, Kang L, Yang C, Wang Y, Zhang K. The prognosis and changes of regional brain gray matter volume in MDD with gastrointestinal symptoms. Neuropsychiatr Dis Treat 2019; 15:1181-1191. [PMID: 31190826 PMCID: PMC6514124 DOI: 10.2147/ndt.s197351] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 04/08/2019] [Indexed: 12/12/2022] Open
Abstract
Objective: It is common that major depressive disorder (MDD) is accompanied by gastrointestinal (GI) symptoms. However, few studies have focused on the clinical characteristics and its possible mechanism, while brain gray matter (GM) structure is important in the pathogenesis of GI symptoms. In this study, we aimed to investigate the basic clinical characteristics and regional GM volume changes in MDD accompanied by GI symptoms. Method: Patients with MDD (n=49) and age, gender, and educational level-matched healthy controls (n=30) were recruited. Patients with MDD were divided into two groups based on the GI status: MDD with (n=27) and without (n=22) GI symptoms. The 24-item Hamilton Depression Rating Scale (HAMD) was administered. T1-weighted anatomical images were obtained and analyzed. Correlation analysis was used to identify the possible associations between changed regional GM volume and GI symptoms and depressive symptoms. Results: The HAMD reductive ratio for 2 weeks of treatment in the GI symptoms group was significantly higher than the non-GI symptoms group (P<0.05). The regional GM volume showed significant differences among the three groups (Gaussian Random Field [GRF] correction, voxel-P<0.01, cluster-P <0.05). Compared with non-GI symptoms group, GI symptoms group exhibited significantly increased GM volume in the left hippocampus, left parahippocampal gyrus, right parahippocampal gyrus; and decreased GM volume in the right middle frontal gyrus, right precentral gyrus, right cuneus, right precuneus, right superior occipital gyrus (GRF correction, voxel-P <0.01, cluster-P <0.05). These altered brain areas were correlated with the GI symptoms, not depressive symptoms. Conclusion: The changed regional brain GM volume in GI-MDD group may be the pathogenesis for the GI symptoms. In addition, the GI symptoms may predict the prognosis of MDD.
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Affiliation(s)
- Penghong Liu
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, People's Republic of China.,Department of Psychiatry, Shanxi Medical University, Taiyuan, 030001, People's Republic of China
| | - Gaizhi Li
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, People's Republic of China
| | - Aixia Zhang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, People's Republic of China
| | - Ning Sun
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, People's Republic of China
| | - Lijun Kang
- Department of Psychiatry, Shanxi Medical University, Taiyuan, 030001, People's Republic of China
| | - Chunxia Yang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, People's Republic of China
| | - Yanfang Wang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, People's Republic of China
| | - Kerang Zhang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, People's Republic of China
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15
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Peng K, Yücel MA, Steele SC, Bittner EA, Aasted CM, Hoeft MA, Lee A, George EE, Boas DA, Becerra L, Borsook D. Morphine Attenuates fNIRS Signal Associated With Painful Stimuli in the Medial Frontopolar Cortex (medial BA 10). Front Hum Neurosci 2018; 12:394. [PMID: 30349466 PMCID: PMC6186992 DOI: 10.3389/fnhum.2018.00394] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 09/12/2018] [Indexed: 11/26/2022] Open
Abstract
Functional near infrared spectroscopy (fNIRS) is a non-invasive optical imaging method that provides continuous measure of cortical brain functions. One application has been its use in the evaluation of pain. Previous studies have delineated a deoxygenation process associated with pain in the medial anterior prefrontal region, more specifically, the medial Brodmann Area 10 (BA 10). Such response to painful stimuli has been consistently observed in awake, sedated and anesthetized patients. In this study, we administered oral morphine (15 mg) or placebo to 14 healthy male volunteers with no history of pain or opioid abuse in a crossover double blind design, and performed fNIRS scans prior to and after the administration to assess the effect of morphine on the medial BA 10 pain signal. Morphine is the gold standard for inhibiting nociceptive processing, most well described for brain effects on sensory and emotional regions including the insula, the somatosensory cortex (the primary somatosensory cortex, S1, and the secondary somatosensory cortex, S2), and the anterior cingulate cortex (ACC). Our results showed an attenuation effect of morphine on the fNIRS-measured pain signal in the medial BA 10, as well as in the contralateral S1 (although observed in a smaller number of subjects). Notably, the extent of signal attenuation corresponded with the temporal profile of the reported plasma concentration for the drug. No clear attenuation by morphine on the medial BA 10 response to innocuous stimuli was observed. These results provide further evidence for the role of medial BA 10 in the processing of pain, and also suggest that fNIRS may be used as an objective measure of drug-brain profiles independent of subjective reports.
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Affiliation(s)
- Ke Peng
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Meryem A. Yücel
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
- Neurophotonics Center, Boston University, Boston, MA, United States
| | - Sarah C. Steele
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Edward A. Bittner
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Christopher M. Aasted
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Mark A. Hoeft
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Arielle Lee
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Edward E. George
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - David A. Boas
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
- Neurophotonics Center, Boston University, Boston, MA, United States
| | - Lino Becerra
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - David Borsook
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA, United States
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
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16
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Mugie SM, Koppen IJN, van den Berg MM, Groot PFC, Reneman L, de Ruiter MB, Benninga MA. Brain processing of rectal sensation in adolescents with functional defecation disorders and healthy controls. Neurogastroenterol Motil 2018; 30. [PMID: 28975729 DOI: 10.1111/nmo.13228] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 09/14/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Decreased sensation of urge to defecate is often reported by children with functional constipation (FC) and functional nonretentive fecal incontinence (FNRFI). The aim of this cross-sectional study was to evaluate cerebral activity in response to rectal distension in adolescents with FC and FNRFI compared with healthy controls (HCs). METHODS We included 15 adolescents with FC, 10 adolescents with FNRFI, and 15 young adult HCs. Rectal barostat was performed prior to functional magnetic resonance imaging (fMRI) to determine individual pressure thresholds for urge sensation. Subjects received 2 sessions of 5 × 30 seconds of barostat stimulation during the acquisition of blood oxygenation level-dependent fMRI. Functional magnetic resonance imaging signal differences were analyzed using SPM8 in Matlab. KEY RESULTS Functional constipation and FNRFI patients had higher thresholds for urgency than HCs (P < .001). During rectal distension, FC patients showed activation in the anterior cingulate cortex, dorsolateral prefrontal cortex, inferior parietal lobule, and putamen. No activations were observed in controls and FNRFI patients. Functional nonretentive fecal incontinence patients showed deactivation in the hippocampus, parahippocampal gyrus, fusiform gyrus (FFG), lingual gyrus, posterior parietal cortex, and precentral gyrus. In HCs, deactivated areas were detected in the hippocampus, amygdala, FFG, insula, thalamus, precuneus, and primary somatosensory cortex. In contrast, no regions with significant deactivation were detected in FC patients. CONCLUSIONS & INFERENCES Children with FC differ from children with FNRFI and HCs with respect to patterns of cerebral activation and deactivation during rectal distension. Functional nonretentive fecal incontinence patients seem to resemble HCs when it comes to brain processing of rectal distension.
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Affiliation(s)
- S M Mugie
- Department of Pediatric Gastroenterology and Nutrition, Academic Medical Center, Emma Children's Hospital, Amsterdam, The Netherlands
| | - I J N Koppen
- Department of Pediatric Gastroenterology and Nutrition, Academic Medical Center, Emma Children's Hospital, Amsterdam, The Netherlands
| | - M M van den Berg
- Department of Pediatrics, Haaglanden Medical Centre, The Hague, The Netherlands
| | - P F C Groot
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
| | - L Reneman
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
| | - M B de Ruiter
- Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands
| | - M A Benninga
- Department of Pediatric Gastroenterology and Nutrition, Academic Medical Center, Emma Children's Hospital, Amsterdam, The Netherlands
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17
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Ide S, Yamamoto R, Takeda H, Minami M. Bidirectional brain-gut interactions: Involvement of noradrenergic transmission within the ventral part of the bed nucleus of the stria terminalis. Neuropsychopharmacol Rep 2018; 38:37-43. [PMID: 30106262 PMCID: PMC7292304 DOI: 10.1002/npr2.12004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 11/24/2017] [Accepted: 11/25/2017] [Indexed: 12/16/2022] Open
Abstract
Introduction Although the important roles of bidirectional interactions between the brain and gut in stress and emotional responses have long been recognized, the underlying neuronal mechanisms remain unclear. The bed nucleus of the stria terminalis (BNST) is a limbic structure involved in stress responses and negative affective states, such as anxiety and depression. We have previously demonstrated that noradrenergic transmission within the ventral part of the BNST (vBNST) plays a crucial role in anxiety‐like behaviors and pain‐induced aversion. Objectives This study aimed to examine the involvement of noradrenergic transmission via β‐adrenoceptors within the vBNST in bidirectional brain‐gut interactions. Methods We measured the gastric distention (GD)‐induced noradrenaline release within the vBNST of freely moving rats using an in vivo microdialysis technique. Gastric emptying and intestinal transit were examined following intra‐vBNST injections of isoproterenol, a β‐adrenoceptor agonist, in the absence or presence of the coadministration of timolol, a β‐adrenoceptor antagonist. Results Gastric distention at a higher pressure (45 mm Hg) but not at a lower pressure (25 mm Hg) resulted in a significant increase in extracellular noradrenaline levels within the vBNST. Intra‐vBNST injections of isoproterenol (30 nmol/side) induced significant reductions in gastric emptying and small intestinal transit, both of which were reversed by the coadministration of timolol (30 nmol/side). Conclusion Noradrenergic transmission via β‐adrenoceptors within the vBNST was involved in bidirectional brain‐gut interactions. These findings suggest that gastric dysfunction may induce negative affective states via the enhanced release of noradrenaline within the vBNST which, in turn, may cause gastrointestinal impairments. In vivo microdialysis experiments demonstrated that gastric distention induced an increase in noradrenaline release within the vBNST. Intra‐vBNST injections of isoproterenol, a β‐adrenoceptor agonist, reduced gastric emptying and small intestinal transit, and these reducing effects were reversed by the coadministration of timolol, a β‐adrenoceptor antagonist. The present findings demonstrated important roles of noradrenergic transmission via β‐adrenoceptors within the vBNST in the bidirectional brain‐gut interactions.
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Affiliation(s)
- Soichiro Ide
- Department of Pharmacology, Graduate School of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan.,Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Ryuta Yamamoto
- Department of Pharmacology, Graduate School of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan
| | - Hiroshi Takeda
- Laboratory of Pathophysiology and Therapeutics, Graduate School of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan
| | - Masabumi Minami
- Department of Pharmacology, Graduate School of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan
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18
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Peng K, Steele SC, Becerra L, Borsook D. Brodmann area 10: Collating, integrating and high level processing of nociception and pain. Prog Neurobiol 2017; 161:1-22. [PMID: 29199137 DOI: 10.1016/j.pneurobio.2017.11.004] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 11/16/2017] [Accepted: 11/28/2017] [Indexed: 02/08/2023]
Abstract
Multiple frontal cortical brain regions have emerged as being important in pain processing, whether it be integrative, sensory, cognitive, or emotional. One such region, Brodmann Area 10 (BA 10), is the largest frontal brain region that has been shown to be involved in a wide variety of functions including risk and decision making, odor evaluation, reward and conflict, pain, and working memory. BA 10, also known as the anterior prefrontal cortex, frontopolar prefrontal cortex or rostral prefrontal cortex, is comprised of at least two cytoarchitectonic sub-regions, medial and lateral. To date, the explicit role of BA 10 in the processing of pain hasn't been fully elucidated. In this paper, we first review the anatomical pathways and functional connectivity of BA 10. Numerous functional imaging studies of experimental or clinical pain have also reported brain activations and/or deactivations in BA 10 in response to painful events. The evidence suggests that BA 10 may play a critical role in the collation, integration and high-level processing of nociception and pain, but also reveals possible functional distinctions between the subregions of BA 10 in this process.
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Affiliation(s)
- Ke Peng
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States; Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, United States; Department of Psychiatry and Radiology, Massachusetts General Hospital, Charlestown, MA, United States.
| | - Sarah C Steele
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States; Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, United States; Department of Psychiatry and Radiology, Massachusetts General Hospital, Charlestown, MA, United States
| | - Lino Becerra
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States; Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, United States; Department of Psychiatry and Radiology, Massachusetts General Hospital, Charlestown, MA, United States; Department of Psychiatry, Mclean Hospital, Belmont, MA, United States
| | - David Borsook
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, United States; Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, United States; Department of Psychiatry and Radiology, Massachusetts General Hospital, Charlestown, MA, United States; Department of Psychiatry, Mclean Hospital, Belmont, MA, United States
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Richter CG, Babo-Rebelo M, Schwartz D, Tallon-Baudry C. Phase-amplitude coupling at the organism level: The amplitude of spontaneous alpha rhythm fluctuations varies with the phase of the infra-slow gastric basal rhythm. Neuroimage 2017; 146:951-958. [PMID: 27557620 PMCID: PMC5312779 DOI: 10.1016/j.neuroimage.2016.08.043] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 08/16/2016] [Accepted: 08/20/2016] [Indexed: 12/31/2022] Open
Abstract
A fundamental feature of the temporal organization of neural activity is phase-amplitude coupling between brain rhythms at different frequencies, where the amplitude of a higher frequency varies according to the phase of a lower frequency. Here, we show that this rule extends to brain-organ interactions. We measured both the infra-slow (~0.05Hz) rhythm intrinsically generated by the stomach - the gastric basal rhythm - using electrogastrography, and spontaneous brain dynamics with magnetoencephalography during resting-state with eyes open. We found significant phase-amplitude coupling between the infra-slow gastric phase and the amplitude of the cortical alpha rhythm (10-11Hz), with gastric phase accounting for 8% of the variance of alpha rhythm amplitude fluctuations. Gastric-alpha coupling was localized to the right anterior insula, and bilaterally to occipito-parietal regions. Transfer entropy, a measure of directionality of information transfer, indicates that gastric-alpha coupling is due to an ascending influence from the stomach to both the right anterior insula and occipito-parietal regions. Our results show that phase-amplitude coupling so far only observed within the brain extends to brain-viscera interactions. They further reveal that the temporal structure of spontaneous brain activity depends not only on neuron and network properties endogenous to the brain, but also on the slow electrical rhythm generated by the stomach.
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Affiliation(s)
- Craig G Richter
- Laboratoire de Neurosciences Cognitives (ENS - INSERM), Ecole Normale Supérieure - PSL Research University, Paris, France; Ernst Strüngmann Institute (ESI) for Neuroscience in Cooperation with Max Planck Society, Frankfurt, Germany.
| | - Mariana Babo-Rebelo
- Laboratoire de Neurosciences Cognitives (ENS - INSERM), Ecole Normale Supérieure - PSL Research University, Paris, France
| | - Denis Schwartz
- Sorbonne Universités, Inserm U 1127, CNRS UMR 7225, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, Paris, France
| | - Catherine Tallon-Baudry
- Laboratoire de Neurosciences Cognitives (ENS - INSERM), Ecole Normale Supérieure - PSL Research University, Paris, France.
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20
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Ly HG, Dupont P, Van Laere K, Depoortere I, Tack J, Van Oudenhove L. Differential brain responses to gradual intragastric nutrient infusion and gastric balloon distension: A role for gut peptides? Neuroimage 2017; 144:101-112. [DOI: 10.1016/j.neuroimage.2016.09.032] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 08/18/2016] [Accepted: 09/13/2016] [Indexed: 12/15/2022] Open
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21
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Kuo PC, Chen YT, Chen YS, Chen LF. Decoding the perception of endogenous pain from resting-state MEG. Neuroimage 2016; 144:1-11. [PMID: 27746387 DOI: 10.1016/j.neuroimage.2016.09.040] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 07/17/2016] [Accepted: 09/16/2016] [Indexed: 02/08/2023] Open
Abstract
Decoding the neural representations of pain is essential to obtaining an objective assessment as well as an understanding of its underlying mechanisms. The complexities involved in the subjective experience of pain make it difficult to obtain a quantitative assessment from the induced spatiotemporal patterns of brain activity of high dimensionality. Most previous studies have investigated the perception of pain by analyzing the amplitude or spatial patterns in the response of the brain to external stimulation. This study investigated the decoding of endogenous pain perceptions according to resting-state magnetoencephalographic (MEG) recordings. In our experiments, we applied a beamforming method to calculate the brain activity for every brain region and examined temporal and spectral features of brain activity for predicting the intensity of perceived pain in patients with primary dysmenorrhea undergoing menstrual pain. Our results show that the asymmetric index of sample entropy in the precuneus and the sample entropy in the left posterior cingulate gyrus were the most informative characteristics associated with the perception of menstrual pain. The correlation coefficient (ρ=0.64, p<0.001) between the predicted and self-reported pain scores demonstrated the high prediction accuracy. In addition to the estimated brain activity, we were able to predict accurate pain scores directly from MEG channel signals (ρ=0.65, p<0.001). These findings suggest the possibility of using the proposed model based on resting-state MEG to predict the perceived intensity of endogenous pain.
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Affiliation(s)
- Po-Chih Kuo
- Department of Computer Science, National Chiao Tung University, Hsinchu, Taiwan
| | - Yi-Ti Chen
- Department of Computer Science, National Chiao Tung University, Hsinchu, Taiwan
| | - Yong-Sheng Chen
- Department of Computer Science, National Chiao Tung University, Hsinchu, Taiwan; Institute of Biomedical Engineering, National Chiao Tung University, Hsinchu, Taiwan.
| | - Li-Fen Chen
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Integrated Brain Research Unit, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
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22
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Dudley L, Stevenson RJ. Interoceptive awareness and its relationship to hippocampal dependent processes. Brain Cogn 2016; 109:26-33. [PMID: 27643947 DOI: 10.1016/j.bandc.2016.08.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 08/10/2016] [Accepted: 08/11/2016] [Indexed: 12/11/2022]
Abstract
Many neuropsychological and animal lesion studies point to the hippocampus as being critical for mediating interoceptive awareness, while neuroimaging studies have been used to argue for the importance of the insula and anterior cingulate cortex. Here, using healthy young adults - as with the neuroimaging data - we tested for an association between performance on a hippocampal dependent learning and memory (HDLM) measure (logical memory percent retention) and interoceptive awareness assessed on three tasks - heart rate tracking, water loading and the Multidimensional Assessment of Interoceptive Awareness questionnaire (MAIA). After controlling for other relevant potentially confounding variables, we found significant associations between both the water loading and MAIA measures (which were both correlated) and HDLM performance. These findings imply that hippocampal dependent processes are involved in interoceptive awareness in healthy young adults. More tentatively, they suggest that medial temporal lobe structures may mediate interoceptive tasks that involve ingestion and/or integration of past and current state-based information.
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Affiliation(s)
- Leah Dudley
- Department of Psychology, Macquarie University, Sydney, NSW 2109, Australia
| | - Richard J Stevenson
- Department of Psychology, Macquarie University, Sydney, NSW 2109, Australia.
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23
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Becerra L, Aasted CM, Boas DA, George E, Yücel MA, Kussman BD, Kelsey P, Borsook D. Brain measures of nociception using near-infrared spectroscopy in patients undergoing routine screening colonoscopy. Pain 2016; 157:840-848. [PMID: 26645550 PMCID: PMC4794375 DOI: 10.1097/j.pain.0000000000000446] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Colonoscopy is an invaluable tool for the screening and diagnosis of many colonic diseases. For most colonoscopies, moderate sedation is used during the procedure. However, insufflation of the colon produces a nociceptive stimulus that is usually accompanied by facial grimacing/groaning while under sedation. The objective of this study was to evaluate whether a nociceptive signal elicited by colonic insufflation could be measured from the brain. Seventeen otherwise healthy patients (age 54.8 ± 9.1; 6 female) undergoing routine colonoscopy (ie, no history of significant medical conditions) were monitored using near-infrared spectroscopy (NIRS). Moderate sedation was produced using standard clinical protocols for midazolam and meperidine, titrated to effect. Near-infrared spectroscopy data captured during the procedure was analyzed offline to evaluate the brains' responses to nociceptive stimuli evoked by the insufflation events (defined by physician or observing patients' facial responses). Analysis of NIRS data revealed a specific, reproducible prefrontal cortex activity corresponding to times when patients grimaced. The pattern of the activation is similar to that previously observed during nociceptive stimuli in awake healthy individuals, suggesting that this approach may be used to evaluate brain activity evoked by nociceptive stimuli under sedation, when there is incomplete analgesia. Although some patients report recollection of procedural pain after the procedure, the effects of repeated nociceptive stimuli in surgical patients may contribute to postoperative changes including chronic pain. The results from this study indicate that NIRS may be a suitable technology for continuous nociceptive afferent monitoring in patients undergoing sedation and could have applications under sedation or anesthesia.
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Affiliation(s)
- Lino Becerra
- P.A.I.N. Group, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, MA, USA Center for Pain and the Brain, Harvard Medical School, Boston, MA, USA Departments of Radiology Anesthesia and Critical Care, and Medicine, Massachusetts General Hospital, Boston, MA, USA
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Manuello J, Vercelli U, Nani A, Costa T, Cauda F. Mindfulness meditation and consciousness: An integrative neuroscientific perspective. Conscious Cogn 2016; 40:67-78. [DOI: 10.1016/j.concog.2015.12.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 12/02/2015] [Accepted: 12/16/2015] [Indexed: 01/23/2023]
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Nan J, Zhang L, Zhu F, Tian X, Zheng Q, Deneen KMV, Liu J, Zhang M. Topological Alterations of the Intrinsic Brain Network in Patients with Functional Dyspepsia. J Neurogastroenterol Motil 2015; 22:118-28. [PMID: 26510984 PMCID: PMC4699729 DOI: 10.5056/jnm15118] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 10/15/2015] [Accepted: 10/18/2015] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND/AIMS Previous studies reported that integrated information in the brain ultimately determines the subjective experience of patients with chronic pain, but how the information is integrated in the brain connectome of functional dyspepsia (FD) patients remains largely unclear. The study aimed to quantify the topological changes of the brain network in FD patients. METHODS Small-world properties, network efficiency and nodal centrality were utilized to measure the changes in topological architecture in 25 FD patients and 25 healthy controls based on functional magnetic resonance imaging. Pearson's correlation assessed the relationship of each topological property with clinical symptoms. RESULTS FD patients showed an increase of clustering coefficients and local efficiency relative to controls from the perspective of a whole network as well as elevated nodal centrality in the right orbital part of the inferior frontal gyrus, left anterior cingulate gyrus and left hippocampus, and decreased nodal centrality in the right posterior cingulate gyrus, left cuneus, right putamen, left middle occipital gyrus and right inferior occipital gyrus. Moreover, the centrality in the anterior cingulate gyrus was significantly associated with symptom severity and duration in FD patients. Nevertheless, the inclusion of anxiety and depression scores as covariates erased the group differences in nodal centralities in the orbital part of the inferior frontal gyrus and hippocampus. CONCLUSIONS The results suggest topological disruption of the functional brain networks in FD patients, presumably in response to disturbances of sensory information integrated with emotion, memory, pain modulation, and selective attention in patients.
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Affiliation(s)
- Jiaofen Nan
- Zhengzhou University of Light Industry, Zhengzhou, China
| | - Li Zhang
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Fubao Zhu
- Zhengzhou University of Light Industry, Zhengzhou, China
| | - Xiaorui Tian
- The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qian Zheng
- Zhengzhou University of Light Industry, Zhengzhou, China
| | | | - Jixin Liu
- School of Life Science and Technology, Xidian University, Xi'an, China
| | - Ming Zhang
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Royall DR, Salazar R, Palmer RF. Latent variables may be useful in pain's assessment. Health Qual Life Outcomes 2014; 12:13. [PMID: 24479724 PMCID: PMC3918175 DOI: 10.1186/1477-7525-12-13] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 12/17/2013] [Indexed: 12/27/2022] Open
Abstract
Background Unobserved “latent” variables have the potential to minimize “measurement error” inherent to any single clinical assessment or categorical diagnosis. Objectives To demonstrate the potential utility of latent variable constructs in pain’s assessment. Design We created two latent variables representing depressive symptom-related pain (Pd) and its residual, “somatic” pain (Ps), from survey questions. Setting The Hispanic Established Population for Epidemiological Studies in the Elderly (H-EPESE) project, a longitudinal population-based cohort study. Participants Community dwelling elderly Mexican-Americans in five Southwestern U.S. states. The data were collected in the 7th HEPESE wave in 2010 (N = 1,078). Measurements Self-reported pain, Center for Epidemiological Studies Depression Scale (CES-D) scores, bedside cognitive performance measures, and informant-rated measures of basic and instrumental Activities of Daily Living. Results The model showed excellent fit [χ2 = 20.37, DF = 12; p = 0.06; Comparative fit index (CFI) = 0.998; Root mean statistical error assessment (RMSEA) = 0.025]. Ps was most strongly indicated by self-reported pain-related physician visits (r = 0.48, p ≤0.001). Pd was most strongly indicated by self-reported pain-related sleep disturbances (r = 0.65, p <0.001). Both Pd and Ps were significantly independently associated with chronic pain (> one month), regional pain and pain summed across selected regions. Pd alone was significantly independently associated with self-rated health, life satisfaction, self-reported falls, Life-space, nursing home placement, the use of opiates, and a variety of sleep related disturbances. Ps was associated with the use of NSAIDS. Neither construct was associated with declaration of a resuscitation preference, mode of resuscitation preference declaration, or with opting for a “Do Not Resuscitate” (DNR) order. Conclusion This analysis illustrates the potential of latent variables to parse observed data into “unbiased” constructs with unique predictive profiles. The latent constructs, by definition, are devoid of measurement error that affects any subset of their indicators. Future studies could use such phenotypes as outcome measures in clinical pain management trials or associate them with potential biomarkers using powerful parametric statistical methods.
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Affiliation(s)
- Donald R Royall
- Department of Psychiatry, The University of Texas Health Science Center At San Antonio, 7703 Floyd Curl Drive MC 7792, San Antonio, TX 78229, USA.
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Malbert CH. L’axe tube digestif-cerveau : avancées récentes obtenues sur un modèle d’obésité chez le porc. BULLETIN DE L ACADEMIE NATIONALE DE MEDECINE 2013. [DOI: 10.1016/s0001-4079(19)31389-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Raux M, Tyvaert L, Ferreira M, Kindler F, Bardinet E, Karachi C, Morelot-Panzini C, Gotman J, Pike GB, Koski L, Similowski T. Functional magnetic resonance imaging suggests automatization of the cortical response to inspiratory threshold loading in humans. Respir Physiol Neurobiol 2013; 189:571-80. [PMID: 23994177 DOI: 10.1016/j.resp.2013.08.005] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2013] [Revised: 08/13/2013] [Accepted: 08/14/2013] [Indexed: 10/26/2022]
Abstract
Inspiratory threshold loading (ITL) induces cortical activation. It is sustained over time and is resistant to distraction, suggesting automaticity. We hypothesized that ITL-induced changes in cerebral activation may differ between single-breath ITL and continuous ITL, with differences resembling those observed after cortical automatization of motor tasks. We analyzed the brain blood oxygen level dependent (BOLD) signal of 11 naive healthy volunteers during 5 min of random, single-breath ITL and 5 min of continuous ITL. Single-breath ITL increased BOLD in many areas (premotor cortices, bilateral insula, cerebellum, reticular formation of the lateral mesencephalon) and decreased BOLD in regions co-localizing with the default mode network. Continuous ITL induced signal changes in a limited number of areas (supplementary motor area). These differences are comparable to those observed before and after overlearning of motor tasks. We conclude that the respiratory-related cortical activation observed in response to ITL is likely due to automated, attention-independent mechanisms. Also, ITL activates cortical circuits right from the first breath.
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Affiliation(s)
- Mathieu Raux
- Department of Experimental Medicine, Transcranial Magnetic Stimulation Laboratory McGill University Health Centre, Montréal, QC, Canada; Université Paris 6, ER10UPMC Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France; Assistance Publique - Hôpitaux de Paris, Département d'Anesthésie Réanimation, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
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Sun H, Chen Y, Zhao X, Wang X, Jiang Y, Wu P, Tang Y, Meng Q, Xu S. Abnormal activity of default mode network in GERD patients. BMC Neurosci 2013; 14:69. [PMID: 23844702 PMCID: PMC3717012 DOI: 10.1186/1471-2202-14-69] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2012] [Accepted: 07/01/2013] [Indexed: 01/24/2023] Open
Abstract
Background Abnormal processing of esophageal sensation at the level of the central nervous system has been proven to be involved in gastroesophageal reflux disease (GERD). However, most studies were focused on the possible functions of perceptual processing related network during task status, little attention has been paid to default mode network, which has been manifested to be important in the pathogenesis of many diseases. In our study, we compared the brain activity characteristic in GERD patients with the healthy subjects (HS) at baseline, looking for whether activities of default mode network were abnormal in GERD patients and attempting to identify their possible roles in GERD. In present study, fractional amplitude of low-frequency fluctuation was adopted to detect the brain activities at baseline. Group-level analyses were conducted by one-sample t test within groups (voxel thresholds were p < 0.001 and cluster level >42, corrected P < 0.05) and independent-samples t test between groups (p < 0.01 and cluster level >90, corrected P < 0.05) using SPM5. Results The predominant activity area in both groups mainly located in default mode network such as medial superior frontal gyrus, precuneus, posterior cingulate gyrus, etc. However, the activities of precuneus and posterior cingulate gyrus were significantly lower in GERD patients than those in the HS. Conclusions The activities of precuneus and posterior cingulate gyrus of default mode network in GERD patients were significantly lower compared to the HS, suggesting abnormal activities of brain regions in default mode network may be involved in pathophysiology of GERD symptom generation.
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Affiliation(s)
- Huihui Sun
- Department of Gastroenterology, Tongji Institute of Digestive Diseases, Tongji Hospital, Tongji University School of Medicine, No, 389 Xin Cun Road, Shanghai 200065, China
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Kano M, Farmer AD, Aziz Q, Giampietro VP, Brammer MJ, Williams SCR, Fukudo S, Coen SJ. Sex differences in brain response to anticipated and experienced visceral pain in healthy subjects. Am J Physiol Gastrointest Liver Physiol 2013; 304:G687-99. [PMID: 23392235 PMCID: PMC3625873 DOI: 10.1152/ajpgi.00385.2012] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Women demonstrate higher pain sensitivity and prevalence of chronic visceral pain conditions such as functional gastrointestinal disorders than men. The role of sex differences in the brain processing of visceral pain is still unclear. In 16 male and 16 female healthy subjects we compared personality, anxiety levels, skin conductance response (SCR), and brain processing using functional MRI during anticipation and pain induced by esophageal distension at pain toleration level. There was no significant difference in personality scores, anxiety levels, SCR, and subjective ratings of pain between sexes. In group analysis, both men and women demonstrated a similar pattern of brain activation and deactivation during anticipation and pain consistent with previous reports. However, during anticipation women showed significantly greater activation in the cuneus, precuneus, and supplementary motor area (SMA) and stronger deactivation in the right amygdala and left parahippocampal gyrus, whereas men demonstrated greater activation in the cerebellum. During pain, women demonstrated greater activation in the midcingulate cortex, anterior insula, premotor cortex, and cerebellum and stronger deactivation in the caudate, whereas men showed increased activity in the SMA. The pattern of brain activity suggests that, during anticipation, women may demonstrate stronger limbic inhibition, which is considered to be a cognitive modulation strategy for impending painful stimulation. During pain, women significantly activate brain areas associated with the affective and motivation components of pain. These responses may underlie the sex differences that exist in pain conditions, whereby women may attribute more emotional importance to painful stimuli compared with men.
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Affiliation(s)
- Michiko Kano
- 1Wingate Institute of Neurogastroenterology, Queen Mary University of London, London, United Kingdom; ,2Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; and
| | - Adam D. Farmer
- 1Wingate Institute of Neurogastroenterology, Queen Mary University of London, London, United Kingdom;
| | - Qasim Aziz
- 1Wingate Institute of Neurogastroenterology, Queen Mary University of London, London, United Kingdom;
| | - Vincent P. Giampietro
- 3King's College London, Institute of Psychiatry, Department of Neuroimaging, London, United Kingdom
| | - Michael J. Brammer
- 3King's College London, Institute of Psychiatry, Department of Neuroimaging, London, United Kingdom
| | - Steven C. R. Williams
- 3King's College London, Institute of Psychiatry, Department of Neuroimaging, London, United Kingdom
| | - Shin Fukudo
- 2Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; and
| | - Steven J. Coen
- 1Wingate Institute of Neurogastroenterology, Queen Mary University of London, London, United Kingdom; ,3King's College London, Institute of Psychiatry, Department of Neuroimaging, London, United Kingdom
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Wouters MM, Van Wanrooy S, Casteels C, Nemethova A, de Vries A, Van Oudenhove L, Van den Wijngaard RM, Van Laere K, Boeckxstaens G. Altered brain activation to colorectal distention in visceral hypersensitive maternal-separated rats. Neurogastroenterol Motil 2012; 24:678-85, e297. [PMID: 22509925 DOI: 10.1111/j.1365-2982.2012.01919.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Early life trauma can predispose to increased visceral pain perception. Human neuroimaging studies emphasize that altered brain processing may contribute to increased visceral sensitivity. The aim of our study was to evaluate brain responses to painful visceral stimuli in maternal-separated rats before and after acute stress exposure in vivo. METHODS H(2)(15)O microPET scanning was performed during colorectal distention in maternal-separated rats before and after water avoidance stress. Brain images were anatomically normalized to Paxinos space and analyzed by voxel-based statistical parametric mapping (SPM2). Colorectal induced visceral pain was assessed by recording of the visceromotor response using abdominal muscle electromyography. KEY RESULTS Colorectal distention (1.0-2.0 mL) evoked a volume-dependent increase in visceromotor response in maternal-separated rats. Stress [water avoidance (WA)] induced an increased visceromotor response to colorectal distention in awake and anesthetized rats. In pre-WA rats, colorectal distention evoked significant increases in regional blood flow in the cerebellum and periaquaductal gray (PAG). Colorectal distention post-WA revealed activation clusters covering the PAG as well as somatosensory cortex and hippocampus. At maximal colorectal distention, the frontal cortex was significantly deactivated. CONCLUSIONS & INFERENCES WA stress induced increased pain perception as well as activation of the somatosensory cortex, PAG, and hippocampus in maternal-separated rats. These findings are in line with human studies and provide indirect evidence that the maternal separation model mimics the cerebral response to visceral hypersensitivity in humans.
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Affiliation(s)
- M M Wouters
- Division of Gastroenterology, TARGID, Translational Research Center for Gastrointestinal Disorders, Catholic University of Leuven, Leuven, Belgium.
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Farb NAS, Segal ZV, Anderson AK. Mindfulness meditation training alters cortical representations of interoceptive attention. Soc Cogn Affect Neurosci 2012; 8:15-26. [PMID: 22689216 DOI: 10.1093/scan/nss066] [Citation(s) in RCA: 263] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
One component of mindfulness training (MT) is the development of interoceptive attention (IA) to visceral bodily sensations, facilitated through daily practices such as breath monitoring. Using functional magnetic resonance imaging (fMRI), we examined experience-dependent functional plasticity in accessing interoceptive representations by comparing graduates of a Mindfulness-Based Stress Reduction course to a waitlisted control group. IA to respiratory sensations was contrasted against two visual tasks, controlling for attentional requirements non-specific to IA such as maintaining sensation and suppressing distraction. In anatomically partitioned analyses of insula activity, MT predicted greater IA-related activity in anterior dysgranular insula regions, consistent with greater integration of interoceptive sensation with external context. MT also predicted decreased recruitment of the dorsomedial prefrontal cortex (DMPFC) during IA, and altered functional connectivity between the DMPFC and the posterior insula, putative primary interoceptive cortex. Furthermore, meditation practice compliance predicted greater posterior insula and reduced visual pathway recruitment during IA. These findings suggest that interoceptive training modulates task-specific cortical recruitment, analogous to training-related plasticity observed in the external senses. Further, DMPFC modulation of IA networks may be an important mechanism by which MT alters information processing in the brain, increasing the contribution of interoception to perceptual experience.
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Affiliation(s)
- Norman A S Farb
- Rotman Research Institute at Baycrest, 3560 Bathurst Street, Toronto, ON, Canada M6A 2E1.
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Geeraerts B, Van Oudenhove L, Dupont P, Vanderghinste D, Bormans G, Van Laere K, Tack J. Different regional brain activity during physiological gastric distension compared to balloon distension: a H2 15O-PET study. Neurogastroenterol Motil 2011; 23:533-e203. [PMID: 21155950 DOI: 10.1111/j.1365-2982.2010.01642.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Stepwise gastric balloon distension progressively activates a 'visceral pain neuromatrix', ultimately inducing discomfort and pain. On the other hand, normal meal ingestion requires gastric volume expansion without induction of pain. The aim was to test the hypothesis that physiological gastric distension (liquid meal infusion) until maximal satiation elicits brain responses similar to balloon distension at discomfort threshold. METHODS Brain H(2) (15) O-positron emission tomography (PET) was performed in two different groups of healthy volunteers (both n=14) during continuous and stepwise infusion of a liquid meal through a nasogastric tube, until maximal satiation. Brain (de)activation patterns were compared with historical controls in which discomfort was elicited using gastric balloon distension. This latter reference group was acquired on the same scanner using the same acquisition protocol; all data were analyzed using statistical parametric mapping (SPM2). Within each group, brain activity at maximal distension was compared to baseline activity and between-group comparisons were made. KEY RESULTS Intragastric volumes and satiation/gastric sensation scores at endpoint were similar in all groups. Continuous and stepwise nutrient infusion was associated with progressive deactivations in key areas of the 'visceral pain neuromatrix' that were activated during balloon distension. Additionally, stepwise infusion progressively activated prefrontal areas and showed deactivations in 'default network' brain regions also found to be deactivated during balloon distension. CONCLUSIONS & INFERENCES Compared to gastric balloon distension, physiological gastric distension using nutrient infusion elicits opposite brain responses in the 'visceral pain neuromatrix', but similar responses in other areas. We interpret this finding as a prerequisite for tolerance of normal meal volumes in health.
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Affiliation(s)
- B Geeraerts
- Gastroenterology Section, Department of Pathophysiology, University of Leuven, Leuven, Belgium
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Coen SJ. When pain and hunger collide; psychological influences on differences in brain activity during physiological and non-physiological gastric distension. Neurogastroenterol Motil 2011; 23:485-9. [PMID: 21564423 DOI: 10.1111/j.1365-2982.2011.01718.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Functional neuroimaging has been used extensively in conjunction with gastric balloon distension in an attempt to unravel the relationship between the brain, regulation of hunger, satiety, and food intake tolerance. A number of researchers have also adopted a more physiological approach using intra-gastric administration of a liquid meal which has revealed different brain responses to gastric balloon distension. These differences are important as they question the utility and relevance of non-physiological models such as gastric balloon distension, especially when investigating mechanisms of feeding behavior such as satiety. However, an assessment of the relevance of physiological versus non-physiological gastric distension has been problematic due to differences in distension volumes between studies. In this issue of Neurogastroenterology and Motility, Geeraerts et al. compare brain activity during volume matched nutrient gastric distension and balloon distension in healthy volunteers. Gastric balloon distension activated the 'visceral pain neuromatrix'. This network of brain regions was deactivated during nutrient infusion, supporting the notion that brain activity during physiological versus non-physiological distension is indeed different. The authors suggest deactivation of the pain neuromatrix during nutrient infusion serves as a prerequisite for tolerance of normal meal volumes in health.
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Affiliation(s)
- S J Coen
- Wingate Institute of Neurogastroenterology, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK.
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Moeller-Bertram T, Keltner J, Strigo IA. Pain and post traumatic stress disorder - review of clinical and experimental evidence. Neuropharmacology 2011; 62:586-97. [PMID: 21586297 DOI: 10.1016/j.neuropharm.2011.04.028] [Citation(s) in RCA: 108] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2010] [Revised: 03/29/2011] [Accepted: 04/23/2011] [Indexed: 01/09/2023]
Abstract
Pain and Post Traumatic Stress Disorder (PTSD) are highly comorbid conditions. Patients with chronic pain have higher rates of PTSD. Likewise, patients with PTSD are often diagnosed with numerous chronic pain conditions. Despite the high pain-PTSD comorbidity, the neurobehavioral mechanisms underlying this phenomenon are incompletely understood and only recently researchers have started investigating it using experimental models. In this article, we systematically review the substantial clinical evidence on the co-occurrence of pain and PTSD, and the limited experimental evidence of pain processing in this disorder. We provide a detailed overview of the psychophysical and brain imaging experiments that compared somatosensory and pain processing in PTSD and non-PTSD populations. Based on the presented evidence, an extensive body of literature substantiates the clinical coexistence of pain and PTSD in patients but the limited experimental data show inconsistent results highlighting the need for well-controlled future studies. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.
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Ino T, Nakai R, Azuma T, Kimura T, Fukuyama H. Brain activation during autobiographical memory retrieval with special reference to default mode network. Open Neuroimag J 2011; 5:14-23. [PMID: 21643504 PMCID: PMC3106359 DOI: 10.2174/1874440001105010014] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Revised: 11/04/2010] [Accepted: 11/05/2010] [Indexed: 11/22/2022] Open
Abstract
Recent neuroimaging studies have suggested that brain regions activated during retrieval of autobiographical memory (ABM) overlap with the default mode network (DMN), which shows greater activation during rest than cognitively demanding tasks and is considered to be involved in self-referential processing. However, detailed overlap and segregation between ABM and DMN remain unclear. This fMRI study focuses first on revealing components of the DMN which are related to ABM and those which are unrelated to ABM, and second on extracting the neural bases which are specifically devoted to ABM. Brain activities relative to rest during three tasks matched in task difficulty assessed by reaction time were investigated by fMRI; category cued recall from ABM, category cued recall from semantic memory, and number counting task. We delineated the overlap between the regions that showed less activation during semantic memory and number counting relative to rest, which correspond to the DMN, and the areas that showed greater or less activation during ABM relative to rest. ABM-specific activation was defined as the overlap between the contrast of ABM versus rest and the contrast of ABM versus semantic memory. The fMRI results showed that greater activation as well as less activation during ABM relative to rest overlapped considerably with the DMN, indicating that the DMN is segregated to the regions which are functionally related to ABM and the regions which are unrelated to ABM. ABM-specific activation was observed in the left-lateralized brain regions and most of them fell within the DMN.
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Affiliation(s)
- Tadashi Ino
- Department of Neurology, Rakuwakai-Otowa Hospital, Otowachinjicho 2, Yamashina-ku, Kyoto 607-8062, Japan
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Van Oudenhove L. Understanding gut-brain interactions in gastrointestinal pain by neuroimaging: lessons from somatic pain studies. Neurogastroenterol Motil 2011; 23:292-302. [PMID: 21255193 DOI: 10.1111/j.1365-2982.2010.01666.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Neuroimaging research on gut-brain interactions has greatly improved our understanding of the brain mechanisms involved in processing and perceiving visceral pain in health and functional gastrointestinal disorders (FGID). However, discrepancies in the results of these studies continue to exist, which is at least partially due to the fact that important factors contributing to the intrinsic heterogeneity of symptom-based FGID, including psychological processes and psychiatric comorbidity, are insufficiently integrated in visceral pain neuroimaging research. PURPOSE This review will defend the thesis that, to increase our understanding of the heterogeneous etiopathogenesis of FGID, visceral pain neuroimaging studies need to be integrated with: (i) epidemiological and behavioral evidence on the influence of psychological processes on visceral pain in health and FGID, and (ii) methodology and evidence from affective, cognitive, and psychiatric neuroimaging studies. To illustrate this point, the somatic pain neuroimaging field will be taken as an example before giving an overview of novel and integrative visceral pain studies in health and FGID. Some limitations of current pain neuroimaging studies will be outlined, before providing a summary of suggestions for moving the visceral pain neuroimaging field forward.
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Affiliation(s)
- L Van Oudenhove
- Department of Pathophysiology, Translational Research Center for Gastrointestinal Disorders (TARGID) and University Psychiatric Centre, Liaison Psychiatry, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium.
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Janssen P, Vanden Berghe P, Verschueren S, Lehmann A, Depoortere I, Tack J. Review article: the role of gastric motility in the control of food intake. Aliment Pharmacol Ther 2011; 33:880-94. [PMID: 21342212 DOI: 10.1111/j.1365-2036.2011.04609.x] [Citation(s) in RCA: 213] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND From a classical point of view, gastric motility acts to clear the stomach between meals, whereas postprandial motility acts to provide a reservoir for food, mixing and grinding the food and to assure a controlled flow of food to the intestines. AIM To summarise findings that support the role of gastric motility as a central mediator of hunger, satiation and satiety. METHODS A literature review using the search terms 'satiety', 'satiation' and 'food intake' was combined with specific terms corresponding to the sequence of events during and after food intake. RESULTS During food intake, when gastric emptying of especially solids is limited, gastric distension and gastric accommodation play an important function in the regulation of satiation. After food intake, when the stomach gradually empties, the role of gastric distension in the determination of appetite decreases and the focus will shift to gastric emptying and intestinal exposure of the nutrients. Finally, we have discussed the role of the empty stomach and the migrating motor complex in the regulation of hunger signals. CONCLUSIONS Our findings indicate that gastric motility is a key mediator of hunger, satiation and satiety. More specifically, gastric accommodation and gastric emptying play important roles in the regulation of gastric (dis)tension and intestinal exposure of nutrients and hence control satiation and satiety. Correlations between gastric accommodation, gastric emptying and body weight indicate that gastric motility can also play a role in the long-term regulation of body weight.
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Affiliation(s)
- P Janssen
- Division of Gastroenterology, Department of Internal Medicine, University Hospital Gasthuisberg, University of Leuven, Herestraat 49, Leuven, Belgium.
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Van Oudenhove L, Vandenberghe J, Dupont P, Geeraerts B, Vos R, Dirix S, Van Laere K, Bormans G, Vanderghinste D, Demyttenaere K, Fischler B, Tack J. Regional brain activity in functional dyspepsia: a H(2)(15)O-PET study on the role of gastric sensitivity and abuse history. Gastroenterology 2010; 139:36-47. [PMID: 20406641 DOI: 10.1053/j.gastro.2010.04.015] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2010] [Revised: 03/23/2010] [Accepted: 04/08/2010] [Indexed: 12/29/2022]
Abstract
BACKGROUND & AIMS Differences in brain activity between health and functional dyspepsia (FD) have been reported; it is unclear whether this is influenced by gastric hypersensitivity or abuse history. Therefore, we aimed to determine the influence of gastric sensitivity and abuse history on gastric sensation scores and brain activity in homeostatic-afferent, emotional-arousal, and cortical-modulatory brain regions in FD. METHODS Abuse history was assessed using a validated self-report questionnaire. H(2)(15)O positron emission tomography was performed in 25 FD patients (13 hypersensitive and 8 abused) during 3 conditions, that is, no distension, gastric distension at discomfort threshold, and sham distension. Data were analyzed in SPM2. Region of interest analysis was used to confirm differences in prehypothesized regions. RESULTS No association between hypersensitivity and abuse history was found. Gastric hypersensitivity was associated with significantly higher gastric sensation scores during baseline and sham. A condition-independent difference in ventral posterior cingulate activity was found between groups, as well as distension and sham-specific differences in brainstem and cingulate areas. Abuse history was associated with higher gastric sensation scores in all conditions and with differences in insular, prefrontal, and hippocampus/amygdala activity. CONCLUSIONS Gastric sensitivity and abuse history independently influence gastric sensation as well as brain activity in FD.
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Affiliation(s)
- Lukas Van Oudenhove
- Department of Neurosciences, Psychiatry Division, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium.
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Farmer AD, Aziz Q, Tack J, Van Oudenhove L. The future of neuroscientific research in functional gastrointestinal disorders: integration towards multidimensional (visceral) pain endophenotypes? J Psychosom Res 2010; 68:475-81. [PMID: 20403507 DOI: 10.1016/j.jpsychores.2009.12.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2009] [Revised: 12/15/2009] [Accepted: 12/21/2009] [Indexed: 12/19/2022]
Abstract
The growing evidence for a key role of psychophysiological processes in the etiopathogenesis of functional gastrointestinal disorders (FGID) originates from various sources, including epidemiological, psychometric, physiological, and behavioural studies. Functional neuroimaging has improved our knowledge about central processing of visceral pain, a defining feature of FGID. However, results have been disappointingly inconsistent, often due to psychosocial factors not being controlled for. In this paper, we aim to show that using integrated research strategies, encompassing a number of scientific disciplines, is critical to advancing our understanding of FGID. We will illustrate this by describing recent integrative studies that may serve as good examples. More specifically, future FGID neuroimaging studies should control for psychosocial factors and incorporate methods from other branches of neuroscience outside this field, especially cognitive, affective and autonomic neuroscience. We therefore propose a framework for the development of an integrative cross-disciplinary research strategy based on advancing our understanding of visceral nociceptive physiology in health as well as vulnerability and susceptibility factors for FGID. This approach will allow the identification of factors responsible for the inter-individual differences in visceral pain perception and susceptibility to chronic visceral pain, leading to the description of multidimensional (visceral) pain "endophenotypes." These may represent the critical steps needed towards a pathophysiological, rather than symptom-based, classification of FGID, which may be more suitable for genetic association studies. This approach may ultimately culminate in individual tailoring of treatment, in addition to disease prevention, thereby improving outcomes for the patient and researcher alike.
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Affiliation(s)
- Adam D Farmer
- Neurogastroenterology Group, Wingate Institute of Neurogastroenterology, Centre for Gastroenterology, Blizzard Centre for Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Abnormal regional brain activity during rest and (anticipated) gastric distension in functional dyspepsia and the role of anxiety: a H(2)(15)O-PET study. Am J Gastroenterol 2010; 105:913-24. [PMID: 20160711 DOI: 10.1038/ajg.2010.39] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES During gastric distension in hypersensitive functional dyspepsia (FD), activation was found in somatosensory cortex (SI/SII) and ventrolateral prefrontal cortex (vlPFC) but, contrary to controls, not in pregenual anterior cingulate (pACC). The aims of this article were to study (i) cortical activations and deactivations during distension and sham compared with baseline in FD, regardless of sensitivity status; (ii) differences in brain activity between health and FD during "no distension" conditions; and (iii) the relationship between anxiety and brain activity in FD. METHODS Brain H(2)(15)O-PET was performed in 25 FD patients (13 hypersensitive) during three conditions: baseline, distension at discomfort threshold, and sham. Brain activity was compared against healthy controls using SPM2. RESULTS Discomfort threshold was lower; sensation scores in all conditions were higher in patients than controls. (i) Activations were similar to controls, except for a lack of pACC activation during distension in FD. Patients showed no dorsal pons and amygdala deactivation during distension and sham, respectively. (ii) Comparing baseline or sham activity showed the following differences: higher activity in SII/SI, insula, midcingulate (MCC), dorsolateral and ventrolateral PFC in controls; and higher activity in occipital cortex in FD. Differences in left lateral PFC were specific to sham. (iii) Anxiety correlated negatively with pACC and MCC and positively with dorsal pons activity. CONCLUSIONS FD patients failed to activate pACC, to deactivate dorsal pons during distension, and to deactivate amygdala during sham; this may represent arousal-anxiety-driven failure of pain modulation. During baseline and sham, differences between patients and controls were found in sensory as well as affective-cognitive areas.
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Lassman DJ, McKie S, Gregory LJ, Lal S, D'Amato M, Steele I, Varro A, Dockray GJ, Williams SCR, Thompson DG. Defining the role of cholecystokinin in the lipid-induced human brain activation matrix. Gastroenterology 2010; 138:1514-24. [PMID: 20080096 DOI: 10.1053/j.gastro.2009.12.060] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2009] [Revised: 12/04/2009] [Accepted: 12/29/2009] [Indexed: 12/15/2022]
Abstract
BACKGROUND & AIMS In human beings, as in most vertebrates, the release of the intestinal peptide cholecystokinin (CCK) by ingested food plays a major role both in digestion and the regulation of further food intake, but the changes in brain function and their underlying activation mechanisms remain unknown. Our aim was to explore, using a novel physiologic magnetic resonance imaging approach, the temporospatial brain activation matrix, in response to ingestion of a lipid meal and, by use of a CCK-1 receptor antagonist, to define the role of CCK in this activation. METHODS We studied, in 19 healthy subjects, the brain activation responses to ingested lipid (dodecanoic acid) or saline (control) with magnetic resonance imaging. Gallbladder volume, plasma CCK levels, and subjective hunger and fullness scores were also recorded. The experiment was then repeated, with and without prior administration of the CCK-1 receptor antagonist dexloxiglumide (600 mg orally) with a controlled, randomized order, latin-square design. RESULTS Ingested lipid activated bilaterally a matrix of brain areas, particularly the brain stem, pons, hypothalamus, and also cerebellum and motor cortical areas. These activations were abolished by dexloxiglumide, indicating a CCK-mediated pathway, independent of any nutrient-associated awareness cues. CONCLUSION The identification of these activations now defines the lipid-activated brain matrix and provides a means by which the gut-derived homeostatic mechanisms of food regulation can be distinguished from secondary sensory and hedonic cues, thereby providing a new approach to exploring aberrant human gastrointestinal responses and eating behavior.
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Affiliation(s)
- Daniel J Lassman
- Gastrointestinal Sciences, University of Manchester, Salford Royal NHS Foundation Trust, Salford, United Kingdom
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Owen DG, Clarke CF, Ganapathy S, Prato FS, St. Lawrence KS. Using perfusion MRI to measure the dynamic changes in neural activation associated with tonic muscular pain. Pain 2010; 148:375-386. [DOI: 10.1016/j.pain.2009.10.003] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2008] [Revised: 08/12/2009] [Accepted: 10/05/2009] [Indexed: 01/07/2023]
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Hall GBC, Kamath MV, Collins S, Ganguli S, Spaziani R, Miranda KL, Bayati A, Bienenstock J. Heightened central affective response to visceral sensations of pain and discomfort in IBS. Neurogastroenterol Motil 2010; 22:276-e80. [PMID: 20003075 DOI: 10.1111/j.1365-2982.2009.01436.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Typically, conventional functional imaging methods involve repeated exposures to sensory stimulation. In rectal distension (RD) studies that involve multiple distensions, however, it is difficult to disambiguate the central response to RD from pathological alterations in peripheral neural responses associated with relaxation and accommodation of the rectum. METHODS This study addressed potential confounders found in previous imaging studies by collecting functional magnetic resonance imaging studies (fMRI) data during a single slow ramp-tonic distension paradigm and analysing fMRI signal changes using independent component analysis. KEY RESULTS Compared with controls, IBS participants showed increased activation of the anterior cingulate cortices, insula and ventral medial prefrontal regions suggesting heightened affective responses to painful visceral stimuli. In addition, the failure by IBS patients to down-regulate activity within ventral medial prefrontal and the posterior cingulate/precuneus regions was suggestive of reduced sensitivity to somatic changes and delayed shifts away from rest in ;default network' activity patterns. Controls showed heightened activation of the thalamus, striatal regions and dorsolateral prefrontal cortex suggesting greater arousal and salience-driven sustained attention reactions and greater modulation of affective responses to discomfort and pain. CONCLUSION&INFERENCES This work points to alterations in the central response to visceral pain and discomfort in IBS, highlighting diminished modulation and heightened internalization of affective reactions.
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Affiliation(s)
- G B C Hall
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
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Kanazawa M, Hamaguchi T, Watanabe S, Terui T, Mine H, Kano M, Fukudo S. Site-specific differences in central processing of visceral stimuli from the rectum and the descending colon in men. Neurogastroenterol Motil 2010; 22:173-80, e53. [PMID: 19825012 DOI: 10.1111/j.1365-2982.2009.01417.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND It has been reported that different brain activation areas are demonstrated during somatosensory and visceral stimulation. However, no study thus far has investigated how activated patterns in the human brain differ during visceral stimulation of different sites of the digestive tracts. The aim of this study was to determine possible site-specific differences in brain responses and perceptions during visceral stimulation of two different sites, the intraluminal distentions of the rectum and descending colon. METHODS Regional cerebral blood flow was assessed in 32 healthy right-handed male subjects using H(2)(15)O positron emission tomography during distention of the rectum (R group, n = 16) or descending colon (DC group, n = 16) at 40 or 20 mmHg. KEY RESULTS R group reported significantly higher scores of abdominal pain (P < 0.05) and urge to defecate (P < 0.001) during the application of stimulus at 40 mmHg compared with DC group but not of abdominal bloating or anxiety. In comparisons of response to the 40-mmHg stimulus, R group showed significantly greater activation in posterior midcingulate cortex (MCC) and right anterior and posterior insula, whereas DC group showed greater activation in subgenual anterior cingulate cortex (ACC), perigenual ACC and left orbitofrontal and superior temporal cortices. CONCLUSIONS & INFERENCES These findings suggest that central projections of painful visceral stimulation from the rectum and descending colon differ in affective, cognitive and nociceptive processing in the brain, which may result in different perceptions of visceral stimulation from different sites.
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Affiliation(s)
- M Kanazawa
- Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
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Exploring the brain in pain: activations, deactivations and their relation. Pain 2009; 148:257-267. [PMID: 20005043 DOI: 10.1016/j.pain.2009.11.008] [Citation(s) in RCA: 190] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2009] [Revised: 09/25/2009] [Accepted: 11/06/2009] [Indexed: 10/20/2022]
Abstract
The majority of neuroimaging studies on pain focuses on the study of BOLD activations, and more rarely on deactivations. In this study, in a relatively large cohort of subjects (N=61), we assess (a) the extent of brain activation and deactivation during the application of two different heat pain levels (HIGH and LOW) and (b) the relations between these two directions of fMRI signal change. Furthermore, in a subset of our subjects (N=12), we assess (c) the functional connectivity of pain-activated or -deactivated regions during resting states. As previously observed, we find that pain stimuli induce intensity dependent (HIGH pain>LOW pain) fMRI signal increases across the pain matrix. Simultaneously, the noxious stimuli induce activity decreases in several brain regions, including some of the 'core structures' of the default network (DMN). In contrast to what we observe with the signal increases, the extent of deactivations is greater for LOW than HIGH pain stimuli. The functional dissociation between activated and deactivated networks is further supported by correlational and functional connectivity analyses. Our results illustrate the absence of a linear relationship between pain activations and deactivations, and therefore suggest that these brain signal changes underlie different aspects of the pain experience.
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