Andresen Viola, Poellinger Alexander, Tsrouya Chedwa, Bach Dominik, Stroh Albrecht, Foerschler Annette, Georgiewa Petra, Schmidtmann Marco, van der Voort Ivo R, Kobelt Peter, Zimmer Claus, Wiedenmann Bertram, Klapp Burghard F, Monnikes Hubert
Department of Medicine, Division of Hepatology, Gastroenterology, and Endocrinology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
World J Gastroenterol. 2006 Mar 21;12(11):1723-9. doi: 10.3748/wjg.v12.i11.1723.
To determine by brain functional magnetic resonance imaging (fMRI) whether cerebral processing of non-visceral stimuli is altered in irritable bowel syndrome (IBS) patients compared with healthy subjects. To circumvent spinal viscerosomatic convergence mechanisms, we used auditory stimulation, and to identify a possible influence of psychological factors the stimuli differed in their emotional quality.
In 8 IBS patients and 8 controls, fMRI measurements were performed using a block design of 4 auditory stimuli of different emotional quality (pleasant sounds of chimes, unpleasant peep (2000 Hz), neutral words, and emotional words). A gradient echo T2*-weighted sequence was used for the functional scans. Statistical maps were constructed using the general linear model.
To emotional auditory stimuli, IBS patients relative to controls responded with stronger deactivations in a greater variety of emotional processing regions, while the response patterns, unlike in controls, did not differentiate between distressing or pleasant sounds. To neutral auditory stimuli, by contrast, only IBS patients responded with large significant activations.
Altered cerebral response patterns to auditory stimuli in emotional stimulus-processing regions suggest that altered sensory processing in IBS may not be specific for visceral sensation, but might reflect generalized changes in emotional sensitivity and affective reactivity, possibly associated with the psychological comorbidity often found in IBS patients.
通过脑功能磁共振成像（fMRI）确定与健康受试者相比，肠易激综合征（IBS）患者对非内脏刺激的大脑处理过程是否发生改变。为规避脊髓内脏-躯体汇聚机制，我们使用听觉刺激，并为确定心理因素的可能影响，刺激在情感性质上存在差异。
对8例IBS患者和8例对照者进行fMRI测量，采用包含4种不同情感性质听觉刺激（悦耳的编钟声、不愉快的嘟嘟声（2000赫兹）、中性词和情感词）的组块设计。功能扫描采用梯度回波T2*加权序列。使用一般线性模型构建统计图谱。
对于情感性听觉刺激，与对照者相比，IBS患者在更多情感处理区域表现出更强的去激活反应，且与对照者不同，其反应模式在令人痛苦或愉悦的声音之间没有差异。相比之下，对于中性听觉刺激，只有IBS患者表现出明显的显著激活反应。
情感刺激处理区域对听觉刺激的大脑反应模式改变表明，IBS中改变的感觉处理可能并非内脏感觉所特有，而是可能反映了情感敏感性和情感反应性的普遍变化，这可能与IBS患者中常见的心理共病有关。
