Department of Neurosciences, Psychiatry Division, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium.
Gastroenterology. 2010 Jul;139(1):36-47. doi: 10.1053/j.gastro.2010.04.015. Epub 2010 Apr 18.
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.
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.
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.
Gastric sensitivity and abuse history independently influence gastric sensation as well as brain activity in FD.
已有研究报道健康人群与功能性消化不良（FD）人群的大脑活动存在差异；但目前尚不清楚这种差异是否受胃高敏或滥用史的影响。因此，我们旨在确定胃敏感性和滥用史对 FD 患者自主传入、情绪唤醒和皮质调节脑区的胃感觉评分和大脑活动的影响。
采用经过验证的自我报告问卷评估滥用史。在 25 例 FD 患者（13 例胃高敏和 8 例滥用）中进行 H（2）（15）O 正电子发射断层扫描，分别在 3 种条件下进行，即不充气、充气至不适阈值和假充气。使用 SPM2 进行数据分析，采用感兴趣区分析来验证预先假设区域的差异。
未发现胃高敏与滥用史之间存在关联。胃高敏与基线和假充气时的胃感觉评分显著升高有关。两组间腹侧后扣带回活动存在条件独立差异，并且在脑干和扣带回区域存在充气和假充气特异性差异。滥用史与所有条件下的胃感觉评分升高以及岛叶、前额叶和海马/杏仁核活性的差异有关。
胃敏感性和滥用史独立影响 FD 患者的胃感觉和大脑活动。
