Department of Medicine, GI Unit, Massachusetts General Hospital, Harvard Medical School, Martinos Center for Biomedical Imaging, Boston, MA 02114, USA.
Neurogastroenterol Motil. 2011 Apr;23(4):336-46, e158. doi: 10.1111/j.1365-2982.2010.01635.x. Epub 2010 Nov 30.
Brain-imaging literature of irritable bowel syndrome (IBS) suggests an abnormal brain-gut communication. We analyzed the literature to evaluate and compare the aspects of brain activity in individuals with IBS and control subjects experiencing controlled rectal stimulation.
PubMed was searched until September 2010. Data from 16 articles reporting brain activity during rectal balloon distensions in IBS compared to control groups was analyzed. Prevalence rates and pairwise activations were assessed using binomial distributions for 11 selected regions of interest. The data were aggregated to adjust for center effect.
There was considerable variability in the literature regarding regions and their activity patterns in controls and individuals with IBS. There was no significant difference found in the thalamus, anterior cingulate cortex, posterior cingulate cortex, and prefrontal cortex, however, results show limited evidence of consensus for the anterior insula (AI) (P = 0.22). Pairwise activity results suggest that pairs involving the AI tend to have more consistent activity together than pairs which do not involve the AI (posterior insula and AI, P = 0.08; posterior cingulate cortex and AI, P = 0.16), however, no pairwise evaluation reached significance.
CONCLUSIONS & INFERENCES: Our pooled analysis demonstrates that the literature reports are quite heterogeneous but there is some evidence that there may be patterns of higher activity more common in individuals with IBS than in controls. A consensus, though, regarding study designs, analysis approach and reporting could create a clearer understanding of brain involvement in IBS pathophysiology.
肠易激综合征（IBS）的脑影像学文献表明存在异常的脑-肠通讯。我们分析了文献，以评估和比较 IBS 患者和接受控制直肠刺激的对照受试者的大脑活动方面。
检索 PubMed 至 2010 年 9 月。分析了 16 篇报告 IBS 期间直肠球囊扩张时大脑活动的文章的数据，与对照组进行比较。使用二项式分布评估 11 个选定的感兴趣区域的患病率和成对激活。汇总数据以调整中心效应。
文献中关于对照者和 IBS 患者的区域及其活动模式存在相当大的变异性。在丘脑、前扣带皮层、后扣带皮层和前额叶皮层中未发现显著差异，但结果表明对前岛叶（AI）的共识有限（P = 0.22）。成对活动结果表明，涉及 AI 的对倾向于比不涉及 AI 的对（后岛叶和 AI，P = 0.08；后扣带皮层和 AI，P = 0.16）具有更一致的活动，然而，没有成对评估达到显著水平。
我们的汇总分析表明，文献报告非常异质，但有一些证据表明，IBS 患者可能存在比对照者更高的活动模式。然而，关于研究设计、分析方法和报告的共识可以更清楚地了解脑在 IBS 病理生理学中的作用。
