Department of Gastroenterology, Tongji Institute of Digestive Diseases, Tongji Hospital, Tongji University School of Medicine, No, 389 Xin Cun Road, Shanghai 200065, China.
BMC Neurosci. 2013 Jul 11;14:69. doi: 10.1186/1471-2202-14-69.
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.
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.
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.
中枢神经系统食管感觉异常已被证明与胃食管反流病(GERD)有关。然而,大多数研究都集中在任务状态下感知处理相关网络的可能功能上,很少关注默认模式网络,该网络在许多疾病的发病机制中表现得很重要。在我们的研究中,我们比较了 GERD 患者和健康受试者(HS)在基线时的大脑活动特征,寻找 GERD 患者的默认模式网络活动是否异常,并试图确定其在 GERD 中的可能作用。在本研究中,我们采用低频振幅分数来检测基线时的大脑活动。采用 SPM5 进行组内单样本 t 检验(体素阈值为 p<0.001,簇水平>42,校正 P<0.05)和组间独立样本 t 检验(p<0.01,簇水平>90,校正 P<0.05)。
两组的主要活动区域主要位于默认模式网络,如内侧额上回、楔前叶、后扣带回等。然而,GERD 患者的楔前叶和后扣带回的活动明显低于 HS。
与 HS 相比,GERD 患者默认模式网络的楔前叶和后扣带回活动明显降低,提示默认模式网络脑区活动异常可能与 GERD 症状产生的病理生理学有关。