Nan Jiaofen, Liu Jixin, Mu Junya, Dun Wanghuan, Zhang Ming, Gong Qiyong, Qin Wei, Tian Jie, Liang Fanrong, Zeng Fang
School of Life Science and Technology, Xidian University, Xi'an, China.
Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
J Neurogastroenterol Motil. 2015 Jan 1;21(1):103-10. doi: 10.5056/jnm14096.
BACKGROUND/AIMS: Increasing evidence shows involvement of psychological disorders in functional dyspepsia (FD), but how psychological factors exert their influences upon FD remains largely unclear. The purpose of the present study was to explore the brain-based correlations of psychological factors and FD.
Based on Fluorine-18-deoxyglucose positron emission tomography-computed tomography, the altered cerebral glycometabolism was investigated in 40 FD patients compared with 20 healthy controls during resting state using statistical parametric mapping software.
FD patients exhibited increased glucose metabolism in multiple regions relative to controls (P< 0.001, family-wise error corrected). After controlling for the dyspeptic symptoms, increased aberrations persisted within the insula, anterior cingulate cortex (ACC), middle cingulate cortex (MCC) and middle frontal cortex (midFC), which was related to anxiety and depression score. Interestingly, FD patients without anxiety/depression symptoms also showed increased glycometabolism within the insula, ACC, MCC and midFC. Moreover, FD patients with anxiety/depression symptoms exhibited more significant hypermetabolism within the above 4 sites compared with patients without anxiety/depression symptoms.
Our results suggested that the altered cerebral glycometabolism may be in a vicious cycle of psychological vulnerabilities and increased gastrointestinal symptoms.
背景/目的：越来越多的证据表明心理障碍与功能性消化不良（FD）有关，但心理因素如何影响FD在很大程度上仍不清楚。本研究的目的是探讨心理因素与FD基于大脑的相关性。
基于氟-18-脱氧葡萄糖正电子发射断层扫描-计算机断层扫描，使用统计参数映射软件，在静息状态下对40例FD患者和20例健康对照者的脑糖代谢变化进行了研究。
与对照组相比，FD患者多个区域的葡萄糖代谢增加（P<0.001，经家族性错误校正）。在控制消化不良症状后，岛叶、前扣带回皮质（ACC）、中扣带回皮质（MCC）和额中回皮质（midFC）内的异常增加仍然存在，这与焦虑和抑郁评分有关。有趣的是，没有焦虑/抑郁症状的FD患者在岛叶、ACC、MCC和midFC内也显示出糖代谢增加。此外，有焦虑/抑郁症状的FD患者与没有焦虑/抑郁症状的患者相比，在上述4个部位表现出更显著的代谢亢进。
我们的结果表明，脑糖代谢改变可能处于心理易损性和胃肠道症状增加的恶性循环中。
