Lee I-S, Wang H, Chae Y, Preissl H, Enck P
Psychosomatic Medicine and Psychotherapy Department, University of Tübingen, Tübingen, Germany.
Graduate Training Centre of Neuroscience, IMPRS for Cognitive and Systems Neuroscience, Tübingen, Germany.
Neurogastroenterol Motil. 2016 Jun;28(6):793-805. doi: 10.1111/nmo.12793. Epub 2016 Mar 4.
There is increasing evidence in support of the presence of abnormal central changes (compared to healthy controls) in functional dyspepsia (FD) in addition to the peripheral changes in gastrointestinal tract.
This systematic review aims to provide an integrative understanding of the abnormal functional brain activity, visceral sensation, dyspeptic symptoms, and psychological changes of FD. Electronic and hand searches were conducted to identify functional neuroimaging studies involving FD patients. Sixteen studies were selected and divided into three categories: 10 resting state studies, three visceral distention studies, and three acupuncture studies. Changes were reported in several brain areas in FD patients including the frontal cortex, somatosensory cortex, insula, anterior cingulate cortex, thalamus, hippocampus, and amygdala. These brain activity changes were associated with visceral hypersensitivity, dyspeptic symptoms, poorer quality of life, anxiety, and depression. The results show that FD is associated with functional abnormalities in sensory and pain modulation, emotion, saliency, and homeostatic processing regions. The diversity of conditions, heterogeneous results, poorly standardized diagnoses of FD, and various comorbidities may be responsible for the variability in the results.
越来越多的证据表明，除了胃肠道的外周变化外，功能性消化不良（FD）还存在异常的中枢变化（与健康对照相比）。
本系统评价旨在全面了解FD患者大脑功能活动异常、内脏感觉、消化不良症状和心理变化。通过电子检索和手工检索，以识别涉及FD患者的功能性神经影像学研究。选取了16项研究并分为三类：10项静息态研究、3项内脏扩张研究和3项针灸研究。FD患者的几个脑区出现了变化，包括额叶皮质、躯体感觉皮质、岛叶、前扣带回皮质、丘脑、海马体和杏仁核。这些脑活动变化与内脏高敏感性、消化不良症状、较差的生活质量、焦虑和抑郁有关。结果表明，FD与感觉和疼痛调节、情绪、显著性和内稳态处理区域的功能异常有关。研究条件的多样性、结果的异质性、FD诊断标准不统一以及各种合并症可能是导致结果变异性的原因。
