Liu P, Wang G, Liu Y, Zeng F, Lin D, Yang X, Liang F, Calhoun V D, Qin W
Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, China.
Engineering Research Center of Molecular and NeuroImaging, Ministry of Education, Xi'an, China.
Neurogastroenterol Motil. 2017 Aug;29(8). doi: 10.1111/nmo.13060. Epub 2017 Mar 24.
Functional dyspepsia (FD) is a common functional gastrointestinal disorder. Accumulating evidence suggests the crucial role of central nervous system in the development and maintenance of FD. In particular, periaqueductal gray (PAG) has demonstrated an important role in modulation of pain and emotion, which may be related to FD. However, the study of the PAG in FD is still limited. This study aimed to assess intrinsic connectivity of the PAG in FD patients.
Resting-state functional magnetic imaging (fMRI) data were collected from 66 FD patients and 42 healthy controls (HCs). Functional connectivity analysis was performed to investigate the PAG connectivity pattern differences between the patients and HCs. We then examined the relationships between functional connectivity within the PAG networks and FD symptoms.
Compared to HCs, patients had increased PAG connectivity with the insula, and decreased PAG connectivity with the orbitofrontal cortex (OFC), dorsolateral prefrontal cortex (dlPFC) and hippocampus/parahippocampus (HIPP/paraHIPP). There were positive correlations between disease duration and PAG connectivity with the putamen and supplementary motor area (SMA), and positive correlations between symptom severity and PAG connectivity with the insula. FD patients with high level of anxiety and depression had altered PAG connectivity with the anterior cingulate cortex (ACC), precuneus, dlPFC and caudate, compared to other patients.
CONCLUSIONS & INFERENCES: These findings indicate that abnormal intrinsic network of the PAG might be associated with abnormality of pain processing and disruption of emotion processing in FD patients. Our study further complements neuroimaging findings about FD.
功能性消化不良（FD）是一种常见的功能性胃肠疾病。越来越多的证据表明中枢神经系统在FD的发生和维持中起关键作用。特别是中脑导水管周围灰质（PAG）已被证明在疼痛和情绪调节中起重要作用，这可能与FD有关。然而，关于FD中PAG的研究仍然有限。本研究旨在评估FD患者中PAG的内在连接性。
收集了66例FD患者和42名健康对照者（HCs）的静息态功能磁共振成像（fMRI）数据。进行功能连接分析以研究患者与HCs之间PAG连接模式的差异。然后我们检查了PAG网络内的功能连接与FD症状之间的关系。
与HCs相比，患者与岛叶的PAG连接增加，与眶额皮质（OFC）、背外侧前额叶皮质（dlPFC）和海马/海马旁回（HIPP/paraHIPP）的PAG连接减少。病程与PAG与壳核和辅助运动区（SMA）的连接之间存在正相关，症状严重程度与PAG与岛叶的连接之间存在正相关。与其他患者相比，焦虑和抑郁水平高 的FD患者与前扣带回皮质（ACC）、楔前叶、dlPFC和尾状核的PAG连接发生改变。
这些发现表明PAG的异常内在网络可能与FD患者疼痛处理异常和情绪处理中断有关。我们的研究进一步补充了关于FD的神经影像学研究结果。
