Aziz Q, Andersson J L, Valind S, Sundin A, Hamdy S, Jones A K, Foster E R, Långström B, Thompson D G
Department of Medicine, University of Manchester, England.
Gastroenterology. 1997 Jul;113(1):50-9. doi: 10.1016/s0016-5085(97)70079-9.
BACKGROUND & AIMS: Brain loci that process human esophageal sensation remain unidentified. The aim of this study was to identify the brain loci that process nonpainful and painful human esophageal sensation.
In 8 healthy subjects (7 men; age range, 24-47 years), distal esophageal stimulation was performed by repeatedly inflating a balloon at volumes that produced either no sensation, definite sensation, or pain. Two positron emission tomography scans were performed for each sensation using H2(15)O. Magnetic resonance brain scans were also performed in each subject, and the positron emission tomography data were coregistered with magnetic resonance scans. Analysis of covariance-corrected t images showing the contrasts definite sensation-baseline, pain-baseline, and pain-definite sensation were created.
Nonpainful stimulation elicited bilateral activations along the central sulcus, insular cortex, and frontal/parietal operculum (P < 0.01). Painful stimulation produced more intense activations of the same areas and additional activation of the right anterior insular cortex and the anterior cingulate gyrus. Multiple areas of decreased activation were also observed; prominent among these was the right prefrontal cortex, which was inhibited during both nonpainful and painful stimulation.
Esophageal sensation activates bilaterally the insula, primary somatosensory cortex, and operculum. The right anterior insular cortex and anterior cingulate gyrus process esophageal pain.
处理人类食管感觉的脑区尚未明确。本研究旨在确定处理人类食管无痛觉和痛觉的脑区。
对8名健康受试者（7名男性；年龄范围24 - 47岁）进行远端食管刺激，通过反复向气囊充气，产生无感觉、明确感觉或疼痛的不同状态。使用H2(15)O对每种感觉状态进行两次正电子发射断层扫描。对每位受试者还进行了磁共振脑部扫描，并将正电子发射断层扫描数据与磁共振扫描进行配准。创建了协方差校正t图像分析，显示明确感觉-基线、疼痛-基线以及疼痛-明确感觉的对比。
无痛刺激引起双侧沿中央沟、岛叶皮质和额/顶叶岛盖的激活（P < 0.01）。疼痛刺激在相同区域产生更强的激活，并额外激活右侧前岛叶皮质和前扣带回。还观察到多个激活减少的区域；其中突出的是右侧前额叶皮质，在无痛和疼痛刺激期间均受到抑制。
食管感觉双侧激活岛叶、初级躯体感觉皮质和岛盖。右侧前岛叶皮质和前扣带回处理食管疼痛。
