Accarino A M, Azpiroz F, Malagelada J R
Digestive System Research Unit, Hospital General Vall d'Hebron, Autonomous University of Barcelona, Spain.
Gastroenterology. 1997 Aug;113(2):415-22. doi: 10.1053/gast.1997.v113.pm9247458.
BACKGROUND & AIMS: Paying attention to the gut may magnify perception of abdominal symptoms, but the actual influence of attention by anticipatory knowledge and distraction on gut perception remains poorly defined. The aim of this study was to determine whether mental activity, attention vs. distraction, affects intestinal perception and whether mental effects are synergistic with other modulatory mechanisms.
Perception of 1-minute intestinal balloon distentions applied at 7-13-minute random intervals was measured in healthy subjects. First, distentions were tested during attention by anticipatory knowledge and during distraction (n = 8). Because somatic transcutaneous electrical nerve stimulation (TENS) reduces gut perception, distentions were then tested during attention alone, attention plus somatic TENS, and during distraction plus TENS (n = 8).
Perception of intestinal distentions was higher during attention than during distraction (3.3 +/- 0.2 vs. 2.9 +/- 0.1 [mean +/- SEM]; P < 0.05). The area of somatic projection was greater during attention (P < 0.05). Intestinal compliance and oral reflex relaxation remained unchanged. During application of somatic TENS, perception of intestinal distention was higher during attention than distraction (2.4 +/- 0.3 vs. 1.7 +/- 0.2; P < 0.05). However, TENS did not alter the perception score during attention.
Mental activity may modulate gut perception and overrides the effects of somatic TENS on gut perception.
关注肠道可能会放大对腹部症状的感知，但预期知识和分心对肠道感知的注意力实际影响仍不清楚。本研究的目的是确定心理活动（注意力与分心）是否会影响肠道感知，以及心理效应是否与其他调节机制协同作用。
在健康受试者中测量以7 - 13分钟随机间隔施加的1分钟肠道气囊扩张的感知。首先，在通过预期知识引起的注意力期间和分心期间测试扩张情况（n = 8）。由于躯体经皮电神经刺激（TENS）会降低肠道感知，随后在单独注意力、注意力加躯体TENS以及分心加TENS期间测试扩张情况（n = 8）。
注意力期间肠道扩张的感知高于分心期间（3.3±0.2对2.9±0.1[平均值±标准误]；P < 0.05）。注意力期间躯体投射面积更大（P < 0.05）。肠道顺应性和口腔反射松弛保持不变。在施加躯体TENS期间，注意力期间肠道扩张的感知高于分心期间（2.4±0.3对1.7±0.2；P < 0.05）。然而，TENS并未改变注意力期间的感知评分。
心理活动可能调节肠道感知，并超越躯体TENS对肠道感知的影响。
