Clinical—Alimentary TractQuantitative Meta-analysis Identifies Brain Regions Activated During Rectal Distension in Irritable Bowel Syndrome
Section snippets
Inclusionary/Exclusionary Criteria
Studies were included in the meta-analysis if the experimental design included supraliminal rectal balloon distension in male and/or female IBS subjects or controls. Supraliminal rectal distension in this setting includes both painful and nonpainful stimuli. The analysis included both functional magnetic resonance imaging and positron emission tomography studies. Foci were extracted from the results of within-group analyses. Only activated foci were considered for analysis because deactivations
Studies Meeting Inclusionary Criteria
Eighteen studies4, 7, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37 yielded tabulated coordinates for 13 inflation contrasts in IBS subjects and 12 inflation contrasts for control subjects (detailed in Table 1). The ALE analysis of IBS subjects incorporated 161 foci and the control subject analysis used 147 foci.
Brain Regions Associated With Lower Gastrointestinal Stimulation in Healthy Control Subjects
The within-group analysis for control subjects is presented in Table 2 and Figure 1. Regions consistently activated in response to supraliminal lower gastrointestinal
Discussion
The current ALE meta-analysis of supraliminal rectal inflation confirms the involvement of brain regions involved in visceral sensation, emotion arousal, and attentional processes in both controls and IBS. Furthermore, the use of ALE techniques has allowed extension of these within-group analyses to an IBS vs controls comparison showing group differences, particularly that IBS patients reliably engage known emotional arousal circuitry (amygdala, pACC), but healthy control subjects did not … The
Limitations
This meta-analysis was limited by the availability of within-group activation analyses from several previously published studies of lower gastrointestinal stimulation. However, it remains the only analysis of its kind in lower gastrointestinal distension and this quantitative meta-analytic approach significantly improves on the previously published systematic reviews. The individual studies analyzed included a variety of different stimulation paradigms and protocols, so by its nature this
References (61)
- et al.
Regional cerebral activation in irritable bowel syndrome and control subjects with painful and nonpainful rectal distention
Gastroenterology
(2000) - et al.
Effect of abuse history on pain reports and brain responses to aversive visceral stimulation: an FMRI study
Gastroenterology
(2008) - et al.
Alterations of brain activity associated with resolution of emotional distress and pain in a case of severe irritable bowel syndrome
Gastroenterology
(2003) - et al.
Brain networks underlying perceptual habituation to repeated aversive visceral stimuli in patients with irritable bowel syndrome
Neuroimage
(2009) - et al.
Sex differences in brain activity during aversive visceral stimulation and its expectation in patients with chronic abdominal pain: a network analysis
Neuroimage
(2008) - et al.
Brain imaging of visceral functions in healthy volunteers and IBS patients
J Psychosom Res
(2008) - et al.
Meta-analysis of the functional neuroanatomy of single-word reading: method and validation
Neuroimage
(2002) - et al.
Valid conjunction inference with the minimum statistic
Neuroimage
(2005) - et al.
Gender differences in regional brain response to visceral pressure in IBS patients
Eur J Pain
(2000) - et al.
Central processing of rectal pain in patients with irritable bowel syndrome: an fMRI study
Am J Gastroenterol
(2002)
Cerebral activation during anal and rectal stimulation
Neuroimage
Anatomical connections between brain areas activated during rectal distension in healthy volunteers: a visceral pain network
Eur J Pain
Sex-related differences in IBS patients: central processing of visceral stimuli
Gastroenterology
Longitudinal change in perceptual and brain activation response to visceral stimuli in irritable bowel syndrome patients
Gastroenterology
Placebo analgesia is accompanied by large reductions in pain-related brain activity in irritable bowel syndrome patients
Pain
Cortical effects of anticipation and endogenous modulation of visceral pain assessed by functional brain MRI in irritable bowel syndrome patients and healthy controls
Pain
Central representation of visceral and cutaneous hypersensitivity in the irritable bowel syndrome
Pain
Neuroimaging of the brain-gut axis: from basic understanding to treatment of functional GI disorders
Gastroenterology
Touch or pain?Spatio-temporal patterns of cortical fMRI activity following brief mechanical stimuli
Pain
A validated network of effective amygdala connectivity
Neuroimage
The activation of attentional networks
Neuroimage
Limbic and sensory connections of the inferior parietal lobule (area PG) in the rhesus monkey: a study with a new method for horseradish peroxidase histochemistry
Brain Res
Contributions of the amygdala to emotion processing: from animal models to human behavior
Neuron
Differences in brain responses to visceral pain between patients with irritable bowel syndrome and ulcerative colitis
Pain
Putative nociceptive modulatory neurons in the dorsolateral pontomesencephalic reticular formation
Brain Res
Pain modulation: expectation, opioid analgesia and virtual pain
Prog Brain Res
For better or for worse: neural systems supporting the cognitive down- and up-regulation of negative emotion
Neuroimage
Rome III: new standard for functional gastrointestinal disorders
J Gastrointestin Liver Dis
Stress and irritable bowel syndrome
Am J Physiol Gastrointest Liver Physiol
Brain functional magnetic resonance imaging of rectal pain and activation of endogenous inhibitory mechanisms in irritable bowel syndrome patient subgroups and healthy controls
Gut
Cited by (0)
Conflicts of interest The authors disclose no conflicts.
Funding Grant support: NIH K23 DK073451 (K.T.); NIH K08 DK 071626 (J.S.L.); NIH R24 AT 00268; NIH DK 48351, NIH P50 DK 64530 (E.A.M.).