title: Regional brain activation in response to rectal distension in patients with irritable bowel syndrome and the effect of a history of abuse.
abstract: Previous studies have demonstrated alterations in brain response to rectal distension in patients with irritable bowel syndrome (IBS) compared to controls. Our aim was to compare regional brain activity in response to rectal balloon distension in patients with IBS and healthy controls. We studied six patients with IBS and six healthy controls. Positron emission tomography scans were obtained during rectal balloon distensions. Statistical parametric mapping and region of interest analysis were performed to identify and compare differences in regional cerebral blood flow (CBF) for each distension pressure within and between the groups of interest. In post-hoc analyses, patients with a history of sexual or physical abuse were compared to patients without abuse. In response to rectal distension, controls exhibit a greater increase in anterior cingulate cortex (ACC) activity compared to the IBS group (Z = 3.2, P = 0.001). Thalamic activity was higher in the IBS patients relative to the control group (Z = 3.3, P < 0.001). Increased ACC activity was observed in IBS patients with no history of abuse (Z = 5.2, P < 0.001) similar to controls, whereas no such increased activity was noticed in the abused group. In conclusion, this study replicates previous findings showing alterations in brain response to rectal distension in patients with IBS. The observations on the effect of abuse suggest a possible modulating role of abuse history on this brain response.
authors.affiliation: UNC Center for Functional GI and Motility Disorders, University of North Carolina, Department of Medicine, Chapel Hill, North Carolina 27599-7080, USA.
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Ringel
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Drossman
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Turkington
authors.forename: Barbara
authors.initials: B
authors.lastname: Bradshaw
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Hawk
authors.forename: Shrikant
authors.initials: S
authors.lastname: Bangdiwala
authors.forename: R Edward
authors.initials: RE
authors.lastname: Coleman
authors.forename: William E
authors.initials: WE
authors.lastname: Whitehead
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging*; D001931:Brain Mapping; D002560:Cerebrovascular Circulation / Q000502:physiology; D003109:Colonic Diseases, Functional / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology*; D017288:Pain Threshold / Q000502:physiology; D012007:Rectum / Q000503:physiopathology; D012677:Sensation / Q000502:physiology; D014055:Tomography, Emission-Computed