Brain processing of esophageal sensation in health and disease.
This case study demonstrates that patients with NCCP can be subclassified on the basis of sensory responsiveness and neurophysiologic profiles. This approach identifies specific abnormalities within the CNS processing of esophageal sensation in individual patients, allowing us to objectively differentiate those with sensitized esophageal afferents from those that are hypervigilant to esophageal sensations. The importance of this approach is to underline that NCCP comprises a heterogeneous group of patients. and only when we have defined the phenotype of this condition and identified groups of patients with specific CNS abnormalities will it be possible to perform clinical studies aimed at answering specific hypotheses. The development of a comprehensive pathophysiologic model that identifies the specific causes of symptoms in patients with esophageal hypersensitivity will allow the future management strategies of these patients to be targeted more specifically and efficiently. This will have great benefits to patients'well-being and health care use.
Hobson
Anthony R
AR
Section of Gastrointestinal Sciences, University of Manchester, Hope Hospital, Eccles Old Road, Salford, M6 8HD, UK. ahobson@fs1.ho.man.ac.uk
Aziz
Qasim
Q
D002540:Cerebral Cortex / Q000502:physiology*; D002637:Chest Pain / Q000473:pathology / Q000503:physiopathology; D004594:Electrophysiology; D004947:Esophagus / Q000294:innervation* / Q000503:physiopathology; D006801:Humans; D006930:Hyperalgesia / Q000503:physiopathology; D008954:Models, Biological; D009475:Neurons, Afferent / Q000502:physiology; D013131:Spine / Q000294:innervation; D013787:Thalamic Nuclei / Q000502:physiology; D014630:Vagus Nerve / Q000502:physiology; D014781:Viscera / Q000502:physiology