Cerebral processing of auditory stimuli in patients with irritable bowel syndrome.
OBJECTIVE
To determine by brain functional magnetic resonance imaging (fMRI) whether cerebral processing of non-visceral stimuli is altered in irritable bowel syndrome (IBS) patients compared with healthy subjects. To circumvent spinal viscerosomatic convergence mechanisms, we used auditory stimulation, and to identify a possible influence of psychological factors the stimuli differed in their emotional quality.


METHODS
In 8 IBS patients and 8 controls, fMRI measurements were performed using a block design of 4 auditory stimuli of different emotional quality (pleasant sounds of chimes, unpleasant peep (2000 Hz), neutral words, and emotional words). A gradient echo T2*-weighted sequence was used for the functional scans. Statistical maps were constructed using the general linear model.


RESULTS
To emotional auditory stimuli, IBS patients relative to controls responded with stronger deactivations in a greater variety of emotional processing regions, while the response patterns, unlike in controls, did not differentiate between distressing or pleasant sounds. To neutral auditory stimuli, by contrast, only IBS patients responded with large significant activations.


CONCLUSIONS
Altered cerebral response patterns to auditory stimuli in emotional stimulus-processing regions suggest that altered sensory processing in IBS may not be specific for visceral sensation, but might reflect generalized changes in emotional sensitivity and affective reactivity, possibly associated with the psychological comorbidity often found in IBS patients.
Andresen
Viola
V
Department of Medicine, Division of Hepatology, Gastroenterology, and Endocrinology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
Poellinger
Alexander
A
Tsrouya
Chedwa
C
Bach
Dominik
D
Stroh
Albrecht
A
Foerschler
Annette
A
Georgiewa
Petra
P
Schmidtmann
Marco
M
van der Voort
Ivo R
IR
Kobelt
Peter
P
Zimmer
Claus
C
Wiedenmann
Bertram
B
Klapp
Burghard F
BF
Monnikes
Hubert
H
D000161:Acoustic Stimulation / Q000523:psychology; D000328:Adult; D001303:Auditory Cortex / Q000473:pathology* / Q000502:physiology*; D001306:Auditory Pathways / Q000502:physiology*; D001307:Auditory Perception / Q000502:physiology; D016022:Case-Control Studies; D015897:Comorbidity; D004644:Emotions / Q000502:physiology; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011597:Psychomotor Performance / Q000502:physiology