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.
Department of Medicine, Division of Hepatology, Gastroenterology, and Endocrinology, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
Viola
V
Andresen
Alexander
A
Poellinger
Chedwa
C
Tsrouya
Dominik
D
Bach
Albrecht
A
Stroh
Annette
A
Foerschler
Petra
P
Georgiewa
Marco
M
Schmidtmann
Ivo R
IR
van der Voort
Peter
P
Kobelt
Claus
C
Zimmer
Bertram
B
Wiedenmann
Burghard F
BF
Klapp
Hubert
H
Monnikes
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