title: Altered brain responses in subjects with irritable bowel syndrome during cued and uncued pain expectation.
abstract: BACKGROUND
  A majority of the subjects with irritable bowel syndrome (IBS) show increased behavioral and brain responses to expected and delivered aversive visceral stimuli during controlled rectal balloon distension, and during palpation of the sigmoid colon. We aimed to determine if altered brain responses to cued and uncued pain expectation are also seen in the context of a noxious somatic pain stimulus applied to the same dermatome as the sigmoid colon.
  
  
  METHODS
  A task-dependent functional magnetic resonance imaging technique was used to investigate the brain activity of 37 healthy controls (18 females) and 37 IBS subjects (21 females) during: (i) a cued expectation of an electric shock to the abdomen vs a cued safe condition; and (ii) an uncued cross-hair condition in which the threat is primarily based on context vs a cued safe condition.
  
  
  RESULTS
  Regions within the salience, attention, default mode, and emotional arousal networks were more activated by the cued abdominal threat condition and the uncued condition than in the cued safe condition. During the uncued condition contrasted to the cued safe condition, IBS subjects (compared to healthy control subjects) showed greater brain activations in the affective (amygdala, anterior insula) and attentional (middle frontal gyrus) regions, and in the thalamus and precuneus. These disease-related differences were primarily seen in female subjects.
  
  
  CONCLUSIONS
  The observed greater engagement of cognitive and emotional brain networks in IBS subjects during contextual threat may reflect the propensity of IBS subjects to overestimate the likelihood and severity of future abdominal pain.
authors.affiliation: Oppenheimer Center for Neurobiology of Stress, University of California, Los Angeles, CA, USA.|Department of Medicine, University of California, Los Angeles, CA, USA.|Department of Bioengineering, University of California, Los Angeles, CA, USA.
authors.forename: J-Y
authors.initials: JY
authors.lastname: Hong
authors.affiliation: Oppenheimer Center for Neurobiology of Stress, University of California, Los Angeles, CA, USA.|Department of Medicine, University of California, Los Angeles, CA, USA.|Pain and Interoception Imaging Network (PAIN), University of California, Los Angeles, CA, USA.|Brain Research Institute, University of California, Los Angeles, CA, USA.
authors.forename: B
authors.initials: B
authors.lastname: Naliboff
authors.affiliation: Oppenheimer Center for Neurobiology of Stress, University of California, Los Angeles, CA, USA.|Department of Medicine, University of California, Los Angeles, CA, USA.|Pain and Interoception Imaging Network (PAIN), University of California, Los Angeles, CA, USA.|Brain Research Institute, University of California, Los Angeles, CA, USA.
authors.forename: J S
authors.initials: JS
authors.lastname: Labus
authors.affiliation: Oppenheimer Center for Neurobiology of Stress, University of California, Los Angeles, CA, USA.|Department of Medicine, University of California, Los Angeles, CA, USA.
authors.forename: A
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Oppenheimer Center for Neurobiology of Stress, University of California, Los Angeles, CA, USA.|Department of Medicine, University of California, Los Angeles, CA, USA.|Pain and Interoception Imaging Network (PAIN), University of California, Los Angeles, CA, USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Kilpatrick
authors.affiliation: Oppenheimer Center for Neurobiology of Stress, University of California, Los Angeles, CA, USA.|Department of Medicine, University of California, Los Angeles, CA, USA.|Pain and Interoception Imaging Network (PAIN), University of California, Los Angeles, CA, USA.
authors.forename: C
authors.initials: C
authors.lastname: Ashe-McNalley
authors.affiliation: Oppenheimer Center for Neurobiology of Stress, University of California, Los Angeles, CA, USA.|Department of Medicine, University of California, Los Angeles, CA, USA.
authors.forename: J
authors.initials: J
authors.lastname: Stains
authors.affiliation: Oppenheimer Center for Neurobiology of Stress, University of California, Los Angeles, CA, USA.|Department of Medicine, University of California, Los Angeles, CA, USA.
authors.forename: N
authors.initials: N
authors.lastname: Heendeniya
authors.affiliation: Oppenheimer Center for Neurobiology of Stress, University of California, Los Angeles, CA, USA.|Department of Medicine, University of California, Los Angeles, CA, USA.
authors.forename: S R
authors.initials: SR
authors.lastname: Smith
authors.affiliation: Oppenheimer Center for Neurobiology of Stress, University of California, Los Angeles, CA, USA.|Department of Medicine, University of California, Los Angeles, CA, USA.|Pain and Interoception Imaging Network (PAIN), University of California, Los Angeles, CA, USA.
authors.forename: K
authors.initials: K
authors.lastname: Tillisch
authors.affiliation: Oppenheimer Center for Neurobiology of Stress, University of California, Los Angeles, CA, USA.|Department of Medicine, University of California, Los Angeles, CA, USA.|Pain and Interoception Imaging Network (PAIN), University of California, Los Angeles, CA, USA.|Brain Research Institute, University of California, Los Angeles, CA, USA.|Department of Psychiatry, University of California, Los Angeles, CA, USA.|Ahmanson Lovelace Brain Mapping Center, University of California, Los Angeles, CA, USA.
authors.forename: E A
authors.initials: EA
authors.lastname: Mayer
mesh_terms: D015746:Abdominal Pain / Q000503:physiopathology*; D000328:Adult; D000679:Amygdala / Q000503:physiopathology; D059031:Anticipation, Psychological; D001921:Brain / Q000503:physiopathology*; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000503:physiopathology; D012809:Colon, Sigmoid; D003463:Cues; D004558:Electric Stimulation; D005260:Female; D059907:Functional Neuroimaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D043183:Irritable Bowel Syndrome / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology; D017288:Pain Threshold; D010296:Parietal Lobe / Q000503:physiopathology; D017397:Prefrontal Cortex / Q000503:physiopathology; D011312:Pressure; D012007:Rectum; D012737:Sex Factors; D013788:Thalamus / Q000503:physiopathology; D055815:Young Adult
keywords: contextual threat; functional magnetic resonance imaging; irritable bowel syndrome; pain expectations; sex differences