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Sex-related differences in IBS patients: Central processing of visceral stimuli
      07/14/03 02:40 PM

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Gastroenterology June 2003 • Volume 124 • Number 7

Sex-related differences in IBS patients: Central processing of visceral stimuli

Bruce D. Naliboff*,‡ * [MEDLINE LOOKUP]
Steve Berman*,‡,§ [MEDLINE LOOKUP]
Lin Chang*, § [MEDLINE LOOKUP]
Stuart W.G. Derbyshire* [MEDLINE LOOKUP]
Brandall Suyenobu*,‡ [MEDLINE LOOKUP]
Brent A. Vogt'' [MEDLINE LOOKUP]
Mark Mandelkern¶ [MEDLINE LOOKUP]
Emeran A. Mayer*,‡,§,¶,# [MEDLINE LOOKUP]


Background & Aims: Women have a higher prevalence of irritable bowel syndrome (IBS) and possible differences in response to treatment, suggesting sex-related differences in underlying pathophysiology. The aim of this study was to determine possible sex-related differences in brain responses to a visceral and a psychological stressor in IBS.

Methods: Regional cerebral blood flow measurements using H215O positron emission tomography were compared across 23 female and 19 male nonconstipated patients with IBS during a visceral stimulus (moderate rectal inflation) and a psychological stimulus (anticipation of a visceral stimulus).

Results: In response to the visceral stimulus, women showed greater activation in the ventromedial prefrontal cortex, right anterior cingulate cortex, and left amygdala, whereas men showed greater activation of the right dorsolateral prefrontal cortex, insula, and dorsal pons/periaqueductal gray. Similar differences were observed during the anticipation condition. Men also reported higher arousal and lower fatigue.

Conclusions: Male and female patients with IBS differ in activation of brain networks concerned with cognitive, autonomic, and antinociceptive responses to delivered and anticipated aversive visceral stimuli.

Publishing and Reprint Information

*Center for Neurovisceral Sciences and Women's Health UCLA School of Medicine, Los Angeles, California, USA
§Department of Medicine, UCLA School of Medicine, Los Angeles, California, USA
‡Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, California, USA
#Department of Physiology, UCLA School of Medicine, Los Angeles, California, USA
''Brain Research Institute, UCLA School of Medicine, and VA GLAHS PET Center, Los Angeles, California, USA
''Cingulum NeuroSciences Institute, Syracuse, New York, USA

Supported by National Institutes of Health grants NR 04881 (to B.D.N.), DK 64539 (to E.A.M.), and AR 46122 (to L.C.). Lin Chang received research support from Astra Zeneca, participates in the Speaker's Bureau for GSK and Novartis, and is on the Advisory Board for GSK and Merck. Dr. Derbyshire's current address is: University of Pittsburgh Medical Center, MR Research Facility, PUH B-804, Pittsburgh, Pennsylvania 15213.

*Address requests for reprints to: Bruce D. Naliboff, Ph.D., GLAVAHS, CURE Building, 115/Room 223, 11301 Wilshire Boulevard, Los Angeles, California 90073, USA; fax: (310) 794-2864; Email:

Submitted June 18, 2002.

Accepted on February 27, 2003.

Copyright © 2003 by American Gastroenterological Association


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