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IBS Patients Show Greater Brain Response to Subliminal Gut Stimuli
      02/18/06 01:32 PM
HeatherAdministrator

Reged: 12/09/02
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IBS Patients Show Greater Brain Response to Subliminal Gut Stimuli

NEW YORK (Reuters Health) Feb 13 - A new study demonstrates that patients with irritable bowel syndrome (IBS) show greater sensitivity in their visceral sensory neural circuitry in response to subliminal stimuli than healthy controls.

Tests for visceral hypersensitivity in IBS have relied on perceived stimulus, Dr. Reza Shaker and colleagues from the Medical College of Wisconsin and Milwaukee write in the January issue of Gastroenterology. Given that subliminal stimuli have recently been shown to register in the cerebral cortex, they add, it is now possible to evaluate gut neurocircuitry without the effect of cognitive processes.

To test the hypothesis that IBS patients would show a greater response to subliminal stimuli of visceral neurocircuitry, the researchers evaluated fMRI activity in 10 IBS patients and 10 controls during rectal distension with a computerized, barostat-controlled device.

Study participants were evaluated at 10, 15 and 20 mm Hg. Threshold for perception was 21 mm Hg in IBS patients and 25 in controls. All IBS patients showed cerebral cortical activity several times greater in volume in response to the same level of pressure as age- and sex-matched controls.

The findings could be used to distinguish between neural and neurocognitive effects of IBS drugs, and also to stratify patients based on neural or neurocognitive abnormalities, the researchers write.

"The findings of this study also objectively show the existence of long-suspected neural hypersensitivity in IBS patients and as such help better dissect and define different pathophysiologic components that may exist in this patient group," they add.

Questions remain about whether changes in IBS patients' visceral perception and autonomic response may be caused by emotional and cognitive factors that alter central pain modulation, Drs. Bruce D. Naliboff and Emeran A. Mayer of the David Geffen School of Medicine at the University of California, Los Angeles, write in an accompanying editorial. Another question is whether visceral hypersensitivity is specific to IBS or appears in other types of functional disorders as well.

New, more sophisticated imaging and analysis techniques along with more specific study designs should help to answer these questions, the editorialists conclude.

Gastroenterology 2006;130:26-33,267-269.

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Reuters Health Information 2006. 2006 Reuters Ltd.


http://www.medscape.com/viewarticle/523558

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Heather is the Administrator of the IBS Message Boards. She is the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!

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