Neuronal correlates of gastric pain induced by fundus distension: a 3T‐fMRI study

Visceral hypersensitivity in gastric fundus is a possible pathogenesis for functional dyspepsia. The cortical representation of gastric fundus is still unclear. Growing evidence shows that the insula, but not the primary or secondary somatosensory region (SI or SII), may be the cortical target for v...

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Published in:Neurogastroenterology and motility 2004-10, Vol.16 (5), p.575-587
Main Authors: Lu, C.‐L., Wu, Y.‐T., Yeh, T.‐C., Chen, L.‐F., Chang, F.‐Y., Lee, S.‐D., Ho, L.‐T., Hsieh, J.‐C.
Format: Article
Language:English
Subjects:
Abdominal Pain - physiopathology
Adult
Amygdala - physiology
Brain - physiology
Brain Mapping
Female
fMRI
functional dyspepsia
gastric fundus
Gastric Fundus - innervation
Gastric Fundus - physiopathology
Humans
Magnetic Resonance Imaging
Male
Neurons - physiology
Pressure
visceral pain
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Summary:Visceral hypersensitivity in gastric fundus is a possible pathogenesis for functional dyspepsia. The cortical representation of gastric fundus is still unclear. Growing evidence shows that the insula, but not the primary or secondary somatosensory region (SI or SII), may be the cortical target for visceral pain. Animal studies have also demonstrated that amygdala plays an important role in processing visceral pain. We used fMRI to study central projection of stomach pain from fundus balloon distension. We also tested the hypothesis that there will be neither S1 nor S2 activation, but amygdala activation with the fundus distension. A 3T‐fMRI was performed on 10 healthy subjects during baseline, fullness (12.7 ± 0.6 mmHg) and moderate gastric pain (17.0 ± 0.8 mmHg). fMRI signal was modelled by convolving the predetermined psychophysical response. Statistical comparisons were performed between conditions on a group level. Gastric pain activated a wide range of cortical and subcortical structures, including thalamus and insula, anterior and posterior cingulate cortices, basal ganglia, caudate nuclei, amygdala, brain stem, cerebellum and prefrontal cortex (P 
ISSN:1350-1925
1365-2982
DOI:10.1111/j.1365-2982.2004.00562.x