Functional brain imaging in irritable bowel syndrome with rectal balloon－distention by using fMRI

• Published in: World journal of gastroenterology : WJG 2003-06, Vol.9 (6), p.1356-1360
• Main Authors: Yuan, Yao-Zong, Tao, Ran-Jun, Xu, Bin, Sun, Jing, Chen, Ke-Min, Miao, Fei, Zhang, Zhong-Wei, Xu, Jia-Yu
• Format: Article
• Language: English
• Subjects: Adult; Catheterization; Cerebrovascular Circulation; Clinical Research; Colonic Diseases, Functional - diagnosis; Colonic Diseases, Functional - physiopathology; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Oxygen - blood; Rectum - physiopathology; 内脏超敏性; 直肠气囊膨胀刺激; 磁共振成像检查; 肠易激综合症
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v9.i6.1356

AIM: Irritable bowel syndrome (IBS) is characterized by abdominal pain and changes in stool habits. Visceral hypersensitivity is a key factor in the pathophysiology of IBS. The aim of this study was to examine the effect of rectal balloon-distention stimulus by blood oxygenation leveldependent functional magnetic resonance imaging (BOLD-fMRI) in visceral pain center and to compare bhe distribution,extent, and intensity of activated areas between IBS patients and normal controls.METHODS: Twenty-six patients with IBS and eleven normal controls were tested for rectal sensation, and the subjective pain intensity at 90 ml and 120 ml rectal balloon-distention was reported by using Visual Analogue Scale. Then, BOLD-fMRI was performed at 30 ml, 60 ml, 90 ml, and 120 ml rectal balloon-distention in all subjects.RESULTS: Rectal distention stimulation increased the activity of anterior cingulate cortex (35/37), insular cortex (37/37),prefrontal cortex (37/37), and thalamus (35/37) in most cases.At 120 ml of rectal balloon-distention, bhe activation area and percentage change in MR signal intensity of the regions of interest (ROI) at IC, PFC, and THAL were significantly greater in patients with IBS than that in controls. Score of pain sensation at 90 ml and 120 ml rectal balloon-distention was significantly higher in patients wibh IBS bhan bhat in controls.CONCLUSION: Using fMRI, some patients will IBS can be detected having visceral hypersensitivity in response tD painful rectal balloon-distention, fMRI is an objective brain imaging technique to measure the change in regional cerebral activation more precisely. In this study, IC and PFC of the IBS patientsw ere the major loci of the CNS processing of visceral perception.