Clinical–alimentary tractLongitudinal Change in Perceptual and Brain Activation Response to Visceral Stimuli in Irritable Bowel Syndrome Patients
Section snippets
Participants
Twenty IBS patients (6 male, 14 female; average age, 39.6 years; range, 23–55 years), recruited by advertisement, completed all 4 sensory testing sessions and were included in the longitudinal analysis. A total of 28 patients were recruited and finished the first session. After the first testing session, 5 patients dropped out, followed by 3 more after sessions 2 or 3. To be included in the investigation, patients were required on clinical examination by a gastroenterologist to meet Rome I
IBS Symptom Ratings
There were no significant changes in the mean values for self-rated IBS symptoms over the course of the 1-year study in either the total IBS sample (n = 20) or the PET subgroup (n = 12). Figure 1 shows the data for diary measures of symptom severity. Both samples had essentially unchanged symptoms over the 4 time points. There were no sex-related differences in these symptom reports in the total sample (14 females). Within-subject correlations for symptoms over the study year were also
Discussion
This study examined IBS symptoms, perceptual sensitivity to rectal distention, regional brain activation, and functional connectivity within distinct brain circuits longitudinally across multiple sessions of visceral stimulation over a 12-month period and compared these responses with healthy control subjects. It was aimed at evaluating the role of hypervigilance and underlying brain circuit activation in the visceral hypersensitivity of IBS patients. Although self-reported symptom severity and
Limitations and Conclusions
Several limitations of the current methodology should be mentioned. First, this study examined a heterogeneous sample of IBS patients including male and female patients with different predominant bowel habits. However, the fact that male and female patients showed nearly identical time courses of habituation of perceptual and emotional responses to the rectal stimulus over the 12-month period strongly suggests that the observed changes in brain activation are not a sex-related phenomenon.
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Supported by NIH grants NR04881, P50 DK64539, R24 AT002681, and DK 48351 and funds from AstraZeneca R&D, Moelndal, Sweden.