Gastroenterology

Gastroenterology

Volume 131, Issue 6, December 2006, Pages 1925-1942
Gastroenterology

Review in basic and clinical gastroenterology
Neuroimaging of the Brain-Gut Axis: From Basic Understanding to Treatment of Functional GI Disorders

https://doi.org/10.1053/j.gastro.2006.10.026Get rights and content

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Homeostatic Afferents

The term refers to small-diameter sensory afferent fibers terminating in lamina I of the spinal cord that innervate all of the tissues and organs of the body, including the viscera, skin, muscle, joint, and teeth. All of these fibers signal changes in the physiological condition of the body and provide the essential sensory input that is crucial for the autonomic responses that maintain homeostasis.1

Homeostatic Afferent Processing Network

The term refers to a brain network that is consistently activated in response to homeostatic

I. Introduction

Bidirectional brain-gut interactions play an important role in the regulation of many vital functions in health and disease. In health, brain-gut interactions play a crucial role in the regulation of digestive processes (including the regulation of food intake and bowel movements), in the modulation of the gut-associated immune system, and in the coordination of the overall physical and emotional state of the organism with digestive processes (reviewed in Mayer and Saper 20005). Altered

The Functional Neuroanatomy of Homeostatic Afferent Pathways

Small-diameter primary afferent fibers that report the physiological status of all of tissues (including nociceptors, thermoreceptors, osmoreceptors, and metaboreceptors) terminate monosynaptically on projection neurons in lamina I of the spinal dorsal horn. Developmentally, these small-diameter afferents originate from a second wave of small dorsal root ganglion cells that emerge subsequent to the large cells that generate mechanoreceptors and proprioceptors, and their projection into the

III. Clinical Aspects

Visceral pain and discomfort, including hunger, fullness, early satiety, nausea, bloating, or abdominal pain in humans is a subjective, conscious experience, that results from the modulation of homeostatic feelings by cognitive (attention, expectation), emotional (arousal, anxiety), and motivational factors, as well as memories of past experiences. Thus, the conscious experience is an image of the homeostatic state of the body represented in the insular cortex (Figure 1) and is further modified

Pharmacological interventions

Morgan et al reported an effect of low-dose amitriptyline treatment (compared with placebo) on rectal distention–induced brain activation combined with a psychological stressor using fMRI.126 Although the drug had no effect on symptoms, or distentions alone, decreased activation in the rostral ACC and the left posterior parietal cortex was observed during distention when associated with the psychological stressor. Berman et al reported a double-blind, randomized, placebo-controlled study in 49

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    • Cited by (0)

    Supported by NIH grants P50 DK64539 (to E.A.M.), R24 AT002681 (to E.A.M.), R01 DK48351 (to E.A.M.), R01 NR007768 (to B.D.N.), and R01 NS40413 (to A.D.C.).

    We are enthusiastic in the introduction of a new monthly review article series, entitled “Reviews in Basic and Clinical Gastroenterology.” Written by authorities in their respective fields, the objective of each review article is to provide an overview of a particular theme or topic for the broad scientific and clinical readership. Within a given topic, both basic and clinical aspects will be covered, accompanied by key figures and relevant references. The reader will also appreciate that topics will be interwoven from month to month as well. We hope you enjoy this section.—David C. Metz, MD, Wafik El-Deiry, MD, PhD, and Anil K. Rustgi, MD

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