Affective Disturbances Modulate the Neural Processing of Visceral Pain Stimuli in Irritable Bowel Syndrome: An fMRI Study

Aim and methods: In N=15 female irritable bowel syndrome (IBS) patients and N=11 healthy women, we assessed the correlation of trait anxiety and depression, respectively, with the neural response to painful rectal distensions in women with irritable bowel syndrome (IBS) and healthy women. Trait anxiety and depression were assessed with the Hospital Anxiety and Depression Scale (HADS). Results: I.) Multiple regression analyses within the IBS group revealed that anxiety scores were significantly associated with pain-induced activation of the insular cortex (IC) and the anterior cingulate cortex (ACC). Depression scores were significantly correlated with pain-induced activation of the prefrontal cortex (PFC), somatosensory cortex (S1), and ACC. II.) Direct group comparisons with 2-sample t-tests revealed significant activation in the IBS versus controls contrast in the anterior IC, thalamus, S1, dorsal posterior cingulate cortex (dPCC), and PFC. Inclusion of anxiety scores in the 2-sample t-tests as a confounding variable led to a loss of significant group differences with the exception of anterior IC activation. Inclusion of depression scores revealed activation of the thalamus and dPCC, but a loss of activation in other previously detected areas, i.e., IC, S1, PFC. Conclusions: These findings support previous evidence of altered central processing of visceral stimuli in IBS, and suggest that these may at least in part be mediated by affective disturbances.

Angst - Depression - Reizdarmsyndrom - fMRT - viszeraler Schmerz