Imaging brain mechanisms in chronic visceral pain

被引:93
作者
Mayer, Emeran A. [1 ,2 ,3 ,4 ,5 ]
Gupta, Arpana [1 ,2 ]
Kilpatrick, Lisa A. [1 ,2 ]
Hong, Jui-Yang [1 ,6 ]
机构
[1] Univ Calif Los Angeles, Oppenheimer Ctr Neurobiol Stress, Los Angeles, CA 90095 USA
[2] Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA
[3] Univ Calif Los Angeles, Dept Physiol, Los Angeles, CA 90095 USA
[4] Univ Calif Los Angeles, Dept Psychiat, Los Angeles, CA 90095 USA
[5] Univ Calif Los Angeles, CURE Digest Dis Res Ctr, Los Angeles, CA 90095 USA
[6] Univ Calif Los Angeles, Dept Bioengn, Los Angeles, CA 90095 USA
基金
美国国家卫生研究院;
关键词
Irritable bowel syndrome; Functional dyspepsia; Bladder pain syndrome; Interstitial-cystitis; Multimodal brain imaging; Brain networks; IRRITABLE-BOWEL-SYNDROME; DEFAULT MODE NETWORK; FUNCTIONAL DYSPEPSIA; RESTING-STATE; SEX-DIFFERENCES; CONNECTIVITY; RESPONSES; STIMULI; MODULATION; PLACEBO;
D O I
10.1097/j.pain.0000000000000106
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Chronic visceral pain syndromes are important clinical problems with largely unmet medical needs. Based on the common overlap with other chronic disorders of visceral or somatic pain, mood and affect, and their responsiveness to centrally targeted treatments, an important role of central nervous system in their pathophysiology is likely. A growing number of brain imaging studies in irritable bowel syndrome, functional dyspepsia, and bladder pain syndrome/interstitial cystitis has identified abnormalities in evoked brain responses, resting state activity, and connectivity, as well as in gray and white matter properties. Structural and functional alterations in brain regions of the salience, emotional arousal, and sensorimotor networks, as well as in prefrontal regions, are the most consistently reported findings. Some of these changes show moderate correlations with behavioral and clinical measures. Most recently, data-driven machine-learning approaches to larger data sets have been able to classify visceral pain syndromes from healthy control subjects. Future studies need to identify the mechanisms underlying the altered brain signatures of chronic visceral pain and identify targets for therapeutic interventions.
引用
收藏
页码:S50 / S63
页数:14
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