Clinical Research
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Mar 21, 2006; 12(11): 1723-1729
Published online Mar 21, 2006. doi: 10.3748/wjg.v12.i11.1723
Cerebral processing of auditory stimuli in patients with irritable bowel syndrome
Viola Andresen, Alexander Poellinger, Chedwa Tsrouya, Dominik Bach, Albrecht Stroh, Annette Foerschler, Petra Georgiewa, Marco Schmidtmann, Ivo R van der Voort, Peter Kobelt, Claus Zimmer, Bertram Wiedenmann, Burghard F Klapp, Hubert Monnikes
Viola Andresen, Petra Georgiewa, Marco Schmidtmann, Burghard F Klapp, Department of Medicine, Division of Psy-chosomatic Medicine and Psychotherapy, Charité-Universi-tätsmedizin Berlin, Berlin, Germany
Chedwa Tsrouya, Dominik Bach, Peter Kobelt, Bertram Wiedenmann, Hubert Monnikes, Ivo van der Voort, Department of Medicine, Division of Hepatology, Gastroenterology, and En-docrinology
Alexander Poellinger, Albrecht Stroh, Department of Radiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
Annette Foerschler, Department of Neuroradiology, University of Leipzig, Leipzig, Germany
Claus Zimmer, Department of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
Co-first-authors: Viola Andresen and Alexander Poellinger
Correspondence to: Hubert Mönnikes, MD, PhD, Department of Medicine, Division of Hepatology, Gastroenterology, and Endocrinology, Augustenburger Platz 1, 13353 Berlin, Germany.
Telephone: +49-30-450653391 Fax: +49-30-450553991
Received: October 15, 2005
Revised: October 21, 2005
Accepted: November 18, 2005
Published online: March 21, 2006

AIM: To determine by brain functional magnetic resonance imaging (fMRI) whether cerebral processing of non-visceral stimuli is altered in irritable bowel syndrome (IBS) patients compared with healthy subjects. To circumvent spinal viscerosomatic convergence mechanisms, we used auditory stimulation, and to identify a possible influence of psychological factors the stimuli differed in their emotional quality.

METHODS: In 8 IBS patients and 8 controls, fMRI measurements were performed using a block design of 4 auditory stimuli of different emotional quality (pleasant sounds of chimes, unpleasant peep (2000 Hz), neutral words, and emotional words). A gradient echo T2*-weighted sequence was used for the functional scans. Statistical maps were constructed using the general

linear model.

RESULTS: To emotional auditory stimuli, IBS patients relative to controls responded with stronger deactivations in a greater variety of emotional processing regions, while the response patterns, unlike in controls, did not differentiate between distressing or pleasant sounds. To neutral auditory stimuli, by contrast, only IBS patients responded with large significant activations.

CONCLUSION: Altered cerebral response patterns to auditory stimuli in emotional stimulus-processing regions suggest that altered sensory processing in IBS may not be specific for visceral sensation, but might reflect

generalized changes in emotional sensitivity and affective reactivity, possibly associated with the psychological comorbidity often found in IBS patients.

Keywords: Visceral hypersensitivity, Irritable bowel syndrome, Brain processing, fMRI, Auditory stimulation, Emotion