Brain networks underlying perceptual habituation to repeated aversive visceral stimuli in patients with irritable bowel syndrome.

TitleBrain networks underlying perceptual habituation to repeated aversive visceral stimuli in patients with irritable bowel syndrome.
Publication TypeJournal Article
Year of Publication2009
AuthorsLabus, JS, Naliboff BD, Berman SM, Suyenobu B, Vianna EP, Tillisch K, Mayer EA
JournalNeuroImage
Volume47
Issue3
Pagination952-60
Date Published2009 Sep
ISSN1095-9572
KeywordsAttention, Brain, Brain Mapping, Colon, Female, Habituation, Psychophysiologic, Humans, Irritable Bowel Syndrome, Male, Manometry, Nerve Net, Pain, Pain Threshold, Physical Stimulation, Positron-Emission Tomography
Abstract

Patients with irritable bowel syndrome (IBS) show decreased discomfort and pain thresholds to visceral stimuli, as well hypervigilance to gastrointestinal sensations, symptoms, and the context in which these visceral sensations and symptoms occur. Previous research demonstrated normalization of visceral hypersensitivity following repeated exposure to experimental rectal stimuli over a 12-month period that was associated with reduction in cortical regions functionally associated with attention and arousal. Building upon these functional analyses, multivariate functional and effective connectivity analyses were applied to [(15)O] water positron emission tomography (PET) data from 12 IBS patients (male=4) participating in a PET study before and after 4 visceral sensory testing sessions involving rectal balloon distensions over a 1-year period. First, behavioral partial least squares was applied to test for networks related to reduced subjective ratings observed following repeated application of an aversive rectal stimulus. Next, path analysis within a structural equation modeling framework tested the hypothesis that perceptual habituation to the repeated visceral stimuli resulted in part from the reduced connectivity within a selective attention to threat network over time. Two independent, perception-related networks comprised of interoceptive, attentional and arousal regions were engaged differentially during expectation and distension. In addition, changes in the effective connectivity of an attentional network as well as modulatory amygdala influence suggested that perceptual habituation associated with repeated stimulus delivery results both in an increase in top-down modulation of attentional circuits, as well as in a reduction of amygdala-related interference with attentional mechanisms.

Alternate JournalNeuroimage