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Cortical deactivations during gastric fundus distension in health: visceral pain-specific response or attenuation of ‘default mode’ brain function? A H215O-PET study

Authors

  • L. Van Oudenhove,

    1. Department of Neurosciences, Psychiatry Division, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
    2. Department of Pathophysiology, Gastroenterology Division, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
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  • J. Vandenberghe,

    1. Department of Neurosciences, Psychiatry Division, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
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  • P. Dupont,

    1. Division of Nuclear Medicine, Department of Medical Diagnostic Sciences, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
    2. Department of Neurosciences, Division of Experimental Neurology, Laboratory for Cognitive Neurology, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
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  • B. Geeraerts,

    1. Department of Pathophysiology, Gastroenterology Division, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
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  • R. Vos,

    1. Department of Pathophysiology, Gastroenterology Division, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
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  • G. Bormans,

    1. Faculty of Pharmaceutical Sciences, Laboratory for Radiopharmacy, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
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  • K. Van Laere,

    1. Division of Nuclear Medicine, Department of Medical Diagnostic Sciences, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
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  • B. Fischler,

    1. Department of Neurosciences, Psychiatry Division, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
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  • K. Demyttenaere,

    1. Department of Neurosciences, Psychiatry Division, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
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  • J. Janssens,

    1. Department of Pathophysiology, Gastroenterology Division, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
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  • J. Tack

    1. Department of Pathophysiology, Gastroenterology Division, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
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Dr Lukas Van Oudenhove, Secretary of Liaison Psychiatry, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium.
Tel: +32 16 348745; fax: +32 16 348700; e-mail: lukas.vanoudenhove@med.kuleuven.be

Abstract

Abstract  Gastric distension activates a cerebral network including brainstem, thalamus, insula, perigenual anterior cingulate, cerebellum, ventrolateral prefrontal cortex and potentially somatosensory regions. Cortical deactivations during gastric distension have hardly been reported. To describe brain areas of decreased activity during gastric fundus distension compared to baseline, using data from our previously published study (Gastroenterology, 128, 2005 and 564). H215O-brain positron emission tomography was performed in 11 healthy volunteers during five conditions (random order): (C1) no distension (baseline); isobaric distension to individual thresholds for (C2) first, (C3) marked, (C4) unpleasant sensation and (C5) sham distension. Subtraction analyses were performed (in SPM2) to determine deactivated areas during distension compared to baseline, with a threshold of Puncorrected_voxel_level < 0.001 and Pcorrected_cluster_level < 0.05. Baseline–maximal distension (C1–C4) yielded significant deactivations in: (i) bilateral occipital, lateral parietal and temporal cortex as well as medial parietal lobe (posterior cingulate and precuneus) and medial temporal lobe (hippocampus and amygdala), (ii) right dorsolateral and dorso- and ventromedial PFC, (iii) left subgenual ACC and bilateral caudate head. Intragastric pressure and epigastric sensation score correlated negatively with brain activity in similar regions. The right hippocampus/amygdala deactivation was specific to sham. Gastric fundus distension in health is associated with extensive cortical deactivations, besides the activations described before. Whether this represents task-independent suspension of ‘default mode’ activity (as described in various cognitive tasks) or an visceral pain/interoception-specific process remains to be elucidated.

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