Understanding gut–brain interactions in gastrointestinal pain by neuroimaging: lessons from somatic pain studies


  • L. Van Oudenhove

    1. Department of Pathophysiology, Translational Research Center for Gastrointestinal Disorders (TARGID) and University Psychiatric Centre, Liaison Psychiatry, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
    Search for more papers by this author

Address for Correspondence Dr. Lukas Van Oudenhove, Department of Pathophysiology, Translational Research Center for Gastrointestinal Disorders (TARGID), UZ Gasthuisberg, O&N I, bus 701, Herestraat, 49, B-3000 Leuven, Belgium.
Tel: +32 16 330858; fax: +32 16 345939;
e-mail: lukas.vanoudenhove@med.kuleuven.be


Background  Neuroimaging research on gut–brain interactions has greatly improved our understanding of the brain mechanisms involved in processing and perceiving visceral pain in health and functional gastrointestinal disorders (FGID). However, discrepancies in the results of these studies continue to exist, which is at least partially due to the fact that important factors contributing to the intrinsic heterogeneity of symptom-based FGID, including psychological processes and psychiatric comorbidity, are insufficiently integrated in visceral pain neuroimaging research.

Purpose  This review will defend the thesis that, to increase our understanding of the heterogeneous etiopathogenesis of FGID, visceral pain neuroimaging studies need to be integrated with: (i) epidemiological and behavioral evidence on the influence of psychological processes on visceral pain in health and FGID, and (ii) methodology and evidence from affective, cognitive, and psychiatric neuroimaging studies. To illustrate this point, the somatic pain neuroimaging field will be taken as an example before giving an overview of novel and integrative visceral pain studies in health and FGID. Some limitations of current pain neuroimaging studies will be outlined, before providing a summary of suggestions for moving the visceral pain neuroimaging field forward.