Quantitative Meta-analysis Identifies Brain Regions Activated During Rectal Distension in Irritable Bowel Syndrome
Open accessAbstract
Background and aims The responsiveness of the central nervous system is altered in patients with irritable bowel syndrome (IBS). However, because of variations in experimental paradigms, analytic techniques, and reporting practices, little consensus exists on brain responses to visceral stimulation. We aimed to identify brain regions consistently activated by supraliminal rectal stimulation in IBS patients and healthy subjects (controls) by performing a quantitative meta-analysis of published studies. Methods Significant foci from within-group statistical parametric maps were extracted from published neuroimaging studies that employed rectal distension. Voxel-based activation likelihood estimation was applied, pooling the results and comparing them across groups. Results Across studies, there was consistent activation in regions associated with visceral afferent processing (ie, thalamus, insula, anterior midcingulate) among IBS patients and controls, but considerable differences in the extent and specific location of foci. IBS patients differed from controls in that there were more consistent activations in regions associated with emotional arousal (pregenual anterior cingulate cortex, amygdala) and activation of a midbrain cluster, a region playing a role in endogenous pain modulation. Controls showed more consistent activation of the medial and lateral prefrontal cortex. Conclusions Patients with IBS have greater engagement of regions associated with emotional arousal and endogenous pain modulation, but similar activation of regions involved in processing of visceral afferent information. Controls have greater engagement of cognitive modulatory regions. These results support a role for central nervous system dysregulation in IBS. These findings provide specific targets for guiding development of future neuroimaging protocols to more clearly define altered brain-gut interactions in IBS.
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Disordered motility in IBS is manifested by abnormal colonic myoelectric activity, repetitive contractions of the small intestine and colon, associated with abdominal pain, and alterations in gastrointestinal or colonic transit.
“Disordered motility in IBS is manifested by abnormal colonic myoelectric activity, 28 repetitive contractions of the small intestine and colon, associated with abdominal pain, and alterations in gastrointestinal or colonic transit. 29,30”
From Irritable bowel syndrome (2020) · cites this paper as [30]
The Introduction (page not available in our copy) describes IBS as involving chronic abdominal pain and altered bowel habits. It does not establish the claimed abnormal myoelectric activity, repetitive intestinal contractions, or changes in gastrointestinal or colonic transit; the paper focuses on brain responses to rectal distension. (LLM, conf=0.79)
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- Authors
- Tillisch, K., Mayer, E. A., & Labus, J. S.
- Affiliations
- University of California, Los Angeles (US)
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2011-01
- Volume
- 140
- Issue
- 1
- Pages
- 91-100
- ISSN
- 0016-5085 (ISSN-L)
- PMC
- PMC3253553
- OpenAlex
- W2064638321
- Cited by
- 412
- References
- 65
- Citations by year
- 2026: 14 · 2025: 14 · 2024: 15 · 2023: 21 · 2022: 30 · 2021: 29 · 2020: 25 · 2019: 30 · 2018: 25 · 2017: 27 · 2016: 28 · 2015: 39 · 2014: 41 · 2013: 29 · 2012: 23
- FWCI
- 3.62
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (DK 64530, K08 DK, AT 00268, NIH P50, DK 48351)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK-48351, K08DK071626, R01DK048351, K23DK073451, P50DK064539, P50 DK 64530)
- National Center for Complementary and Integrative Health (R24AT002681, R24 AT00268)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Health Professions › Pharmacy › Infant Health and Development
- Keywords
- irritable bowel syndrome, rectal distension, brain-gut interaction, visceral pain, emotional arousal, endogenous pain modulation, prefrontal cortex, amygdala, anterior cingulate cortex, thalamus, insula, neuroimaging
- MeSH terms
- Brain, Brain Mapping, Female, Humans, Male, Pain, Rectum, Models, Statistical, Irritable Bowel Syndrome
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