Gastroenterology
Volume 139, Issue 1 , Pages 36-47, July 2010

Regional Brain Activity in Functional Dyspepsia: A H215O-PET Study on the Role of Gastric Sensitivity and Abuse History

  • Lukas Van Oudenhove

      Affiliations

    • Department of Neurosciences, Psychiatry Division, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
    • Department of Pathophysiology, Gastroenterology Division, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
    • Corresponding Author InformationReprint requests Address requests for reprints to: Lukas Van Oudenhove, MD, PhD, Centre for Gastroenterological Research, University Hospital Gasthuisberg, O&N I, bus 701 Herestraat, 49, B-3000 Leuven, Belgium. fax: (016) 345939
    • ,
  • Joris Vandenberghe

      Affiliations

    • Department of Neurosciences, Psychiatry Division, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
    • ,
  • Patrick Dupont

      Affiliations

    • Department of Neurosciences, Experimental Neurology Division, Laboratory for Cognitive Neurology, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
    • Medical Imaging Research Center, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
    • ,
  • Brecht Geeraerts

      Affiliations

    • Department of Pathophysiology, Gastroenterology Division, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
    • ,
  • Rita Vos

      Affiliations

    • Department of Pathophysiology, Gastroenterology Division, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
    • ,
  • Stijn Dirix

      Affiliations

    • Department of Medical Diagnostic Sciences, Nuclear Medicine Division, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
    • ,
  • Koen Van Laere

      Affiliations

    • Department of Medical Diagnostic Sciences, Nuclear Medicine Division, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
    • ,
  • Guy Bormans

      Affiliations

    • Faculty of Pharmaceutical Sciences, Laboratory for Radiopharmacy, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
    • ,
  • Dominique Vanderghinste

      Affiliations

    • Faculty of Pharmaceutical Sciences, Laboratory for Radiopharmacy, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
    • ,
  • Koen Demyttenaere

      Affiliations

    • Department of Neurosciences, Psychiatry Division, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
    • ,
  • Benjamin Fischler

      Affiliations

    • Department of Neurosciences, Psychiatry Division, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium
    • ,
  • Jan Tack

      Affiliations

    • Department of Pathophysiology, Gastroenterology Division, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium

Received 7 January 2010; accepted 8 April 2010. published online 19 April 2010.

Background & Aims

Differences in brain activity between health and functional dyspepsia (FD) have been reported; it is unclear whether this is influenced by gastric hypersensitivity or abuse history. Therefore, we aimed to determine the influence of gastric sensitivity and abuse history on gastric sensation scores and brain activity in homeostatic-afferent, emotional-arousal, and cortical-modulatory brain regions in FD.

Methods

Abuse history was assessed using a validated self-report questionnaire. H215O positron emission tomography was performed in 25 FD patients (13 hypersensitive and 8 abused) during 3 conditions, that is, no distension, gastric distension at discomfort threshold, and sham distension. Data were analyzed in SPM2. Region of interest analysis was used to confirm differences in prehypothesized regions.

Results

No association between hypersensitivity and abuse history was found. Gastric hypersensitivity was associated with significantly higher gastric sensation scores during baseline and sham. A condition-independent difference in ventral posterior cingulate activity was found between groups, as well as distension and sham-specific differences in brainstem and cingulate areas. Abuse history was associated with higher gastric sensation scores in all conditions and with differences in insular, prefrontal, and hippocampus/amygdala activity.

Conclusions

Gastric sensitivity and abuse history independently influence gastric sensation as well as brain activity in FD.

Keywords: Functional Dyspepsia, Gastric Hypersensitivity, Abuse, Brain

Abbreviations used in this paper: ACC, anterior cingulate cortex, BA, Brodmann area, DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, 4th edition, DSS, Dyspepsia Symptom Score, FD, functional dyspepsia, GI, gastrointestinal, IBS, irritable bowel syndrome, MCC, midcingulate cortex, PCC, posterior cingulate cortex, PET, positron emission tomography, PFC, prefrontal cortex, PHQ, Patient Health Questionnaire, PTSD, post-traumatic stress disorder, ROI, region of interest, SII, secondary somatosensory cortex

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 Conflicts of interest The authors disclose no conflicts.

 Funding This research is supported by a Methusalem grant and an FWO-Vlaanderen (Research Foundation-Flanders) grant to Prof J. Tack. Lukas Van Oudenhove is a postdoctoral research fellow of the FWO-Vlaanderen. Patrick Dupont is supported by Federaal Wetenschapsbeleid belspo IUAP P6/29.

PII: S0016-5085(10)00586-X

doi:10.1053/j.gastro.2010.04.015

Gastroenterology
Volume 139, Issue 1 , Pages 36-47, July 2010

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