期刊
PAIN
卷 154, 期 -, 页码 S63-S70出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1016/j.pain.2013.09.008
关键词
Stress; Visceral pain; Irritable bowel syndrome (IBS); Anterior cingulate cortex (ACC); Amygdala; Periaqueductal gray matter (PAG); Dorsolateral prefronatal cortex (DLPFC); Corticotropin-releasing hormone (CRH); Serotonin (5-HT)
资金
- Ministry of Education, Science, and Culture of Japan
- Ministry of Health, Welfare, and Labour of Japan
Recent advances in brain science have shown that the brain function encoding emotion depends on interoceptive signals such as visceral pain. Visceral pain arose early in our evolutionary history. Bottom-up processing from gut-to-brain and top-down autonomic/neuroendocrine mechanisms in brain-to-gut signaling constitute a circuit. Brain imaging techniques have enabled us to depict the visceral pain pathway as well as the related emotional circuit. Irritable bowel syndrome (IBS) is characterized by chronic recurrent abdominal pain or abdominal discomfort associated with bowel dysfunction. It is also thought to be a disorder of the brain-gut link associated with an exaggerated response to stress. Corticotropin-releasing hormone (CRH), a major mediator of the stress response in the brain-gut axis, is an obvious candidate in the pathophysiology of IBS. Indeed, administration of CRH has been shown to aggravate the visceral sensorimotor response in IBS patients, and the administration of peptidergic CRH antagonists seems to alleviate IBS pathophysiology. Serotonin (5-HT) is another likely candidate associated with brain-gut function in IBS, as 5-HT3 antagonists, 5-HT4 agonists, and antidepressants were demonstrated to regulate 5-HT neurotransmission in IBS patients. Autonomic nervous system function, the neuroimmune axis, and the brain-gut-microbiota axis show specific profiles in IBS patients. Further studies on stress and visceral pain neuropathways in IBS patients are warranted. 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
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