Brain imaging approaches to the study of functional GI disorders: a Rome working team report

Abstract

Progresses in the understanding of human brain-gut interactions in health and disease have been limited by the lack of non-invasive techniques to study brain activity. The advent of neuroimaging techniques has made it possible not only to study the structure and function of the brain, but also to characterize signaling system underlying brain function. This article gives a brief overview of relevant functional neuroanatomy, and of the most commonly used brain imaging techniques. It summarizes published functional brain imaging studies using acute visceral stimulation of the oesophagus, stomach and colon in healthy control subjects and patients with functional GI disorders, and briefly discusses pertinent findings from these studies. The article concludes with a critical assessment of published studies, and with recommendations for improved study paradigms and analysis strategies.

Figure 1. Schematic illustration of functional organization of central neuroaxis in processing and modulation of visceral afferent signals

A. Hierarchial organization of reflex responses to visceral afferent stimuli B. Modulation of visceral afferent input by cognitive and emotional factors within the central neuroaxis (Need to get copyright permission from Gastroenterology/ Elsevier) Legend: PAG Periaqueductal grey; RVLM Rostroventrolateral medulla; VMM ventromedial medulla; ANS autonomic nervous system; hypoth hypothalamus; Amy amygdala; orbFC orbitofrontal cortex