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. 2018 Apr 30;24(2):268-279.
doi: 10.5056/jnm17076.

Regional Brain Activity During Rest and Gastric Water Load in Subtypes of Functional Dyspepsia: A Preliminary Brain Functional Magnetic Resonance Imaging Study

Yanwen Chen  1   2 , Ruifeng Wang  1   3 , Bo Hou  4 , Feng Feng  4 , Xiucai Fang  1 , Liming Zhu  1 , Xiaohong Sun  1 , Zhifeng Wang  1 , Meiyun Ke  1
Affiliations

Regional Brain Activity During Rest and Gastric Water Load in Subtypes of Functional Dyspepsia: A Preliminary Brain Functional Magnetic Resonance Imaging Study

Yanwen Chen et al. J Neurogastroenterol Motil. .

Abstract

Background/aims: Functional dyspepsia (FD) remains a great clinical challenge since the FD subtypes, defined by Rome III classification, still have heterogeneous pathogenesis. Previous studies have shown notable differences in visceral sensation processing in the CNS in FD compared to healthy subjects (HS). However, the role of CNS in the pathogenesis of each FD subtype has not been recognized.

Methods: Twenty-eight FD patients, including 10 epigastric pain syndrome (EPS), 9 postprandial distress syndrome (PDS), and 9 mixed-type, and 10 HS, were enrolled. All subjects underwent a proximal gastric perfusion water load test and the regional brain activities during resting state and water load test were investigated by functional magnetic resonance imaging.

Results: For regional brain activities during the resting state and water load test, each FD subtype was significantly different from HS (P ＜ 0.05). Focusing on EPS and PDS, the regional brain activities of EPS were stronger than PDS in the left paracentral lobule, right inferior frontal gyrus pars opercularis, postcentral gyrus, precuneus, insula, parahippocampal gyrus, caudate nucleus, and bilateral cingulate cortices at the resting state (P ＜ 0.05), and stronger than PDS in the left inferior temporal and fusiform gyri during the water load test (P ＜ 0.05).

Conclusions: Compared to HS, FD subtypes had different regional brain activities at rest and during water load test, whereby the differences displayed distinct manifestations for each subtype. Compared to PDS, EPS presented more significant differences from HS at rest, suggesting that the abnormality of central visceral pain processing could be one of the main pathogenesis mechanisms for EPS.

Keywords: Dyspepsia; Epigastric pain syndrome; Functional neuroimaging; Post-prandial distress syndrome; Regional homogeneity.

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Conflict of interest statement

Conflicts of interest: None.

Figures

Figure 1
Figure 1
The flowchart diagram showing how this study was performed on the participants. FD, functional dyspepsia; EPS, epigastric pain syndrome; PDS, postprandial distress syndrome; HS, healthy subjects.
Figure 2
Figure 2
Screening and exclusion chart for the patient selection. FD, functional dyspepsia.
Figure 3
Figure 3
Regional brain activity differences between epigastric pain syndrome (EPS) (or postprandial distress syndrome [PDS]) and healthy subjects (HS) during resting state (or water load test). (A) EPS vs HS (resting state). (B) PDS vs HS (resting state). (C) EPS vs HS (water load). (D) PDS vs HS (water load). Every figure is the parameter distribution map of the T value corresponding to every voxel plotted in the standard brain, after the independent sample t test between two groups. The color temperature represents the magnitude of T value, eg, warm colors represent the positive T value, meaning the former group has stronger signal intensity than the latter group, and cold colors represent the negative T value, meaning the opposite relationship between the 2 groups. The brighter the color, the greater the absolute value of T value, meaning more apparent difference between the 2 groups. The color band on the right indicates the correlation between the color and the T value. The layer interval in the figures is 8 mm.
Figure 4
Figure 4
Regional brain activity differences between epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS) during resting state. The principle of plotting is similar to Figure 3. The layer interval is 4 mm.
See this image and copyright information in PMC

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