Cognitive modulation of the cerebral processing of human oesophageal sensation using functional magnetic resonance imaging - PubMed (original) (raw)

Cognitive modulation of the cerebral processing of human oesophageal sensation using functional magnetic resonance imaging

L J Gregory et al. Gut. 2003 Dec.

Abstract

Background: While cortical processing of visceral sensation has been described, the role that cognitive factors play in modulating this processing remains unclear.

Aim: To investigate how selective and divided attention modulate the cerebral processing of oesophageal sensation.

Methods: In seven healthy volunteers (six males, mean age 33 years; ranging from 24 to 41 years old) from the general community, phasic visual and oesophageal (non-painful balloon distension) stimuli were presented simultaneously. During the selective attention task, subjects were instructed to press a button either to a change in frequency of oesophageal or visual stimuli. During a divided attention task, subjects received simultaneous visual and oesophageal stimuli and were instructed to press a button in response to a change in frequency of both stimuli.

Results: Selectively focussing attention on oesophageal stimuli activated the visceral sensory and cognitive neural networks (primary and secondary sensory cortices and anterior cingulate cortex respectively) while selective attention to visual stimuli primarily activated the visual cortex. When attention was divided between the two sensory modalities, more brain regions in the sensory and cognitive domains were utilised to process oesophageal stimuli in comparison to those employed to process visual stimuli (p=0.003).

Conclusion: Selective and divided attention to visceral stimuli recruits more neural resources in both the sensory and cognitive domains than attention to visual stimuli. We provide neurobiological evidence that demonstrates the biological importance placed on visceral sensations and demonstrate the influence of cognitive factors such as attention on the cerebral processing of visceral sensation.

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Figures

Figure 1

Figure 1

Schematic representation of the visual stimulus during background visual stimulation (A) and during target visual stimulation (B). During background visual stimulation, circles fill with colour in a clockwise direction at a rate of one every six seconds. As the next circle in the sequence is filled with colour, the previous circle empties. During target visual stimulation, there is a failure of a circle to fill with colour and the next circle following the empty circle fills with colour. When subjects detect the target visual stimulus, they indicate by pressing a button on a game pad. (C) Simplified schematic of protocol for selective and divided attention experiments. Note: The order of visual and oesophageal background and target stimuli are counterbalanced across all subjects for both selective and divided attention tasks. An interstimulus of six seconds occurs between each visual and oesophageal stimulus.

Figure 2

Figure 2

(A) Comparison of brain activation between selective attention to visual (yellow) and selective attention to oesophageal (red) stimuli. Images run inferior to superior (left to right). (B) Comparison of brain activation between divided attention to visual (yellow) and divided attention to oesophageal stimuli (red). Images run inferior to superior (top left to bottom right). Stereotactic (z) coordinate is shown across the top of the figure. Note: the comparisons of oesophageal v visual targets in both selective and divided attention experiments were generated from the product of the target stimuli of sensory modality 1 (for example, visual) subtracted from a standardised rest condition (that is generated from interstimulus intervals) being compared to the product of target stimuli of sensory modality 2 (for example, visceral) subtracted from a standardised rest condition.

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