Neural circuitry of abdominal pain-related fear learning and reinstatement in irritable bowel syndrome.

摘要: Background Altered pain anticipation likely contributes to disturbed central processing in chronic conditions like irritable bowel syndrome (IBS), but the learning processes shaping expectation of remain poorly understood. We assessed neural circuitry mediating formation, extinction, and reactivation abdominal pain-related memories IBS patients compared healthy controls (HC) a differential fear conditioning paradigm. Methods During acquisition, predictive visual cues (CS+) were paired with rectal distensions (US), while control (CS−) presented unpaired. During only CSs presented. Subsequently, memory was reinstatement procedure involving unexpected USs. Using functional magnetic resonance imaging, group differences activation CS+ vs CS− analyzed, along skin conductance responses (SCR), CS valence, CS-US contingency, state anxiety, salivary cortisol, alpha-amylase activity. The contribution anxiety symptoms addressed covariance analyses. Key Results Fear acquisition altered IBS, as indicated by more accurate contingency awareness, greater CS-related valence change, enhanced CS+-induced prefrontal cortex amygdala. further revealed cingulate during extinction hippocampal reinstatement. Anxiety affected formation reinstatement. Conclusions & Inferences Abdominal are mediated amygdala, cortex, areas, hippocampus. Enhanced may contribute hypervigilance amplification, especially anxious patients. Preventing ‘relapse’ learned utilizing extinction-based interventions be promising treatment goal IBS.