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Volume 14, Issue 2, Pages 142-148 (February 2010)


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Anatomical connections between brain areas activated during rectal distension in healthy volunteers: A visceral pain network

Xavier Moissetab, Didier BouhassiraabCorresponding Author Informationemail address, Denis Ducreuxd, Dominique Glutrond, Benoit Coffinace, Jean-Marc Sabatéace

Received 8 December 2008; received in revised form 11 March 2009; accepted 28 April 2009. published online 27 May 2009.

Abstract 

Diffusion Tensor Imaging (DTI) is a promising new imaging method allowing in vivo mapping of anatomical connections in the living human brain. We combined DTI with functional magnetic resonance imaging (fMRI) to investigate the anatomical relationships between areas involved in visceral sensations in humans.

Non-painful and moderately painful rectal distensions were performed in 11 healthy women (38.4±3.1years). fMRI was used to analyse the changes in brain activity during both types of distension. Then, DTI was applied for tracking fibers between the main activated regions.

Non-painful distension bilaterally activated the PreFrontal Cortex (PFC), the Anterior Cingulate Cortex (ACC) and the right insula. Painful distension bilaterally activated the primary (S1) and secondary (S2) somatosensory cortices, the motor cortex, the frontal inferior gyrus, the thalamus, the insula, the striatum and the cerebellum. DTI revealed direct connections between insula, and the four areas more frequently activated in this study, i.e. ACC, thalamus, S1, S2 and PFC.

The combined use of fMRI and DTI in healthy subjects during rectal distension revealed a neural network of visceral sensory perception involving the insula, thalamus, somatosensory cortices, ACC and PFC.

a INSERM U792, Physiopathologie et pharmacologie clinique de la douleur, Hôpital Ambroise Paré, 92100 Boulogne, France

b Université Versailles-Saint-Quentin, Versailles F-78035, France

c Université Paris 7, René Diderot, 10 avenue de Verdun, Paris 75010, France

d AP-HP, Hôpital Bicêtre, Service de neuroradiologie et CIERM, 94275 Le Kremlin Bicêtre, France

e AP-HP, Hôpital Louis Mourier, Service d’Hépato-Gastroentérologie, 92701 Colombes, France

Corresponding Author InformationCorresponding author. Address: INSERM U792, Physiopathologie et pharmacologie clinique de la douleur, Hôpital Ambroise Paré, 92100 Boulogne, France. Tel.: +33 1 49 09 45 56; fax: +33 1 49 09 44 35.

PII: S1090-3801(09)00087-1

doi:10.1016/j.ejpain.2009.04.011


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