Effect of hypnotherapy and educational intervention on brain response to visceral stimulusin the irritable bowel syndrome
Identifieur interne : 000511 ( Main/Merge ); précédent : 000510; suivant : 000512Effect of hypnotherapy and educational intervention on brain response to visceral stimulusin the irritable bowel syndrome
Auteurs : Mats B. O. Lowén ; Emeran A. Mayer ; Martha Sjöberg ; Kirsten Tillisch ; Bruce Naliboff ; Jennifer Labus ; Peter Lundberg ; Magnus Ström ; Maria Engström ; Susanna A. WalterSource :
- Alimentary pharmacology & therapeutics [ 0269-2813 ] ; 2013.
Abstract
Gut directed hypnotherapy can reduce IBS symptoms but the mechanisms underlying this therapeutic effect remain unknown.
We determined the effect of hypnotherapy and educational intervention on brain responses to cued rectal distensions in IBS patients.
44 women with moderate to severe IBS and 20 healthy controls (HCs) were included. Blood oxygen level dependent (BOLD) signals were measured by functional Magnetic Resonance Imaging (fMRI) during expectation and delivery of high (45 mmHg) and low (15 mmHg) intensity rectal distensions. Twenty-five patients were assigned to hypnotherapy (HYP) and 16 to educational intervention (EDU). 31 patients completed treatments and post treatment fMRI.
Similar symptom reduction was achieved in both groups. Clinically successful treatment (all responders) was associated with significant BOLD attenuation during high intensity distension in the dorsal and ventral anterior insula (cluster size 142, p=0.006, and cluster size 101, p=0.005, respectively). Moreover HYP responders demonstrated a pre-post treatment BOLD attenuation in posterior insula (cluster sizes 59, p=0.05) while EDU responders had a BOLD attenuation in prefrontal cortex (cluster size 60, p=0.05). Pre-post differences for expectation conditions were almost exclusively seen in the HYP group. Following treatment, the brain response to distension was similar to that observed in HCs, suggesting that the treatment had a normalizing effect on the central processing abnormality of visceral signals in IBS.
The abnormal processing and enhanced perception of visceral stimuli in IBS can be normalized by psychological interventions. Symptom improvement in the treatment groups may be mediated by different brain mechanisms.
Url:
DOI: 10.1111/apt.12319
PubMed: 23617618
PubMed Central: 4084976
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Mayer</name></author><author><name sortKey="Sjoberg, Martha" sort="Sjoberg, Martha" uniqKey="Sjoberg M" first="Martha" last="Sjöberg">Martha Sjöberg</name></author><author><name sortKey="Tillisch, Kirsten" sort="Tillisch, Kirsten" uniqKey="Tillisch K" first="Kirsten" last="Tillisch">Kirsten Tillisch</name></author><author><name sortKey="Naliboff, Bruce" sort="Naliboff, Bruce" uniqKey="Naliboff B" first="Bruce" last="Naliboff">Bruce Naliboff</name></author><author><name sortKey="Labus, Jennifer" sort="Labus, Jennifer" uniqKey="Labus J" first="Jennifer" last="Labus">Jennifer Labus</name></author><author><name sortKey="Lundberg, Peter" sort="Lundberg, Peter" uniqKey="Lundberg P" first="Peter" last="Lundberg">Peter Lundberg</name></author><author><name sortKey="Strom, Magnus" sort="Strom, Magnus" uniqKey="Strom M" first="Magnus" last="Ström">Magnus Ström</name></author><author><name sortKey="Engstrom, Maria" sort="Engstrom, Maria" uniqKey="Engstrom M" first="Maria" last="Engström">Maria Engström</name></author><author><name sortKey="Walter, Susanna A" sort="Walter, Susanna A" uniqKey="Walter S" first="Susanna A." last="Walter">Susanna A. 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O." last="Lowén">Mats B. O. Lowén</name></author><author><name sortKey="Mayer, Emeran A" sort="Mayer, Emeran A" uniqKey="Mayer E" first="Emeran A." last="Mayer">Emeran A. Mayer</name></author><author><name sortKey="Sjoberg, Martha" sort="Sjoberg, Martha" uniqKey="Sjoberg M" first="Martha" last="Sjöberg">Martha Sjöberg</name></author><author><name sortKey="Tillisch, Kirsten" sort="Tillisch, Kirsten" uniqKey="Tillisch K" first="Kirsten" last="Tillisch">Kirsten Tillisch</name></author><author><name sortKey="Naliboff, Bruce" sort="Naliboff, Bruce" uniqKey="Naliboff B" first="Bruce" last="Naliboff">Bruce Naliboff</name></author><author><name sortKey="Labus, Jennifer" sort="Labus, Jennifer" uniqKey="Labus J" first="Jennifer" last="Labus">Jennifer Labus</name></author><author><name sortKey="Lundberg, Peter" sort="Lundberg, Peter" uniqKey="Lundberg P" first="Peter" last="Lundberg">Peter Lundberg</name></author><author><name sortKey="Strom, Magnus" sort="Strom, Magnus" uniqKey="Strom M" first="Magnus" last="Ström">Magnus Ström</name></author><author><name sortKey="Engstrom, Maria" sort="Engstrom, Maria" uniqKey="Engstrom M" first="Maria" last="Engström">Maria Engström</name></author><author><name sortKey="Walter, Susanna A" sort="Walter, Susanna A" uniqKey="Walter S" first="Susanna A." last="Walter">Susanna A. Walter</name></author></analytic><series><title level="j">Alimentary pharmacology & therapeutics</title><idno type="ISSN">0269-2813</idno><idno type="eISSN">1365-2036</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>SUMMARY</title><sec id="S1"><title>Background</title><p id="P1">Gut directed hypnotherapy can reduce IBS symptoms but the mechanisms underlying this therapeutic effect remain unknown.</p></sec><sec id="S2"><title>Aim</title><p id="P2">We determined the effect of hypnotherapy and educational intervention on brain responses to cued rectal distensions in IBS patients.</p></sec><sec id="S3"><title>Methods</title><p id="P3">44 women with moderate to severe IBS and 20 healthy controls (HCs) were included. Blood oxygen level dependent (BOLD) signals were measured by functional Magnetic Resonance Imaging (fMRI) during expectation and delivery of high (45 mmHg) and low (15 mmHg) intensity rectal distensions. Twenty-five patients were assigned to hypnotherapy (HYP) and 16 to educational intervention (EDU). 31 patients completed treatments and post treatment fMRI.</p></sec><sec id="S4"><title>Results</title><p id="P4">Similar symptom reduction was achieved in both groups. Clinically successful treatment (all responders) was associated with significant BOLD attenuation during high intensity distension in the dorsal and ventral anterior insula (cluster size 142, p=0.006, and cluster size 101, p=0.005, respectively). Moreover HYP responders demonstrated a pre-post treatment BOLD attenuation in posterior insula (cluster sizes 59, p=0.05) while EDU responders had a BOLD attenuation in prefrontal cortex (cluster size 60, p=0.05). Pre-post differences for expectation conditions were almost exclusively seen in the HYP group. Following treatment, the brain response to distension was similar to that observed in HCs, suggesting that the treatment had a normalizing effect on the central processing abnormality of visceral signals in IBS.</p></sec><sec id="S5"><title>Conclusions</title><p id="P5">The abnormal processing and enhanced perception of visceral stimuli in IBS can be normalized by psychological interventions. Symptom improvement in the treatment groups may be mediated by different brain mechanisms.</p></sec></div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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