Brain–gut connections in functional GI disorders: anatomic and physiologic relationships

Neurogastroenterology and Motility - Tập 18 Số 2 - Trang 91-103 - 2006
Michael Jones1, Jonathan Dilley2, Douglas A. Drossman3, Michael D. Crowell4
1Division of Gastroenterology, Feinberg School of Medicine, Northwestern University, Chicago, IL - USA
2Division of Psychology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
3UNC Center for Functional GI & Motility Disorders, Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC, USA
4Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Scottsdale, AZ, USA

Tóm tắt

Abstract  Understanding the neural regulation of gut function and sensation makes it easier to understand the interrelatedness of emotionality, symptom‐attentive behavior or hypervigilance, gut function and pain. The gut and the brain are highly integrated and communicate in a bidirectional fashion largely through the ANS and HPA axis. Within the CNS, the locus of gut control is chiefly within the limbic system, a region of the mammalian brain responsible for both the internal and external homeostasis of the organism. The limbic system also plays a central role in emotionality, which is a nonverbal system that facilitates survival and threat avoidance, social interaction and learning. The generation of emotion and associated physiologic changes are the work of the limbic system and, from a neuroanatomic perspective, the ‘mind‐body interaction’ may largely arise in this region. Finally, the limbic system is also involved in the ‘top down’ modulation of visceral pain transmission as well as visceral perception. A better understanding of the interactions of the CNS, ENS and enteric immune system will significantly improve our understanding of ‘functional’ disorders and allow for a more pathophysiologic definition of categories of patients currently lumped under the broad umbrella of FGID.

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Neurogastroenterology and Motility

Tập 18 Số 2

91-103

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