著者

Michiko Kano Lukas Van Oudenhove Patrick Dupont Tor D. Wager Shin Fukudo

出版者

Tohoku University Medical Press

雑誌

The Tohoku Journal of Experimental Medicine (ISSN:00408727)

巻号頁・発行日

vol.250, no.3, pp.137-152, 2020 (Released:2020-03-03)

参考文献数

124

被引用文献数

3 8

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When patients present with persistent bodily complaints that cannot be explained by a symptom-linked organic pathology (medically unexplained symptoms), they are diagnosed with ‘functional’ somatic syndromes (FSS). Despite their prevalence, the management of FSS is notoriously challenging in clinical practice. This may be because FSS are heterogeneous disorders in terms of etiopathogenesis. They include patients with primarily peripheral dysfunction, primarily centrally driven somatic symptoms, and a mix of both. Brain-imaging studies, particularly data-driven pattern recognition methods using machine learning algorithms, could provide brain-based biomarkers for these clinical conditions. In this review, we provide an overview of our brain imaging data on brain-body interactions in one of the most well-known FSS, irritable bowel syndrome (IBS), and discuss the possible development of a brain-based biomarker for FSS. Anticipation of unpredictable pain, which commonly elicits fear in FSS patients, induced increased activity in brain areas associated with hypervigilance during rectal distention and non-distention conditions in IBS. This was coupled with dysfunctional inhibitory influence of the medial prefrontal cortex (mPFC) and pregenual anterior cingulate cortex (pACC) on stress regulation systems, resulting in the activated autonomic nervous system (ANS) and neuroendocrine system stimulated by corticotropin-releasing hormone (CRH). IBS subjects with higher alexithymia, a risk factor for FSS, showed stronger activity in the insula during rectal distention but reduced subjective sensitivity. Reduced top-down regulation of the ANS and CRH system by mPFC and pACC, discordance between the insula response to stimulation and subjective sensation of pain, and stronger threat responses in hypervigilance-related areas may be a candidate brain-based biomarker.

著者

Masaaki Tagawa Michiko Kano Nobuyuki Okamura Masatoshi Itoh Eiko Sakurai Takehiko Watanabe Kazuhiko Yanai

出版者

The Japanese Pharmacological Society

雑誌

The Japanese Journal of Pharmacology (ISSN:00215198)

巻号頁・発行日

vol.83, no.3, pp.253-260, 2000 (Released:2001-01-31)

参考文献数

46

被引用文献数

16 14

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Ethanol is a social drug and has been generally known to be a CNS depressant.A large fluctuation of blood alcohol concentration(BAC)is well−known to occur due to main factors such as the genetic polymorphism of the main alcohol metabolizing enzymes and the effect of blood.Few studies have substantially discussed the relationship between impaired CNS activities and BAC.In this study, focusing on the correlation of BAC, we investigated the acute effects of alcohol intake on cognitive performance in humans by objective evaluation methods consisting of the attention−demanding cognitive tasks.Tasks were administered to ten healthy male volunteers before and after ingesting established amounts of alcohol.With increased BAC, we observed prolongation of reaction time performances and lowering of a coordination performance.From the results, we concluded that cognitive performance deteriorates with an increase of BAC.Additionally, the BAC threshold that causes significant impairment of cognitive performance was estimated to be approximately 50 mg/dl(ca.10 mM).