Abstract
A previous brain imaging study demonstrated activation of the right dorsolateral prefrontal cortex (DLPFC) during visceral nociception, and this activation was associated with anxiety. We hypothesized that functional modulation of the right DLPFC by repetitive transcranial magnetic stimulation (rTMS) can reveal the actual role of right DLPFC in brain-gut interactions in humans. Subjects were 11 healthy males aged 23.5±1.4 (mean±SE) years. Viscerosensory evoked potential (VEP) with sham (0mA) or actual (30mA) electrical stimulation (ES) of the rectum was taken after sham, low frequency rTMS at 0.1Hz, and high frequency rTMS at 10Hz to the right DLPFC. Rectal tone was measured with a rectal barostat. Visceral perception and emotion were analyzed using an ordinate scale, rectal barostat, and VEP. Low frequency rTMS significantly reduced anxiety evoked by ES at 30mA (p<0.05). High frequency rTMS-30mA ES significantly produced more phasic volume events than sham rTMS-30mA ES (p<0.05). We successfully modulated the gastrointestinal function of healthy individuals through rTMS to the right DLPFC. Thus, rTMS to the DLPFC appears to modulate the affective, but not direct, component of visceral perception and motility of the rectum.
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