Abstract
Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder associated with chronic abdominal pain and altered pain processing. The aim of this study was to examine whether attentional processes contribute to altered pain inhibition processes in patients with IBS. Nine female patients with IBS and nine age-/sex-matched controls were included in a pain inhibition paradigm using counter-stimulation and distraction with electroencephalography. Patients with IBS showed no inhibition of pain-related brain activity by heterotopic noxious counter-stimulation (HNCS) or selective attention. In the control group, HNCS and selective attention decreased the N100, P260 and high-gamma oscillation power. In addition, pain-related high-gamma power in sensorimotor, anterior cingulate and left dorsolateral prefrontal cortex was decreased by HNCS and selective attention in the control group, but not in patients with IBS. These results indicate that the central pain inhibition deficit in IBS reflects interactions between several brain processes related to pain and attention.
Highlights
Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disorder characterized by chronic abdominal pain and bowel dysfunction [1]
Cognitive performance is lower in patients with chronic pain [17] and decreased cognitive inhibition may be associated with reduced pain inhibition [18], this remains to be demonstrated in patients with chronic pain
In the Stroop test, reaction times (RT) in the inhibition trials of the switching condition were higher in patients with IBS compared with the control group this effect did not reach statistical significance (982 ± 170 ms vs. 842 ± 109 ms, p = 0.054), while RT were not significantly different in the naming condition (754 ± 36 ms vs. 663 ± 36 ms, p = 0.10)
Summary
Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disorder characterized by chronic abdominal pain and bowel dysfunction [1]. Several mechanisms have been proposed, the underlying physiopathology of chronic pain in IBS remains unclear. Cognitive performance is lower in patients with chronic pain [17] and decreased cognitive inhibition may be associated with reduced pain inhibition [18], this remains to be demonstrated in patients with chronic pain. In patients with IBS, reduced cognitive performance may affect how pain symptoms are processed and perceived and Rustamov et al J Physiol Sci (2020) 70:46 may contribute to altered pain inhibition, exacerbating chronic pain symptoms. A deficit in episodic visuospatial memory suggests that cognitive functions are altered in patients with IBS [19], this remains to be replicated [20]
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