Alimentary TractIdentification and characterization of cerebral cortical response to esophageal mucosal acid exposure and distention☆
Section snippets
Subjects
Ten healthy normal volunteers (6 women and 4 men; age range, 19–44 years) were studied. All volunteers filled out a detailed health-related questionnaire before the study and did not have any present or previous history of reflux disease, dysphagia, or other gastrointestinal-related diseases. All study protocols were approved by the Human Research Review Committee of the Medical College of Wisconsin, and the subjects gave written informed consent before the studies.
MRI scanning
FMRI has been shown to
Cerebral cortical FMRI response to esophageal saline and acid perfusion
Although saline perfusion elicited no detectable change in cerebral cortical FMRI activity, intraesophageal acid perfusion produced a characteristic response in all studied subjects. As shown in Figure 4A, cerebral cortical FMRI activity was concentrated in the posterior cingulate, parietal, and anteromesial frontal lobes.
Discussion
In this study we characterized the cerebral cortical response to esophageal mucosal acid exposure and compared the findings with that of esophageal balloon distention. Study findings indicate that chemical stimulation of esophageal mucosa by 0.1N HCl at a threshold below the development of heartburn is relayed to the cerebral cortex and induces neuronal activity detectable by the FMRI technique. Study findings also indicate that a cerebral FMRI response to esophageal acid exposure develops
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Address requests for reprints to: Reza Shaker, M.D., Division of Gastroenterology and Hepatology, Froedtert Memorial Lutheran Hospital, 9200 West Wisconsin Avenue, Milwaukee, Wisconsin 53226. Fax: (414) 456-6215.