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Title: Psychobiological mechanisms in functional dyspepsia. Converging evidence from psychophysiology & functional brain imaging?
Other Titles: Psychobiologische mechanismen in functionele dyspepsie. Gemeenschappelijke evidentie uit psychofysiologie en functionele hersenbeeldvorming?
Authors: Van Oudenhove, Lukas
Issue Date: 30-Sep-2008
Table of Contents: Introduction

1. Introduction & Research Objectives

1.1. Functional Gastrointestinal Disorders: definition & epidemiology
1.2. Psychological factors & Functional Gastrointestinal Disorders
1.3. Neural underpinnings of psychobiological interactions in Functional Gastrointestinal Disorders: the ‘Brain-Gut Axis’
1.4. Research objectives & outline of the thesis manuscript

2. Psychosocial Factors, Psychiatric Illness & Functional Gastrointestinal Disorders: a Historical Perspective

2.1. Abstract
2.2. Introduction
2.3. ‘The father of gastric physiology’: William Beaumont
2.4. The James-Lange & Cannon-Bard theories of emotion and their significance for psychosomatics in gastroenterology
2.5. The link between psychiatric & gastrointestinal disorders in the 19th & early 20th century: the chicken or the egg?
2.6. The rise (and the fall?) of psychoanalysis in psychosomatic medicine
2.7. Walter B. Cannon & Ivan Pavlov: pioneers of psychophysiological research
2.8. ‘The patient as a whole’
2.9. Psychosomatic research in gastroenterology in the early 20th century
2.10. The dawn of visceral sensory & affective neuroscience Paul MacLean & György Ádám
2.11. Conclusion

3. Functional Brain Imaging of Gastrointestinal Sensation in Health & Disease

3.1. Abstract
3.2. Introduction
3.3. The ‘Brain-Gut Axis’
3.3.1. The vagal (‘parasympathetic’) afferent system
3.3.2. The spinal (‘sympathetic’) afferent system
3.3.3. The cerebral cortex: the ‘visceral pain neuromatrix’
3.3.4. Descending modulatory pathways
3.4. Influence of psychological factors on brain processing of visceral sensation in health
3.4.1. Emotional modulation
3.4.2. Cognitive modulation: attention
3.4.3. Anticipation: classical conditioning
3.5. Brain imaging on visceral sensation/pain in FGID patients
3.5.1. Irritable Bowel Syndrome (IBS)
3.5.2. Functional Dyspepsia (FD)
3.6. Conclusion


PART I. ‘Psychophysiological’ Studies

4. Relationship between Anxiety & Gastric Sensorimotor Function in Functional Dyspepsia

4.1. Abstract
4.2. Introduction
4.3. Materials & Methods
4.3.1. Patient sample
4.3.2. Questionnaires
4.3.3. Barostat investigation
4.3.4. Data analysis
4.3.5. Statistical analysis
4.4. Results
4.4.1. Patient characteristics
4.4.2. Hypersensitive versus normosensitive patients
4.4.3. Univariate correlations & multiple linear regression in the whole patient group
4.4.4. Univariate correlations & multiple linear regression in hypersensitive patients
4.5. Discussion
4.5.1. Anxiety scores
4.5.2. Relationship between anxiety and gastric sensorimotor function
4.5.3. Limitations of the study
4.5.4. Putative mechanisms underlying the relationship between anxiety and gastric sensorimotor function

5. Relationship between Psychosocial Factors, Somatization & Gastric Sensorimotor Function in Functional Dyspepsia

5.1. Abstract
5.2. Introduction
5.3. Materials & Methods
5.3.1. Patient sample
5.3.2. Gastric sensorimotor function testing
5.3.3. Psychosocial factors & psychiatric disorders measurements
5.3.4. Somatization measurement
5.3.5. Statistical analysis
5.4. Results
5.4.1. Patient characteristics
5.4.2. Univariate assocations
5.4.3. General Linear Models
5.5. Discussion
5.5.1. Gastric sensitivity
5.5.2. Gastric emptying
5.5.3. Limitations
5.5.4. Conclusion

6. Determinants of Symptoms in Functional Dyspepsia: Gastric Sensorimotor Function, Psychosocial Factors, or Somatization?

6.1. Abstract
6.2. Introduction
6.3. Materials & Methods
6.3.1. Patient sample
6.3.2. Gastric sensorimotor function testing
6.3.3. Dyspepsia Symptom Severity (DSS) & weight loss measurement
6.3.4. Psychosocial factors & psychiatric disorders measurements
6.3.5. Somatization measurements
6.3.6. Statistical analysis
6.4. Results
6.4.1. Patient characteristics
6.4.2. Univariate associations
6.4.3. Multiple regression
6.5. Discussion


PART II. Functional Brain Imaging Studies

7. Cortical Deactivations during Gastric Fundus Distension in Health: Visceral Sensation-specific Response or Attenuation of ‘Default Mode’ Brain Function? a H215O-PET study

7.1. Abstract
7.2. Introduction
7.3. Methods
7.3.1. Subjects
7.3.2. Barostat procedure
7.3.3. PET imaging
7.4. Results
7.4.1. Baseline – unpleasant/painful sensation
7.4.2. Baseline – marked sensation
7.4.3. Baseline – weak/first sensation
7.4.4. Weak/first sensation – unpleasant/painful sensation
7.4.5. Marked sensation – unpleasant/painful sensation
7.4.6. Correlation analyses
7.4.7. Baseline – sham
7.5. Discussion
7.6. Conclusion

8. Neural Correlates of Gastric Sensation in Functional Dyspepsia & the Role of Anxiety: a H215O-PET study

8.1. Abstract
8.2. Introduction
8.3. Materials & Methods
8.3.1. Patient selection
8.3.2. Barostat procedure
8.3.3. Behavioural measures
8.3.4. Statistical analysis
8.3.5. PET functional brain imaging
8.3.6. Anatomic magnetic resonance imaging
8.4. Results
8.4.1. Descriptive & behavioural
8.4.2. Brain imaging
8.5. Discussion
8.5.1. Behavioural data
8.5.2. Within-group analyses
8.5.3. Between-group analyses: patients-controls

9. Neural Correlates of Gastric Sensation in Functional Dyspepsia & the Role of Gastric Sensitivity & Abuse History: a H215O-PET study

9.1. Abstract
9.2. Introduction
9.3. Materials & Methods
9.3.1. Patient selection
9.3.2. Barostat procedure
9.3.3. Behavioural measures
9.3.4. Statistical analysis
9.3.5. PET functional brain imaging
9.3.6. Anatomic magnetic resonance imaging
9.4. Results
9.4.1. Descriptive & behavioural
9.4.2. Brain imaging
9.5. Discussion
9.5.2. Behavioural results
9.5.3. Brain imaging findings
ISBN: 978-90-429-2170-2
Publication status: published
KU Leuven publication type: TH
Appears in Collections:Translational Research in GastroIntestinal Disorders
Research Group Psychiatry

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