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  • Review Article
  • Published:

Functional brain imaging in gastroenterology: to new beginnings

Nature Reviews Gastroenterology & Hepatology volume 11, pages 565–576 (2014)Cite this article

Subjects

Key Points

  • Functional brain imaging is an established field in gastroenterology

  • Although functional brain imaging studies have provided important insights into brain–gut interactions in health and disease, progress in this field has been hampered due to issues with reproducibility and lack of standardization

  • Reproducibility and standardization issues are not unique to studies of the gastrointestinal tract and are present in other disciplines using functional brain imaging

  • Adequate control for psychobiological factors, inter-centre collaboration for standardization of imaging and analysis methods, and study of homogenous and psychophysiologically well-characterized healthy individuals could improve reproducibility and standardization

  • These approaches might provide the crucial first steps towards developing an understanding of the mechanisms of visceral pain in health and disease, and lead to patient-tailored treatments with improved efficacy

Abstract

With more than 100 studies published over the past two decades, functional brain imaging research in gastroenterology has become an established field; one that has enabled improved insight into the supraspinal responses evoked by gastrointestinal stimulation both in health and disease. However, there remains considerable inter-study variation in the published results, largely owing to methodological differences in stimulation and recording techniques, heterogeneous patient selection, lack of control for psychological factors and so on. These issues with reproducibility, although not unique to studies of the gastrointestinal tract, can lead to unjustified inferences. To obtain consistent and more clinically relevant results, there is a need to optimize and standardize brain imaging studies across different centres. In addition, the use of complementary and more novel brain imaging modalities and analyses, which are now being used in other fields of research, might help unravel the factors at play in functional gastrointestinal disorders. This Review highlights the areas in which functional brain imaging has been useful and what it has revealed, the areas that are in need of improvement, and finally suggestions for future directions.

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Figure 1: Networks of brain activation in visceral stimulation studies.
Figure 2: Pain clusters after visceral stimulation.

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  1. Centre for Digestive Diseases, Blizard Institute, Wingate Institute of Neurogastroenterology, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, 26 Ashfield Street, London, E1 2AJ, UK

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Y.A.O. researched data for and wrote the article. Both authors made substantial contributions to discussion of content and reviewing/editing the manuscript before submission.

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Correspondence to Qasim Aziz.

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The authors declare no competing financial interests.

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Omran, Y., Aziz, Q. Functional brain imaging in gastroenterology: to new beginnings. Nat Rev Gastroenterol Hepatol 11, 565–576 (2014). https://doi.org/10.1038/nrgastro.2014.89

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