Effect of sex on perception of rectosigmoid stimuli in irritable bowel syndrome

Chang, Lin; Mayer, Emeran A.; Labus, Jennifer S.; Schmulson, Max; Lee, Oh Young; Olivas, Teresa I.; Stains, Jean; Naliboff, Bruce D.

doi:10.1152/ajpregu.00729.2005

Cited by 99 publications

(93 citation statements)

References 55 publications

(88 reference statements)

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“…Using validated psychophysiological techniques, we have previously reported that women with IBS show greater subjective emotional and perceptual responses to colorectal distension than male patients or healthy men or women (Chang et al, 2006a). One may speculate that the sex-related differences in the connectivity of the "emotional-arousal" network seen in the current study may be related to these greater emotional and perceptual responses previously reported.…”

Section: Possible Correlation Of Findings With Sex Differences In Behsupporting

confidence: 60%

Sex differences in brain activity during aversive visceral stimulation and its expectation in patients with chronic abdominal pain: A network analysis

Labus¹,

Naliboff²,

Fallon³

et al. 2008

NeuroImage

128

115

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Differences in brain responses to aversive visceral stimuli may underlie previously reported sex differences in symptoms as well as perceptual and emotional responses to such stimuli in patients with Irritable Bowel Syndrome (IBS). The goal of the current study was to identify brain networks activated by expected and delivered aversive visceral stimuli in male and female patients with chronic abdominal pain, and to test for sex differences in the effective connectivity of the circuitry comprising these networks. Network analysis was applied to assess the brain response of 46 IBS patients (22 men and 24 women) recorded using [ 15 O] water positron emission tomography during rest/baseline and expected and delivered aversive rectal distension. Functional connectivity results from partial least squares analyses provided support for the hypothesized involvement of 3 networks corresponding to: 1) visceral afferent information processing (thalamus, insula and dorsal anterior cingulate cortex, orbital frontal cortex), 2) emotional arousal (amygdala, rostral and subgenual cingulate regions, and locus coeruleus complex) and 3) cortical modulation (frontal and parietal cortices). Effective connectivity results obtained via structural equation modeling indicated that sex-related differences in brain response are largely due to alterations in the effective connectivity of emotional-arousal circuitry rather than visceral afferent processing circuits. Sex differences in the cortico-limbic circuitry involved in emotional-arousal, pain facilitation and autonomic responses may underlie the observed differences in symptoms, and in perceptual and emotional responses to aversive visceral stimuli.

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Section: Possible Correlation Of Findings With Sex Differences In Behsupporting

confidence: 60%

Sex differences in brain activity during aversive visceral stimulation and its expectation in patients with chronic abdominal pain: A network analysis

Labus¹,

Naliboff²,

Fallon³

et al. 2008

NeuroImage

128

115

View full text Add to dashboard Cite

show abstract

“…With respect to visceral pain, a lower pain threshold to esophageal distension was demonstrated in females [149], whereas rectal stimulation studies showed no gender differences in mechanical thresholds [11,186], or higher thresholds in healthy women [34]. Additionally, women have shown larger referred pain areas to the mechanical and thermal stimulation of the esophagus [161].…”

Section: What Types Of Pain Tests Are Appropriate? Human Studiesmentioning

confidence: 99%

“…For instance, evaluation of pain sensitivity at asymptomatic body sites can reveal information about general pain-processing alterations, as has been shown for fibromyalgia [118,189], various types of headaches [182], and temporomandibular disorders (TMD) [175]. Additionally, experimental provocation of a patient's clinical pain allows separate assessment of that pathological condition, for instance evaluating pressure pain sensitivity of symptomatic muscles of fibromyalgia patients [188], or rectosigmoid distension of irritable bowel syndrome patients [34].…”

Section: What Types Of Pain Tests Are Appropriate? Human Studiesmentioning

confidence: 99%

“…When possible, studies should compare not only women with pain to men with the same pain condition, but also healthy women to healthy men and patients of each sex to sex-matched healthy controls. For example, differences in symptoms and/or in pain sensitivity in the intestinal tract have been found between women with IBS and healthy women, between women with IBS and men with IBS, and between healthy women and healthy men [34]. Similarly, exaggerated temporal summation of pain has been documented for women with TMD, but not for men with TMD [174,175].…”

Section: Health Vs Disease-a Wide Range Of Diseases Have Different Pmentioning

confidence: 99%

“…Sex differences may be more consistently observed when using particular stimulus modalities or psychophysical protocols. Specifically, a meta-analysis reported that sex differences in threshold and tolerance measures were largest and most consistently found for pressure pain and electrical stimulation, while smallest and least consistently found for thermal pain stimuli [164].With respect to visceral pain, a lower pain threshold to esophageal distension was demonstrated in females [149], whereas rectal stimulation studies showed no gender differences in mechanical thresholds [11,186], or higher thresholds in healthy women [34]. Additionally, women have shown larger referred pain areas to the mechanical and thermal stimulation of the esophagus [161].…”

mentioning

confidence: 99%

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Studying sex and gender differences in pain and analgesia: A consensus report

Greenspan

Craft

LeResche

et al. 2007

Pain

Self Cite

870

633

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In September 2006, members of the Sex, Gender and Pain Special Interest Group of the International Association for the Study of Pain met to discuss the following: (1) what is known about sex and gender differences in pain and analgesia; (2) what are the "best practice" guidelines for pain research with respect to sex and gender; and (3) what are the crucial questions to address in the near future? The resulting consensus presented herein includes input from basic science, clinical and psychosocial pain researchers, as well as from recognized experts in sexual differentiation and reproductive endocrinology. We intend this document to serve as a utilitarian and thought-provoking guide for future research on sex and gender differences in pain and analgesia, both for those currently working in this field as well as those still wondering, "Do I really need to study females?" Keywords Sex differences; Gonadal hormones; Estrogens The case for studying sex and gender differences in pain and analgesiaThe pain field has moved from debating whether sex differences in pain exist to recognizing the importance of these differences. Attention is now directed toward understanding (1) what conditions lead to the expression of sex and gender differences in pain experience and reactivity, (2) what mechanisms underlie these differences, and (3) how these differences can inform clinical management of pain.As noted in a recent review, at least 79% of animal studies published in Pain over the preceding 10 years included male subjects only, with a mere 8% of studies on females only, and another 4% explicitly designed to test for sex differences (the rest did not specify) [142]. Given the substantially greater prevalence of many clinical pain conditions in women vs. men [20,199], and growing evidence for sex differences in sensitivity to experimental pain and to analgesics [21,41,213], we recommend that all pain researchers consider testing their hypotheses in both sexes, or if restricted by practical considerations, only in females. It is invalid to assume that data obtained in male subjects will generalize to females, and the best non-human model of the modal human pain sufferer -a woman -is a female animal. If only males are examined in a given study, it is important that a rationale for exclusion of females be provided and that the potential limitation in generalizability of the findings be addressed in the discussion, particularly when examining a pain phenomenon that occurs with greater prevalence or severity in females. In both preclinical and clinical studies, a comparison of both sexes will further our understanding of individual differences in sensitivity to pain and analgesia, thus improving our ability to treat and prevent pain in all people. General considerationsTwo issues of terminology are important. First, the term "sex" refers to biologically based differences, while the term "gender" refers to socially based phenomena. Although biological sex exerts a major influence on one's gender identity, sex and gender a...

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Assessment and manifestation of central sensitisation across different chronic pain conditions

Arendt-Nielsen

Morlion

Perrot

et al. 2017

European Journal of Pain

517

494

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Different neuroplastic processes can occur along the nociceptive pathways and may be important in the transition from acute to chronic pain and for diagnosis and development of optimal management strategies. The neuroplastic processes may result in gain (sensitisation) or loss (desensitisation) of function in relation to the incoming nociceptive signals. Such processes play important roles in chronic pain, and although the clinical manifestations differ across condition processes, they share some common mechanistic features. The fundamental understanding and quantitative assessment of particularly some of the central sensitisation mechanisms can be translated from preclinical studies into the clinic. The clinical perspectives are implementation of such novel information into diagnostics, mechanistic phenotyping, prevention, personalised treatment, and drug development. The aims of this paper are to introduce and discuss (1) some common fundamental central pain mechanisms, (2) how they may translate into the clinical signs and symptoms across different chronic pain conditions, (3) how to evaluate gain and loss of function using quantitative pain assessment tools, and (4) the implications for optimising prevention and management of pain. The chronic pain conditions selected for the paper are neuropathic pain in general, musculoskeletal pain (chronic low back pain and osteoarthritic pain in particular), and visceral pain (irritable bowel syndrome in particular). The translational mechanisms addressed are local and widespread sensitisation, central summation, and descending pain modulation. Significance Central sensitisation is an important manifestation involved in many different chronic pain conditions. Central sensitisation can be different to assess and evaluate as the manifestations vary from pain condition to pain condition. Understanding central sensitisation may promote better profiling and diagnosis of pain patients and development of new regimes for mechanism based therapy. Some of the mechanisms underlying central sensitisation can be translated from animals to humans providing new options in development of therapies and profiling drugs under development.

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Effect of sex on perception of rectosigmoid stimuli in irritable bowel syndrome

Cited by 99 publications

References 55 publications

Sex differences in brain activity during aversive visceral stimulation and its expectation in patients with chronic abdominal pain: A network analysis

Sex differences in brain activity during aversive visceral stimulation and its expectation in patients with chronic abdominal pain: A network analysis

Studying sex and gender differences in pain and analgesia: A consensus report

Assessment and manifestation of central sensitisation across different chronic pain conditions

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