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The Journal of Neuroscience, April 1, 2000, 20(7):2657-2663

Cortical Processing of Human Somatic and Visceral Sensation

Q. Aziz¹, D. G. Thompson³, V. W. K. Ng¹, S. Hamdy³, S. Sarkar³, M. J. Brammer², E. T. Bullmore², A. Hobson³, I. Tracey⁴, L. Gregory¹, A. Simmons¹, and S. C. R. Williams¹

Departments of ¹ Clinical Neurosciences, and ² Biostatistics and Computing, Institute of Psychiatry, London SE5 8AF, United Kingdom, ³ Department of Gastroenterology, Hope Hospital, University of Manchester, Salford M6 8HD, United Kingdom, and ⁴ Oxford University Center for Functional Magnetic Resonance Imaging of the Brain, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom

Somatic sensation can be localized precisely, whereas localization of visceral sensation is vague, possibly reflecting differences in the pattern of somatic and visceral input to the cerebral cortex. We used functional magnetic resonance imaging to study the cortical processing of sensation arising from the proximal (somatic) and distal (visceral) esophagus in six healthy male subjects. Esophageal stimulation was performed by phasic distension of a 2 cm balloon at 0.5 Hz. For each esophageal region, five separate 30 sec periods of nonpainful distension were alternated with five periods of similar duration without distension. Gradient echoplanar images depicting bold contrast were acquired using a 1.5 T GE scanner. Distension of the proximal esophagus was localized precisely to the upper chest and was represented in the trunk region of the left primary somatosensory cortex. In contrast, distension of the distal esophagus was perceived diffusely over the lower chest and was represented bilaterally at the junction of the primary and secondary somatosensory cortices. Different activation patterns were also observed in the anterior cingulate gyrus with the proximal esophagus being represented in the right midanterior cingulate cortex (BA 24) and the distal esophagus in the perigenual area (BA32). Differences in the activation of the dorsolateral prefrontal cortex and cerebellum were also observed for the two esophageal regions. These findings suggest that cortical specialization in the sensory-discriminative, affective, and cognitive areas of the cortex accounts for the perceptual differences observed between the two sensory modalities.

Key words: cerebral cortex; esophagus; somatic; visceral; functional magnetic resonance imaging; sensation

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Copyright © 2000 Society for Neuroscience  0270-6474/00/2072657-07$05.00/0

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