Citation

Kano M, Farmer AD, Aziz Q, Giampietro V, Brammer MJ, Williams SC, Fukudo S, Coen SJ. Am J Physiol Gastrointest Liver Physiol 2013; 304(8): G687-99.

Affiliation

1Tohoku University, Graduate School of Medicine.

Copyright

(Copyright © 2013, American Physiological Society)

DOI

10.1152/ajpgi.00385.2012

PMID

23392235

Abstract

Females demonstrate higher pain sensitivity and prevalence of chronic visceral pain conditions such as functional gastrointestinal disorders, than males. The role of sex differences in the brain processing of visceral pain is still unclear. In 16 male and 16 female healthy subjects we compared personality, anxiety levels, skin conductance response (SCR) and brain processing using functional MRI during anticipation and pain induced by oesophageal distension at pain toleration level. There was no significant difference in personality scores, anxiety levels, SCR and subjective ratings of pain between sexes. In group analysis, both males and females demonstrated a similar pattern of brain activation and deactivation during anticipation and pain consistent with previous reports. However, during anticipation females showed significantly greater activation in the cuneus, precuneus, and supplementary motor area (SMA) and stronger deactivation in the right amygdala and left parahippocampal gyrus , whilst males demonstrated greater activation in the cerebellum. During pain, females demonstrated greater activation in the midcingulate cortex, anterior insula, premotor cortex, and cerebellum and stronger deactivation in the caudate, whilst males showed increased activity in the SMA. The pattern of brain activity suggests that, during anticipation, females may demonstrate stronger limbic inhibition, which is considered to be a cognitive modulation strategy for impending painful stimulation. During pain, females significantly activate brain areas associated with the affective and motivation components of pain. These responses may underlie the sex differences that exist in pain conditions, whereby females may attribute more emotional importance to painful stimuli in comparison to males.

Language: en