{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T21:36:23Z","timestamp":1776893783843,"version":"3.51.2"},"reference-count":53,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,12,18]],"date-time":"2013-12-18T00:00:00Z","timestamp":1387324800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Endogenous pain modulation (<jats:styled-content style=\"fixed-case\">EPM<\/jats:styled-content>) is central to the processing of sensory information. Visceral and somatic <jats:styled-content style=\"fixed-case\">EPM<\/jats:styled-content> are abnormal in irritable bowel syndrome, but have not been studied in functional dyspepsia (<jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Visceral <jats:styled-content style=\"fixed-case\">EPM<\/jats:styled-content> was assessed in 34 <jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content> patients and 42 healthy controls. Gastric pain was induced with oral capsaicin and <jats:styled-content style=\"fixed-case\">EPM<\/jats:styled-content> was studied by adding heterotopic thermal foot stimulation or distraction by <jats:styled-content style=\"fixed-case\">STROOP<\/jats:styled-content> test. Somatic <jats:styled-content style=\"fixed-case\">EPM<\/jats:styled-content> was assessed using foot heat stimulation with heterotopic hand electrical stimulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Endogenous pain modulation by distraction reduced mean gastric pain by 11.9 on the 0\u2013100 visual analog scale (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 3.8\u201320.1) in controls (p\u00a0=\u00a00.006) and by 2.0 (\u22126.18 to 10.44) in <jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content> (p\u00a0=\u00a00.6), with greater <jats:styled-content style=\"fixed-case\">EPM<\/jats:styled-content> in controls than in <jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content> (difference \u221213.3 [\u221226.1 to \u22120.5]; p\u00a0=\u00a00.04). Endogenous pain modulation by heterotopic foot stimulation reduced gastric pain by 6.5 (\u22120.7 to 13.6) in controls (p\u00a0=\u00a00.07) and by 7.1 (\u22122.29 to 16.47) in <jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content> (p\u00a0=\u00a00.1), with no significant difference in <jats:styled-content style=\"fixed-case\">EPM<\/jats:styled-content> between controls and <jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content> (\u22122.0 [\u221214.5 to 10.5]; p\u00a0=\u00a00.75). In patients with prominent <jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content> pain, greater pain correlated with decreased visceral <jats:styled-content style=\"fixed-case\">EPM<\/jats:styled-content> by distraction (r\u00a0=\u00a00.51, p\u00a0=\u00a00.04). Somatic <jats:styled-content style=\"fixed-case\">EPM<\/jats:styled-content> by heterotopic stimulation significantly decreased foot pain in controls (p\u00a0=\u00a00.004), but not in <jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content> (p\u00a0=\u00a00.80).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Inferences<\/jats:title><jats:p>In <jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content>, visceral pain modulation by distraction was dysfunctional compared to controls. Somatic pain modulation was also decreased in <jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content>. These data and the correlation of abnormal pain modulation by distraction with clinical pain in pain\u2010predominant <jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content> suggest a potential pathophysiological significance of abnormal pain modulation in <jats:styled-content style=\"fixed-case\">FD<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.12291","type":"journal-article","created":{"date-parts":[[2013,12,19]],"date-time":"2013-12-19T03:12:23Z","timestamp":1387422743000},"page":"489-498","source":"Crossref","is-referenced-by-count":17,"title":["Dysfunctional endogenous pain modulation in patients with functional dyspepsia"],"prefix":"10.1111","volume":"26","author":[{"given":"C. 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