Highlights
- •A systematic review of brain imaging studies identifies areas related with nausea.
- •Inferior frontal gyrus, anterior insula and cingulate cortex were most commonly activated.
- •Basal ganglia (e.g., putamen) structures were also consistently activated.
- •Some evidence for lateralization was identified (e.g., left inferior frontal gyrus).
- •Results are discussed in relation to visceral sensations, study limitations and research lacunae.
Abstract
Nausea is a common clinical symptom, poorly managed with anti-emetic drugs. To identify
potential brain regions which may be therapeutic targets we systematically reviewed
brain imaging in subjects reporting nausea. The systematic review followed PRISMA
statements with methodological quality (MINORS) and risk of bias (ROBINS-I) assessed.
Irrespective of the nauseagenic stimulus the common (but not only) cortical structures
activated were the inferior frontal gyrus (IFG), the anterior cingulate cortex (ACC)
and the anterior insula (AIns) with some evidence for lateralization (Left-IFG, Right-AIns,
Right-ACC). Basal ganglia structures (e.g., putamen) were also consistently activated.
Inactivation was rarely reported but occurred mainly in the cerebellum and occipital
lobe. During nausea, functional connectivity increased, mainly between the posterior
and mid- cingulate cortex. Limitations include, a paucity of studies and stimuli,
subject demographics, inconsistent definition and measurement of nausea. Structures
implicated in nausea are discussed in the context of knowledge of central pathways
for interoception, emotion and autonomic control. Comparisons are made between nausea
and other aversive sensations as multimodal aversive conscious experiences.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: December 19, 2022
Accepted:
December 14,
2022
Received in revised form:
September 20,
2022
Received:
June 27,
2022
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