Postprandial distress syndrome (PDS) is the most common functional dyspepsia (FD) subtype. Early satiety is one of the cardinal symptoms of the PDS subtype in FD patients. The heterogeneity of symptoms in FD patients hampered therapy for patients based on specific symptoms, necessitating a symptom-based understanding of the pathophysiology of FD. To investigate the correlation between reward circuit and symptom severity of PDS patients, seed (Nucleus accumbens, NAc, a key node in the reward circuit) based resting-state functional connectivity (FC) was applied in the neuroimaging data analysis. The results demonstrated that the patients with PDS manifested strengthened FC between NAc and the caudate, putamen, pallidum, amygdala, hippocampus, thalamus, anterior cingulate cortex (ACC), and insula. Moreover, the FC between NAc and ACC, insula, thalamus, and hippocampus exhibited significant positive associations with symptom severity. More importantly, the strengthened FC between NAc and the ACC, insula, amygdala, and hippocampus were found associated with the early satiety symptom of patients with PDS. This study indicated that the altered FC of reward circuit regions may play a role in the pathophysiology of patients with PDS, and some of the aberrant NAc-based FC within the reward circuit were more related to the early satiety of patients with PDS. These findings improve our symptom-based understanding of the central pathophysiology of FD, lay the groundwork for an objective diagnosis of FD, and shed light on the precise prescription for treating FD based on symptoms.

中文翻译：

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奖赏回路功能连接异常与餐后窘迫综合征患者的早饱感相关

餐后窘迫综合征（PDS）是最常见的功能性消化不良（FD）亚型。早饱是PDS亚型FD患者的主要症状之一。 FD 患者症状的异质性阻碍了根据特定症状对患者进行治疗，因此需要基于症状来了解 FD 的病理生理学。为了研究 PDS 患者的奖赏回路与症状严重程度之间的相关性，将基于种子（伏隔核，NAc，奖赏回路中的关键节点）的静息态功能连接（FC）应用于神经影像数据分析。结果表明，PDS患者表现为NAc与尾状核、壳核、苍白球、杏仁核、海马、丘脑、前扣带皮层（ACC）和岛叶之间的FC增强。此外，NAc 和 ACC、岛叶、丘脑和海马之间的 FC 与症状严重程度呈显着正相关。更重要的是，NAc 与 ACC、岛叶、杏仁核和海马之间的 FC 增强与 PDS 患者的早饱症状有关。这项研究表明，奖赏回路区域的FC改变可能在PDS患者的病理生理学中发挥作用，并且奖赏回路内一些异常的基于NAc的FC与PDS患者的早饱感更相关。这些发现提高了我们对 FD 核心病理生理学的基于症状的理解，为 FD 的客观诊断奠定了基础，并为根据症状治疗 FD 提供了精确的处方。