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Cortical and spinal evoked potential response to electrical stimulation in human rectum

World Journal of Gastroenterology 2010年第43期16卷 5440-5446页

作者： Brian Garvin Lisa Lovely Alex Tsodikov Danielle Minecan shaungson hong John W Wiley Department of Internal Medicine University of Michigan Michigan Clinical Research Unit Level 1 Room 1702 Cardiovascular Center 1500E Medical Center Drive Ann Arbor MI 48109 United States Department of Neurology University of Michigan Ann Arbor MI 48109 United States Department of Biostatistics University of Michigan Ann Arbor MI 48109 United States

AIM: To study a novel technique to record spinal and cortical evoked potentials (EPs) simultaneously in response to electrical stimulation in the human rectum. METHODS: Eight male and nine female healthy volunteers participated. Stimulating electrodes were attached to the rectal mucosa at 15 cm and 12 cm above the dentate line. Recording skin electrodes were positioned over vertebrae L4 through S2. The electrical stimulus was a square wave of 0.2 ms duration and the intensity of the stimulus varied between 0 and 100 mA. EP responses were recorded using a Nicolet Viking IV programmable signal ***: Simultaneous recording of cortical and spinal EPs was obtained in > 80% of the trials. The EP responses increased with the intensity of the electrical stimulation, were reproducible overtime, and were blocked by application of Lidocaine jelly at the site of stimulation. The morphology (N1/P1), mean ± SD for latency (spinal N1, 4.6 ± 0.4 ms; P1, 6.8 ± 0.5 ms; cortical N1, 136.1 ± 4.2 ms; P1, 233.6 ± 12.8 ms) and amplitude (N1/P1, spinal, 38 ± 7 μV; cortical 19 ± 3 μV) data for the EP responses were consistent with those in the published literature. Reliable and reproducible EP recordings were obtained with the attachment of the electrodes to the rectal mucosa at predetermined locations between 16 and 8 cm above the anal verge, and the distance between the attachment sites of the electrodes (the optimal distance being approximately 3.0 cm between the two electrodes). CONCLUSION: This technique can be used to assess potential abnormalities in primary afferent neural pathways innervating the rectum in several neurodegenerative and functional pain disorders.

关键词： Spinal evoked potentials Cortical evoked potentials Rectum Electrical stimulation Primary afferent neurons Visceral sensation

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