Document Detail


Neurophysiological evaluation of healthy human anorectal sensation.
MedLine Citation:
PMID:  16690905     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients with functional gastrointestinal disorders often demonstrate abnormal visceral sensation. Currently, rectal sensation is assessed by manual balloon distension or barostat. However, neither test is adaptable for use in the neurophysiological characterization of visceral afferent pathways by sensory evoked potentials. The aim of this study was to assess the reproducibility and quality of sensation evoked by electrical stimulation (ES) and rapid balloon distension (RBD) in the anorectum and to apply the optimum stimulus to examine the visceral afferent pathway with rectal evoked potentials. Healthy subjects (n = 8, median age 33 yr) were studied on three separate occasions. Variability, tolerance, and stimulus characteristics were assessed with each technique. Overall ES consistently invoked pain and was chosen for measuring rectal evoked potential whereas RBD in all cases induced the strong urge to defecate. Rectal intraclass correlation coefficient (ICC) for ES and RBD (0.82 and 0.72, respectively) demonstrated good reproducibility at pain/maximum tolerated volume but not at sensory threshold. Only sphincter ICC for ES at pain showed acceptable between-study reproducibility (ICC 0.79). Within studies ICC was good (>0.6) for anorectal ES and RBD at both levels of sensation. All subjects reported significantly more unpleasantness during RBD than ES (P < 0.01). This study demonstrates that ES and RBD are similarly reproducible. However, the sensations experienced with each technique differed markedly, probably reflecting differences in peripheral and/or central processing of the sensory input. This is of relevance in interpreting findings of neuroimaging studies of anorectal sensation and may provide insight into the physiological characteristics of visceral afferent pathways in health and disease.
Authors:
M L Harris; A R Hobson; S Hamdy; D G Thompson; L M Akkermans; Q Aziz
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-05-11
Journal Detail:
Title:  American journal of physiology. Gastrointestinal and liver physiology     Volume:  291     ISSN:  0193-1857     ISO Abbreviation:  Am. J. Physiol. Gastrointest. Liver Physiol.     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-10-10     Completed Date:  2006-11-24     Revised Date:  2014-02-19    
Medline Journal Info:
Nlm Unique ID:  100901227     Medline TA:  Am J Physiol Gastrointest Liver Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  G950-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anal Canal / innervation*,  physiology*
Anxiety / psychology
Catheterization
Electric Stimulation
Evoked Potentials / physiology
Female
Humans
Male
Manometry
Middle Aged
Muscle Contraction / physiology
Pain / psychology
Pain Measurement
Physical Stimulation
Rectum / innervation*,  physiology*
Reference Values
Reproducibility of Results
Sensation / physiology
Grant Support
ID/Acronym/Agency:
G0300195//Medical Research Council

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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