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[皮层和腰部磁刺激后诱发的肛门括约肌机械和电反应]

[Evoked mechanical and electrical anal sphincter responses after cortical and lumbar magnetic stimulation].

作者信息

Welter M L, Dechoz S, Leroi A M, Weber J

机构信息

Service de neurophysiologie, hôpital Charles-Nicolle, Rouen, France.

出版信息

Neurophysiol Clin. 2000 Aug;30(4):246-53. doi: 10.1016/s0987-7053(00)00222-7.

Abstract

In 13 healthy volunteers we recorded electrical and mechanical anal sphincter (AS) evoked responses. Electrical responses were obtained with surface electrodes, and mechanical responses by anal manometry; all responses were compared with those of anterior tibialis. Mechanical evoked responses' latency and amplitude were calculated. The mean total conduction time of the electrical responses was 26.07 ms at rest and 23.31 ms with mild contraction (p < 0.003). After lumbar magnetic stimulations, because of stimulation artefact, electrical responses couldn't be correctly measured. The mean central conduction time calculated with mechanical responses was 21.44 ms at rest and 18.81 ms with mild contraction (p < 0.003). The mean central conduction time to the anterior tibialis was shorter (14.38 ms; p < 0.003). Evoked mechanical responses', amplitudes were respectively 128.2 cm H2O (cortical stimulations at rest), 138.8 cm H2O (cortical stimulations with mild contraction) and 133.1 cm H2O (lumbar stimulations at rest) (NS). Evoked mechanical responses amplitudes were correlated with the AS maximal voluntary contraction amplitude (p < 10(-4)). Mechanical motor evoked responses after cortical and lumbar magnetic stimulations can be recorded and quantified. In anorectal disorders, this technique could be of major interest for the diagnosis of neurologic lesions versus behavioural problems.

摘要

在13名健康志愿者中,我们记录了肛门括约肌(AS)的电反应和机械反应。电反应通过表面电极获得,机械反应通过肛门测压获得;所有反应均与胫前肌的反应进行比较。计算机械诱发反应的潜伏期和幅度。电反应的平均总传导时间在静息时为26.07毫秒,轻度收缩时为23.31毫秒(p<0.003)。在腰椎磁刺激后,由于刺激伪迹,无法正确测量电反应。用机械反应计算的平均中枢传导时间在静息时为21.44毫秒,轻度收缩时为18.81毫秒(p<0.003)。至胫前肌的平均中枢传导时间较短(14.38毫秒;p<0.003)。诱发的机械反应幅度分别为128.2厘米水柱(静息时皮层刺激)、138.8厘米水柱(轻度收缩时皮层刺激)和133.1厘米水柱(静息时腰椎刺激)(无显著性差异)。诱发的机械反应幅度与AS最大自主收缩幅度相关(p<10⁻⁴)。皮层和腰椎磁刺激后的机械运动诱发反应可以被记录和量化。在肛门直肠疾病中,这项技术对于诊断神经病变与行为问题可能具有重要意义。

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