Rössel P, Pedersen P, Niddam D, Arendt-Nielsen L, Chen A C, Drewes A M
Dept. of Medical Gastroenterology, Aalborg Hospital, Denmark.
Scand J Gastroenterol. 2001 Dec;36(12):1259-66. doi: 10.1080/003655201317097092.
Visceral hyperalgesia may play an important part in the pathophysiology of the irritable bowel syndrome (IBS). We investigated the neuronal afferent pathways in healthy volunteers and IBS patients by recording evoked potentials (EPs) elicited by electrical stimulation of the colon and abdominal skin inside and outside the referred pain area.
Six healthy subjects and nine IBS patients met the inclusion criteria. Morphology and topography of EPs to painful electrical stimuli were estimated in the rectosigmoid junction and on the skin inside/outside the referred pain areas.
The EPs to painful stimuli of the gut showed a shorter latency and a smaller amplitude of the first positive peak (P1) in the IBS group. The controls had a mid-latency frontal positive component after 100 ms, whereas no reliable early activation was seen in the IBS patients. In controls, a single late (>150 ms) positive component was seen, whereas the late component was biphasic in the IBS group. The EPs to painful stimuli of the two skin areas differed in IBS patients, but not in controls.
Differences in the EPs to electrical painful stimulation of the sigmoid colon and skin inside/outside the experimentally evoked referred pain area were seen comparing healthy subjects and IBS patients. The results indicate altered central nervous system responses.
内脏高敏反应可能在肠易激综合征（IBS）的病理生理学中起重要作用。我们通过记录结肠电刺激以及牵涉痛区域内外腹部皮肤电刺激诱发的诱发电位（EP），研究了健康志愿者和IBS患者的神经传入通路。
6名健康受试者和9名IBS患者符合纳入标准。评估了直肠乙状结肠交界处以及牵涉痛区域内外皮肤对疼痛性电刺激的EP的形态和地形图。
IBS组中，肠道对疼痛刺激的EP显示出较短的潜伏期和第一个正向波峰（P1）较小的波幅。对照组在100毫秒后有一个中潜伏期额叶正向成分，而IBS患者未观察到可靠的早期激活。在对照组中，观察到一个单一的晚期（>150毫秒）正向成分，而IBS组中的晚期成分是双相的。IBS患者中，两个皮肤区域对疼痛刺激的EP不同，但对照组中无差异。
与健康受试者相比，在乙状结肠以及实验诱发的牵涉痛区域内外皮肤的疼痛性电刺激的EP上，健康受试者和IBS患者之间存在差异。结果表明中枢神经系统反应发生了改变。
