Loening-Baucke V, Anderson R H, Yamada T, Zhu Y X
Department of Pediatrics, University of Iowa, Iowa City, USA.
Neurology. 1995 Aug;45(8):1510-6. doi: 10.1212/wnl.45.8.1510.
Quantitative studies of the afferent pathways from hollow viscera have been limited by the lack of an easily controlled, reproducible visceral stimulus. We adapted a slow distention device to allow for rapid distention to study the afferent pathways from the rectum. The device produced a pressure increase of 10 mm Hg in 42 msec and of 20 mm Hg in 60 msec. We recorded cerebral evoked potentials (EPs) after rectal balloon distention in 17 healthy subjects. Several averages of 25 to 50 rectal distentions at 0.17-Hz frequency were recorded. The responses consisted of multiple peaks within 200 msec after stimulation. The mean latency of the initial positive peak was 44 msec, suggesting that a myelinated pathway was stimulated with mechanical rectal distention. Our device produced reliable and repeatable EPs that were independent of balloon characteristics or rectal pressures. EP recording after rectal stimulation may become a useful technique for the physiologic investigation of disorders such as fecal incontinence, constipation, irritable bowel syndrome, and chronic intestinal pseudo-obstruction.
对中空脏器传入通路的定量研究一直受到缺乏易于控制、可重复的内脏刺激的限制。我们改良了一种缓慢扩张装置，使其能够快速扩张，以研究直肠的传入通路。该装置在42毫秒内使压力升高10毫米汞柱，在60毫秒内使压力升高20毫米汞柱。我们记录了17名健康受试者直肠气囊扩张后的大脑诱发电位（EP）。以0.17赫兹的频率对直肠进行25至50次扩张，并记录了几次平均值。反应包括刺激后200毫秒内的多个峰值。初始正峰的平均潜伏期为44毫秒，这表明机械性直肠扩张刺激了一条有髓通路。我们的装置产生了可靠且可重复的EP，这些EP与气囊特征或直肠压力无关。直肠刺激后的EP记录可能成为一种用于生理研究诸如大便失禁、便秘、肠易激综合征和慢性肠道假性梗阻等疾病的有用技术。
