Kamath M V, Tougas G, Fitzpatrick D, Fallen E L, Watteel R, Shine G, Upton A R
Department of Medicine, McMaster University, Hamilton.
Clin Invest Med. 1998 Jun;21(3):100-13.
To examine the effects of esophageal stimulation on vagal afferent and efferent pathways in volunteers without diabetes and patients with diabetes.
Prospective physiological study.
Fourteen control subjects without diabetes and 6 patients with diabetes.
Electrical and mechanical stimulation of the esophagus.
Cortical evoked potentials and the power spectra of heart rate variability.
For the control subjects, there was a significant decrease in the ratio of the low frequency to high frequency (LF:HF) power (i.e., increased vagal efferent modulation) during stimulation. Reproducible cortical evoked potentials were obtained from all control subjects. In the 6 patients with diabetes, who had viscerosensory and autonomic neuropathy, the cortical evoked potentials showed an erratic non-reproducible response to electrical esophageal stimulation; however, the LF:HF ratio decreased in these patients during stimulation, suggesting an intact subcortical reflex circuit.
Vago-afferent fibres can be studied using minimally invasive techniques, and the power spectral analysis of heart rate variability permits study of autonomic vago-efferent pathways.
研究食管刺激对无糖尿病志愿者和糖尿病患者迷走神经传入和传出通路的影响。
前瞻性生理学研究。
14名无糖尿病的对照受试者和6名糖尿病患者。
食管的电刺激和机械刺激。
皮层诱发电位和心率变异性的功率谱。
对于对照受试者，刺激期间低频与高频功率之比（LF:HF）显著降低（即迷走神经传出调制增加）。所有对照受试者均获得了可重复的皮层诱发电位。在6名患有内脏感觉和自主神经病变的糖尿病患者中，皮层诱发电位对食管电刺激表现出不稳定的不可重复反应；然而，这些患者在刺激期间LF:HF比值降低，提示皮层下反射回路完整。
可以使用微创技术研究迷走神经传入纤维，心率变异性的功率谱分析有助于研究自主迷走神经传出通路。
