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60例成年人直肠电刺激脑诱发电位特点及结果分析

来源:泰然健康网 时间:2024年12月08日 00:54

目的

探讨正常人直肠电刺激脑诱发电位(CEP)的正常值及波形特征。

方法

检查者将刺激电极经肛置入受试者直肠内,在头顶部Cz点放置记录电极,参考电极置于前额部Fz点,使用英国Oxford公司肌电诱发电位仪采样分析。

结果

所有检测对象均记录有直肠电刺激脑诱发电位,各波参数范围分别是:P1波潜伏期(45.55±3.26)ms,N1波(101.71±15.71)ms,P2波(198.35±27.70)ms,P1/N1波幅(5.62±1.58)μV,N1/P2波幅(8.26±2.48)μV。直肠电刺激脑诱发电位各波潜伏期及波幅在性别、年龄分组间比较,差异无统计学意义。经一般线性回归分析发现,在控制年龄分组、性别后,波幅随BMI增加而降低,BMI每增加1 kg/m2,P1/N1波幅平均下降0.234 μV(P=0.011),N1/P2波幅平均下降0.320 μV(P=0.027)。

结论

直肠电刺激脑诱发电位提供了一种简单、有效的评估直肠到大脑皮层感觉神经通路的方法。本研究对了解功能性胃肠疾病中的脑肠互动作用具有重要价值。本研究的检测结果及其影响因素分析,可供后续临床研究借鉴。

Objective

To investigate the normal range and waveform characteristics of rectal electrical stimulation cerebral evoked potential (CEP) in healthy people.

Methods

The examiner placed the stimulus electrode in the rectum of the subjects through the anus, the recording electrode at Cz point on the top of the head, the reference electrode at Fz point on the forehead and sampled by Oxford EMP.

Results

Rectal electrical stimulation cerebral evoked potentials were recorded in all subjects. The waveform parameters are P1 wave latency (45.55±3.26) ms, N1 wave (101.71±15.71) ms, P2 wave (198.35±27.70) ms, P1/N1 amplitude (5.62±1.58) μV, N1/P2 amplitude (8.26±2.48) μV. There was no significant difference in latency and amplitude of the evoked potential waves between sex and age groups. By general linear regression analysis, it was found that the amplitude decreased with the increase of BMI after controlling age group and sex. For each increase of BMI of 1 kg/m2, the amplitude of P1/N1 decreased by 0.234 μV (P=0.011), and the amplitude of N1/P2 decreased by 0.320 μV (P=0.027).

Conclusion

Rectal electrical stimulation cerebral evoked potentials provides a simple and effective method for evaluating the sensory nerve pathway from rectum to cerebral. This study is of great value in understanding the brain-intestinal interaction in functional gastrointestinal diseases. The results of this study and the analysis of its influencing factors can be used for reference in the follow-up clinical research.

[1]

彭超,汤颖. 体感诱发电位临床新进展[J/CD]. 中华临床医师杂志(电子版), 2013, 7(22): 10260-10262.

[2]

胡晓晴,唐娜. 体感诱发电位的基本原理[J]. 国外医学(物理医学与康复学分册), 2005, (2): 53-55+79.

[3]

倪敏,丁义江,丁曙晴. 神经调节在功能性胃肠病发病中的作用及其研究进展[J]. 世界华人消化杂志, 2011, 19(25): 2649-2653.

[4]

王心刚. 神经电生理诊断技术规范(续) [J]. 现代电生理学杂志, 2018, 25(01): 55-62.

[5]

Ridding MC, Ziemann U. Determinants of the induction of cortical plasticity by non-invasive brain stimulation in healthy subjects [J]. J Physiol, 2010, 588(13): 2291-2304.

[6]

刘娟. 脑电图检查在临床规范应用中的若干注意事项[J]. 现代电生理学杂志, 2009, 16(1): 36-38.

[7]

Harris ML, Hobson AR, Hamdy S, et al. Neurophysiological evaluation of healthy human anorectal sensation [J]. American Journal of Physiology Gastrointestinal & Liver Physiology, 2006, 291(5): G950.

[8]

Hobson AR, Aziz Q, Furlong PL, et al. Identification of the optimal parameters for recording cortical evoked potentials to human oesophageal electrical stimulation [J]. Neurogastroenterol Motil, 1998, 10(5): 421-430.

[9]

潘映辐. 临床诱发电位学[M]. 北京: 人民卫生出版社, 1988: 85-87.

[10]

Thiruppathy K, Mason J, Akbari K, et al. A physiological study of the anorectal reflex in patients with functional anorectal and defecation disorders [J]. Journal of Digestive Diseases, 2017, 18(4): 222-228.

[11]

匡荣光,匡彦,左秀丽, 等. 功能性便秘患者直肠扩张脑诱发电位研究[J]. 中国医师杂志, 2008, 10(10): 1380-1381.

[12]

李延青,左秀丽,匡荣光, 等. 肠易激综合征患者直肠扩张后脑诱发电位的研究[J]. 基础医学与临床, 2003, 12(z1): 349-351.

[13]

Drossman DA. Functional gastrointestinal disorders: history, pathophysiology, clinical features and romeⅣ [J]. Gastroenterology, 2016, 150(6): 1262-1279. e2.

[14]

Grunkemeier DMS, Cassara JE, Dalton CB, et al. The narcotic bowel syndrome: clinical features, pathophysiology, and Management [J]. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association, 2007, 5(10): 1126-1139.

[15]

Iovino P, Bucci C, Tremolaterra F, et al. Bloating and functional gastro-intestinal disorders: where are we and where are we going? [J]. World Journal of Gastroenterology, 2014, 20(39): 14407.

[16]

Peter H, Aitak F, Hassan AM, et al. Visceral inflammation and immune activation stress the brain [J]. Frontiers in Immunology, 2017, 8: 1613.

[17]

Mertz H. Role of the brain and sensory pathways in gastrointestinal sensory disorders in humans [J]. Gut, 2002, 51(1): 29-33.

[18]

Whitehead WE, Holtkotter B, Enck P, et al. Tolerance for rectosigmoid distention in irritable bowel syndrome [J]. Gastroenterology, 1990, 98(5 Pt 1): 1187.

[19]

蒋晓忠,王邦茂,赵晓志, 等. 直肠内不同温度刺激对肠易激综合征患者内脏敏感性的影响[J]. 胃肠病学和肝病学杂志, 2006, (2): 163-166.

[20]

Su A, Gandhy R, Barlow C, et al. Utility of high-resolution anorectal manometry and wireless motility capsule in the evaluation of patients with Parkinson′s disease and chronic constipation[J]. BMJ Open Gastroenterology, 2016, 3(1): e000118.

[21]

Sinhamahapatra P, Saha SP, Chowdhury A, et al. Visceral afferent hypersensitivity in irritable bowel syndrome--evaluation by cerebral evoked potential after rectal stimulation [J]. American Journal of Gastroenterology, 2001, 96(7): 2150-2157.

[22]

丁曙晴. 肛管直肠测压在排便障碍性疾病中的价值及临床解读[J]. 中华胃肠外科杂志, 2016, (12): 1342-1344.

[23]

Sauter M, Heinrich H, Fox M, et al. Toward more accurate measurements of anorectal motor and sensory function in routine clinical practice: Validation of High-Resolution Anorectal Manometry and Rapid Barostat Bag measurements of rectal function [J]. Neurogastroenterology & Motility, 2014, 26(5): 685-695.

[24]

Gaman A, Kuo B. A review of CNS activation patterns from fMRI studies in IBS patients versus healthy controls [J]. Gastroenterology, 2007, 32: 600-602.

[25]

Dimcevski G, Sami SA, Funch-Jensen P, et al. Pain in Chronic Pancreatitis: The Role of Reorganization in the Central Nervous System [J]. Gastroenterology, 2007, 132(4): 1546-1556.

[26]

Delechenault P, Leroi AM, Bruna T, et al. Cerebral potentials evoked by electrical stimulation of the anal canal [J]. Diseases of the Colon & Rectum, 1993, 36(1): 55.

[27]

Lelic D, Nissen TD, Brock C, et al. Rapid balloon distension as a tool to study cortical processing of visceral sensations and pain [J]. Neurogastroenterology & Motility the Official Journal of the European Gastrointestinal Motility Society, 2015, 27(6): 832-840.

[28]

Haas S, Brock C, Krogh K, et al. Cortical evoked potentials in response to rapid balloon distension of the rectum and anal canal [J]. Neurogastroenterology & Motility, 2014, 26(6): 862-873.

[29]

Hobday DI, Hobson A, Furlong PL, et al. Comparison of cortical potentials evoked by mechanical and electrical stimulation of the rectum. Neurogastroenterol Motil. 2000 Dec; 12(6): 547-554.

[30]

Leroi AM, Ducrotté P, Bouaniche M, et al. Assessment of the reliability of cerebral potentials evoked by electrical stimulation of the anal canal [J]. International Journal of Colorectal Disease, 1997, 12(6): 335-339.

[31]

Remes-Troche JM, Tantiphlachiva K, Attaluri A, et al. A bi-directional assessment of the human brain-anorectal axis [J]. Neurogastroenterology & Motility the Official Journal of the European Gastrointestinal Motility Society, 2011, 23(3): 117-118.

[32]

Vasudevan SP, Scott SM, Gladman MA, et al. Rectal hyposensitivity: evaluation of anal sensation in female patients with refractory constipation with and without faecal incontinence [J]. Neurogastroenterology & Motility, 2007, 19(8): 660-667.

[33]

Gagliardo A, Galli F, Grippo A, et al. Motor evoked potentials in multiple sclerosis patients without walking limitation: amplitude vs. conduction time abnormalities [J]. Journal of Neurology, 2007, 254(2): 220-227.

[34]

Delgadoaros S, Locke GR, Camilleri M, et al. Obesity is associated with increased risk of gastrointestinal symptoms: A population-based study [J]. American Journal of Gastroenterology, 2004, 99(9): 1801-1806.

[35]

Delgadoaros S, Camilleri M, Garcia MA, et al. High body mass alters colonic sensory-motor function and transit in humans [J]. American Journal of Physiology Gastrointestinal & Liver Physiology, 2008, 295(2): G382-388.

[36]

Teitelbaum JE, Sinha P, Micale M, et al. Obesity is related to multiple functional abdominal diseases [J]. J Pediatr, 2009, 154(3): 444-446.

[37]

Gudsoorkar VS, Quigley EM. Colorectal sensation and motility [J]. Current Opinion in Gastroenterology, 2014, 30(1): 75-83.

[38]

郭椿,贺平. 脑肠轴及其研究进展[J]. 世界最新医学信息文摘, 2017, 17(95): 89-91.

[39]

Andresen V, Bach DR, Poellinger A, et al. Brain activation responses to subliminal or supraliminal rectal stimuli and to auditory stimuli in irritable bowel syndrome [J]. Neurogastroenterol Motil, 2005, 17(6): 827-837.

[40]

Fenton BW. Limbic associated pelvic pain: A hypothesis to explain the diagnostic relationships and features of patients with chronic pelvic pain [J]. Medical Hypotheses, 2007, 69(2): 282-286.

[41]

Takano S, Arakawa H. Bilateral posterior tibial nerve stimulation for functional anorectal pain-short term outcome [J]. International Journal of Colorectal Disease, 2016, 31(5): 1053-1054.

[42]

倪敏,丁曙晴,皇甫少华, 等. 功能性排便障碍患者经腰刺激运动诱发电位的研究[J]. 第三军医大学学报, 2013, 35(21): 2292-2294.

[43]

倪敏,丁义江,丁曙晴, 等. 功能性便秘患者经颅磁刺激运动诱发电位的研究[J]. 南京医科大学学报(自然科学版), 2011, 31(11): 1674-1678.

[44]

Geeraerts B, Oudenhove LV, Dupont P, et al. Different regional brain activity during physiological gastric distension compared to balloon distension: a H215O-PET study [J]. Neurogastroenterology & Motility, 2011, 23(6): 533-e203.

[45]

Wang D, Zhang X, Zhang X, et al. Magnetic resonance imaging analysis of brain function in patients with irritable bowel syndrome [J]. BMC Gastroenterology, 2017, 17(1): 148.

[46]

Rossi S, Hallett M, Rossini PM, et al. Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research [J]. Clinical Neurophysiology, 2009, 120(12): 2008-2039.

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