Abnormal visceral perception in patients with functional dyspepsia: use of cerebral potentials evoked by electrical stimulation of the oesophagus
Abnormal visceral perception in patients with functional dyspepsia: use of cerebral potentials evoked by electrical stimulation of the oesophagus
复制标题
功能性消化不良患者的内脏知觉异常：利用食管电刺激诱发的脑电位
DOI：
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发表时间：
2000
影响因子：
3.5
通讯作者：
Hongo
中科院分区：
文献类型：
--
作者：
Kanazawa;Nomura;Fukudo;Hongo
内脏感觉改变被认为是功能性消化不良的发病机制之一。然而，在以前的研究中，内脏感知的评估仅基于患者自我报告的症状。通过内脏器官的机械或电刺激（ES）产生的脑诱发电位（EP）用于评估经由传入神经通路的内脏感知。在这项研究中，我们通过EP来研究功能性消化不良患者的内脏感知，以消除自我报告偏倚的可能性。用食管电刺激仪记录14例功能性消化不良患者和14例正常对照者的EP反应。 评价了感知阈值水平、EP的峰值潜伏期和峰间振幅。消化不良患者和对照受试者之间的感觉阈值没有差异（中值6 mA，范围2-12 mA，vs. 8 mA，范围6-14 mA; Pthinsp;= 0.09）。 与对照受试者相比，患者的不适阈值有明显降低的趋势（中位数14 mA，范围6-24 mA vs. 20 mA，范围14-26 mA; Pthinsp;= 0.05）。 患者EP后峰潜伏期（N2）（154 ± 4 ms）明显短于对照组（171 ± 3 ms，P <0.01），而前峰潜伏期（N1）与前峰潜伏期（P1）无明显差异。 EP的波幅（N1/P1和P1/N2）在两组间也无差异。一半的患者（14人中有7人）在ES期间抱怨恶心，但对照组受试者未受影响。恶心组第一EP峰潜伏期（N1）（66 ± 3 ms）明显短于无恶心组（79 ± 4 ms，P <0.05）和对照组（80 ± 3 ms，P <0.05）。 这些结果表明，消化不良患者可能会招募更多的快速传导有髓神经纤维，将内脏传入冲动传递到大脑和/或消化不良患者可能会改变内脏感知的中枢处理。我们的结论是，EP记录食管ES提供了一个客观的测量功能性消化不良患者的内脏知觉改变。
Altered visceral perception is thought to be included in the pathogenesis of functional dyspepsia. However, in previous studies, the assessment of visceral perception has been based solely on patients’ self‐reported symptoms. Cerebral evoked potential (EP), either by mechanical or electrical stimulation (ES) of the visceral organ, is used to evaluate visceral perception via afferent neural pathways. In this study, we investigated the visceral perception in patients with functional dyspepsia by EP to eliminate the possibility of self‐reported bias. EP responses were recorded by oesophageal ES at 37 cm from the nostril in 14 patients with functional dyspepsia and 14 normal healthy control subjects. Threshold levels of perception, peak latencies and peak‐to‐peak amplitudes of EP were evaluated. There was no difference in the sensory threshold between the dyspeptic patients and the control subjects (median 6 mA, range 2–12 mA, vs. 8 mA, range 6–14 mA; Pthinsp;= 0.09). There was a strong trend towards a decreased discomfort threshold in the patients when compared to the control subjects (median 14 mA, range 6–24 mA vs. 20 mA, range 14–26 mA; Pthinsp;= 0.05). The latency of the later EP peak (N2) among the patients (154 ± 4 ms) was significantly shorter than that of the control subjects (171 ± 3 ms, P < 0.01) although there was no difference between the earlier peaks (N1 and P1). There was also no difference in the amplitudes (N1/P1 and P1/N2) of EP between the patients and the control subjects. Half of the patients (seven out of 14) complained of nausea during ES but the control subjects were unaffected. The latency of the first EP peak (N1) in the patients with nausea was significantly shorter (66 ± 3 ms) than that of the patients without nausea (79 ± 4 ms, P < 0.05) or among the control subjects (80 ± 3 ms, P < 0.05). These results suggest that dyspeptic patients may recruit a greater number of fast conducting myelinated nerve fibres that convey visceral afferent impulses to the brain and/or that dyspeptic patients may have an altered central processing of the visceral perception. We conclude that EP recording by oesophageal ES provides an objective measurement of altered visceral perception in patients with functional dyspepsia.
影响因子：
29.4
作者：
Silverman, DHS;Munakata, JA;Mayer, EA
通讯作者：
Mayer, EA