Optimized Measurement Parameters of Sensory Evoked Cortical Potentials to Assess Human Bladder Afferents - A Randomized Study
Optimized Measurement Parameters of Sensory Evoked Cortical Potentials to Assess Human Bladder Afferents - A Randomized Study
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DOI：
10.1038/s41598-019-54614-z
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发表时间：
2019-12-20
影响因子：
4.6
通讯作者：
Mehnert, Ulrich
中科院分区：
文献类型：
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作者：
van der Lely, Stephanie;Liechti, Martina D.;Mehnert, Ulrich
膀胱过度活动症和排尿功能障碍非常普遍，并且通常与膀胱传入通路的功能障碍有关。目前缺少用于客观评估人类膀胱传入神经功能的适当诊断工具。一个有希望的可能性是在重复电膀胱刺激期间评估感觉诱发电位（SEP），这在健康受试者中被证明是可行的。然而，对于临床实践的实施，进一步改进以获得高效和可靠的数据是至关重要的。本随机研究的目的是找到关于刺激频率、重复次数和数据采集的最佳测量设置。40名健康受试者接受了两次SEP（Cz-Fz）评估，使用0.5 Hz、1.1 Hz和1.6 Hz的重复（500次刺激）电刺激，脉冲宽度为1 ms，在膀胱圆顶或三角区进行。SEP分析显示，更高的振幅和更好的信号噪声比（SNR）与较低的刺激频率，而潜伏期保持不变。随着持续刺激，观察到振幅和SNR降低，伴随应答率（RR）降低。当以0.5 Hz的频率施加刺激时，在200个刺激之间取平均值显示出最佳的可靠性，具有最佳的SNR、RR和足够高的振幅。这构成了评估持续时间和SEP峰-峰振幅之间的最佳折衷。
Overactive bladder and voiding dysfunction are highly prevalent and often associated with malfunction of the bladder afferent pathways. Appropriate diagnostic tools for an objective assessment of afferent nerve function of the human bladder are currently missing. One promising possibility is the assessment of sensory evoked potentials (SEP) during repetitive electrical bladder stimulation, which proved feasible in healthy subjects. For an implementation into clinical practice, however, further refinements for efficient and reliable data acquisition are crucial. The aim of this randomized study was to find the optimal measurement settings regarding stimulation frequency, repetition number, and data acquisition. Forty healthy subjects underwent two visits of SEP (Cz-Fz) assessments using repetitive (500 stimuli) electrical stimulation of 0.5 Hz, 1.1 Hz, and 1.6 Hz and pulse width of 1 ms at the bladder dome or trigone. SEP analyses revealed higher amplitudes and better signal-to-noise ratio (SNR) with lower stimulation frequencies, while latencies remained unchanged. Decreasing amplitudes and SNR were observed with continuing stimulation accompanied by decreasing responder rate (RR). When applying stimuli at a frequency of 0.5 Hz, averaging across 200 stimuli revealed optimal reliability with best SNR, RR and sufficiently high amplitudes. This constitutes an optimal compromise between the duration of the assessment and SEP peak-to-peak amplitudes.