İrritabl Bağırsak Sendromunda Merkezi İletim Zamanı
Yıl 2022,
Cilt: 7 Sayı: 2, 42 - 48, 02.08.2022
Recep Civan Yüksel
,
Mevlut Başkol
,
Selda Korkmaz
Murat Aksu
Öz
Amaç: İrritabl bağırsak sendromunun (İBS) patofizyolojisi tam olarak anlaşılamamıştır. Bu nedenle, hastalık etkili bir tedaviden yoksundur. Somatosensoriyel uyarılmış potansiyel (SEP), somasensoriyel yoldaki bozuklukları tespit etmek için kullanılan elektro-nörofizyolojik bir ölçüm yöntemidir. Çalışmamızda İBS’de SEP ile somatosensoriyel bozukluk olup olmadığını araştırmayı amaçladık.
Gereç ve Yöntemler: Çalışmaya dahil edilme kriterlerine göre 13 İBS hastası ve 13 kontrol seçilmiş ve deneyimli bir nörolog tarafından tibial ve sural somatosensoriyel uyarılmış potansiyeller ölçülmüştür. Sonuçlar, hastalar hakkında bilgi sahibi olmayan deneyimli başka bir nörolog tarafından yorumlandı.
Bulgular: Hasta grubunda 8 kişide (%61.5), kontrol grubunda 13 kişide (%11) SEP yanıtı ölçtük ve her iki grup arasında bu oranlar arasında istatistiksel olarak anlamlı fark vardı. Kontrol grubuna kıyasla IBS hastalarında Sural N27P32 ve Sural P32N50’nin tepe amplitüdlerinde istatistiksel olarak anlamlı bir artış gözlemledik. Gruplar arasında sural SEP latansı, tibial SEP latansı ve amplitüdleri açısından anlamlı fark yoktu.
Sonuç: İBS hasta grubunda sağlıklı kontrol grubuna göre somatosensoriyel yolda bozulma görüldü. Bu bozukluk somatik bileşenden ziyade sensoriyal kompenenti içeriyordu. Bu, İBS hastalarında sensorial bileşendeki bozulmayı SEP yöntemiyle ortaya koyan ilk çalışmadır
Kaynakça
- Celebi S, Acik Y, Deveci SE, Bahcecioglu IH, Ayar A, Demir A, Durukan P. Epidemiological features of irritable bowel syndrome in a Turkish urban society. J Gastroenterol Hepatol. 2004;19(7):738-43.
- Sandler RS, Everhart JE, Donowitz M, Adams E, Cronin K, et al. The burden of selected digestive diseases in the United States. Gastroenterology. 2002;122(5):1500-11.
- Mayer EA, Tillisch K. The brain-gut axis in abdominal pain syndromes. Annu Rev Med. 2011;62:381-96.
4. Drossman DA, Camilleri M, Mayer EA, Whitehead WE. AGA technical review on irritable bowel syndrome. Gastroenterology. 2002;123(6):2108-31.
- Rosenthal ES. The utility of EEG, SSEP, and other neurophysiologic tools to guide neurocritical care. Neurotherapeutics. 2012;9(1):24-36.
- Aminoff MJ, Eisen AA. AAEM minimonograph 19: somatosensory evoked potentials. Muscle Nerve.
1998;21(3):277-90.
- Karle KN, Schüle R, Klebe S, Otto S, Frischholz C, Liepelt-Scarfone I, Schöls L. Electrophysiological characterisation of motor and sensory tracts in patients with hereditary spastic paraplegia (HSP). Orphanet J Rare Dis. 2013;8:158.
- Wang JT, Young GB, Connolly JF. Prognostic value of evoked responses and event-related brain potentials in coma. Can J Neurol Sci. 2004;31(4):438-50.
- Nuwer MR, Dawson EG, Carlson LG, Kanim LE, Sherman JE. Somatosensory evoked potential spinal cord monitoring reduces neurologic deficits after scoliosis surgery: results of a large multicenter survey. Electroencephalogr Clin Neurophysiol. 1995;96(1):6-11.
- Lorenz J. Hyperalgesia or hypervigilance? An evoked potential approach to the study of fibromyalgia syndrome. Z Rheumatol. 1998;57 Suppl 2:19-22.
- Nuwer MR. Fundamentals of evoked potentials and common clinical applications today. Electroencephalogr Clin Neurophysiol. 1998;106(2):142-8.
- Yuan YZ, Tao RJ, Xu B, Sun J, Chen KM, Miao F, et al. Functional brain imaging in irritable bowel syndrome with rectal balloon-distention by using fMRI. World J Gastroenterol. 2003;9(6):1356-60.
- Simrén M, Agerforz P, Björnsson ES, Abrahamsson H. Nutrient-dependent enhancement of rectal sensitivity in irritable bowel syndrome (IBS). Neurogastroenterol Motil. 2007;19(1):20-9.
- Zhu Y, Wu Z, Ma X, Liu H, Bao C, Yang L, et al. Brain regions involved in moxibustion-induced analgesia in irritable bowel syndrome with diarrhea: a functional magnetic resonance imaging study. BMC Complement Altern Med. 2014;14:500.
- Mertz H, Morgan V, Tanner G, Pickens D, Price R, Shyr Y, Kessler R. Regional cerebral activation in irritable bowel syndrome and control subjects with painful and nonpainful rectal distention. Gastroenterology. 2000;118(5):842-8.
- Törnblom H, Van Oudenhove L, Tack J, Simrén M. Interaction between preprandial and postprandial rectal sensory and motor abnormalities in IBS. Gut. 2014;63(9):1441-9.
- Ludidi S, Conchillo JM, Keszthelyi D, Van Avesaat M, Kruimel JW, Jonkers DM, Masclee AA. Rectal hypersensitivity as hallmark for irritable bowel syndrome: defining the optimal cutoff. Neurogastroenterol Motil. 2012;24(8):729-e346.
- Ludidi S, Mujagic Z, Jonkers D, Keszthelyi D, Hesselink M, Kruimel J, et al. Markers for visceral hypersensitivity in patients with irritable bowel syndrome. Neurogastroenterol Motil. 2014;26(8):1104-11.
- Cui XF, Zhou WM, Yang Y, Zhou J, Li XL, Lin L, Zhang HJ. Epidermal growth factor upregulates serotonin
transporter and its association with visceral hypersensitivity in irritable bowel syndrome. World J Gastroenterol 2014;20(37):13521-9.
- Liu L, Liu BN, Chen S, Wang M, Liu Y, Zhang YL, Yao SK. Visceral and somatic hypersensitivity, autonomic cardiovascular dysfunction and low-grade inflammation in a subset of irritable bowel syndrome patients. J Zhejiang Univ Sci B. 2014;15(10):907-14.
- Lorenz J, Grasedyck K, Bromm B. Middle and long latency somatosensory evoked potentials after painful laser stimulation in patients with fibromyalgia syndrome. Electroencephalogr Clin Neurophysiol. 1996;100(2):165-8.
Central Transmission Time in Irritable Bowel Syndrome
Yıl 2022,
Cilt: 7 Sayı: 2, 42 - 48, 02.08.2022
Recep Civan Yüksel
,
Mevlut Başkol
,
Selda Korkmaz
Murat Aksu
Öz
Objective: Pathophysiology of irritable bowel syndrome (IBS) is not completely understood. Thus, the disease lacks an effective treatment. Somatosensory evoked potential (SEP) is an electroneurophysiological measurement method used to detect disorders in the somasensory pathway. In our study, we aimed to investigate whether there is a somatosensory disorder with SEP in IBS.
Material and Methods: Thirteen IBS patients and 13 control case were selected according to inclusion criteria of the study and tibial and sural somatosensory evoked potentials were measured by an experienced neurologist. The results were interpreted by another experienced neurologist who was not informed about the cases.
Results: We measured SEP response in 8 cases (%61. 5) in patient group and in 13 cases (%11) in the control group and there was a statistically significant difference between these ratios of both groups. We observed a statistically significant increase in peak to peak amplitudes of Sural N27P32 and Sural P32N50 in IBS patients compared to control group. There was no significant difference between groups in terms of sural SEP latency, tibial SEP latency and amplitudes.
Conclusion: The somatosensory pathway was impaired in the IBS patient group compared to the healthy control group. This disorder included the sensory component rather than the somatic component.
Kaynakça
- Celebi S, Acik Y, Deveci SE, Bahcecioglu IH, Ayar A, Demir A, Durukan P. Epidemiological features of irritable bowel syndrome in a Turkish urban society. J Gastroenterol Hepatol. 2004;19(7):738-43.
- Sandler RS, Everhart JE, Donowitz M, Adams E, Cronin K, et al. The burden of selected digestive diseases in the United States. Gastroenterology. 2002;122(5):1500-11.
- Mayer EA, Tillisch K. The brain-gut axis in abdominal pain syndromes. Annu Rev Med. 2011;62:381-96.
4. Drossman DA, Camilleri M, Mayer EA, Whitehead WE. AGA technical review on irritable bowel syndrome. Gastroenterology. 2002;123(6):2108-31.
- Rosenthal ES. The utility of EEG, SSEP, and other neurophysiologic tools to guide neurocritical care. Neurotherapeutics. 2012;9(1):24-36.
- Aminoff MJ, Eisen AA. AAEM minimonograph 19: somatosensory evoked potentials. Muscle Nerve.
1998;21(3):277-90.
- Karle KN, Schüle R, Klebe S, Otto S, Frischholz C, Liepelt-Scarfone I, Schöls L. Electrophysiological characterisation of motor and sensory tracts in patients with hereditary spastic paraplegia (HSP). Orphanet J Rare Dis. 2013;8:158.
- Wang JT, Young GB, Connolly JF. Prognostic value of evoked responses and event-related brain potentials in coma. Can J Neurol Sci. 2004;31(4):438-50.
- Nuwer MR, Dawson EG, Carlson LG, Kanim LE, Sherman JE. Somatosensory evoked potential spinal cord monitoring reduces neurologic deficits after scoliosis surgery: results of a large multicenter survey. Electroencephalogr Clin Neurophysiol. 1995;96(1):6-11.
- Lorenz J. Hyperalgesia or hypervigilance? An evoked potential approach to the study of fibromyalgia syndrome. Z Rheumatol. 1998;57 Suppl 2:19-22.
- Nuwer MR. Fundamentals of evoked potentials and common clinical applications today. Electroencephalogr Clin Neurophysiol. 1998;106(2):142-8.
- Yuan YZ, Tao RJ, Xu B, Sun J, Chen KM, Miao F, et al. Functional brain imaging in irritable bowel syndrome with rectal balloon-distention by using fMRI. World J Gastroenterol. 2003;9(6):1356-60.
- Simrén M, Agerforz P, Björnsson ES, Abrahamsson H. Nutrient-dependent enhancement of rectal sensitivity in irritable bowel syndrome (IBS). Neurogastroenterol Motil. 2007;19(1):20-9.
- Zhu Y, Wu Z, Ma X, Liu H, Bao C, Yang L, et al. Brain regions involved in moxibustion-induced analgesia in irritable bowel syndrome with diarrhea: a functional magnetic resonance imaging study. BMC Complement Altern Med. 2014;14:500.
- Mertz H, Morgan V, Tanner G, Pickens D, Price R, Shyr Y, Kessler R. Regional cerebral activation in irritable bowel syndrome and control subjects with painful and nonpainful rectal distention. Gastroenterology. 2000;118(5):842-8.
- Törnblom H, Van Oudenhove L, Tack J, Simrén M. Interaction between preprandial and postprandial rectal sensory and motor abnormalities in IBS. Gut. 2014;63(9):1441-9.
- Ludidi S, Conchillo JM, Keszthelyi D, Van Avesaat M, Kruimel JW, Jonkers DM, Masclee AA. Rectal hypersensitivity as hallmark for irritable bowel syndrome: defining the optimal cutoff. Neurogastroenterol Motil. 2012;24(8):729-e346.
- Ludidi S, Mujagic Z, Jonkers D, Keszthelyi D, Hesselink M, Kruimel J, et al. Markers for visceral hypersensitivity in patients with irritable bowel syndrome. Neurogastroenterol Motil. 2014;26(8):1104-11.
- Cui XF, Zhou WM, Yang Y, Zhou J, Li XL, Lin L, Zhang HJ. Epidermal growth factor upregulates serotonin
transporter and its association with visceral hypersensitivity in irritable bowel syndrome. World J Gastroenterol 2014;20(37):13521-9.
- Liu L, Liu BN, Chen S, Wang M, Liu Y, Zhang YL, Yao SK. Visceral and somatic hypersensitivity, autonomic cardiovascular dysfunction and low-grade inflammation in a subset of irritable bowel syndrome patients. J Zhejiang Univ Sci B. 2014;15(10):907-14.
- Lorenz J, Grasedyck K, Bromm B. Middle and long latency somatosensory evoked potentials after painful laser stimulation in patients with fibromyalgia syndrome. Electroencephalogr Clin Neurophysiol. 1996;100(2):165-8.