A bi-directional assessment of the human brain-anorectal axis

J. M. Remes-Troche, K. Tantiphlachiva, A. Attaluri, J. Valestin, T. Yamada, S. Hamdy, Satish Sanku Chander Rao

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background Brain-gut dysfunction has been implicated in gastrointestinal disorders but a comprehensive test of brain-gut axis is lacking. We developed and tested a novel method for assessing both afferent anorectal-brain function using cortical evoked potentials (CEP), and efferent brain-anorectal function using motor evoked potentials (MEP). Methods Cortical evoked potentials was assessed following electrical stimulations of anus and rectum with bipolar electrodes in 26 healthy subjects. Anorectal MEPs were recorded following transcranial magnetic stimulation (TMS) over paramedian motor cortices bilaterally. Anal and rectal latencies/amplitudes for CEP and MEP responses and thresholds for first sensation and pain (mA) were analyzed and compared. Reproducibility and interobserver agreement of responses were examined. Key Results Reproducible polyphasic rectal and anal CEPs were recorded in all subjects, without gender differences, and with negative correlation between BMI and CEP amplitude (r -0.66, P=0.001). Transcranial magnetic stimulation evoked triphasic rectal and anal MEPs, without gender differences. Reproducibility for CEP and MEP was excellent (CV <10%). The inter-rater CV for anal and rectal MEPs was excellent (ICC 97-99), although there was inter-subject variation. Conclusions & Inferences Combined CEP and MEP studies offer a simple, inexpensive and valid method of examining bidirectional brain-anorectal axes. This comprehensive method could provide mechanistic insights into lower gut disorders.

Original languageEnglish (US)
JournalNeurogastroenterology and Motility
Volume23
Issue number3
DOIs
StatePublished - Mar 1 2011
Externally publishedYes

Fingerprint

Evoked Potentials
Motor Evoked Potentials
Brain
Transcranial Magnetic Stimulation
Motor Cortex
Anal Canal
Rectum
Electric Stimulation
Healthy Volunteers
Electrodes
Pain

Keywords

  • Anorectal sensation
  • Brain-gut
  • Cortical evoked potentials
  • Transcranial magnetic stimulation

ASJC Scopus subject areas

  • Endocrine and Autonomic Systems
  • Gastroenterology
  • Physiology

Cite this

Remes-Troche, J. M., Tantiphlachiva, K., Attaluri, A., Valestin, J., Yamada, T., Hamdy, S., & Rao, S. S. C. (2011). A bi-directional assessment of the human brain-anorectal axis. Neurogastroenterology and Motility, 23(3). https://doi.org/10.1111/j.1365-2982.2010.01619.x

A bi-directional assessment of the human brain-anorectal axis. / Remes-Troche, J. M.; Tantiphlachiva, K.; Attaluri, A.; Valestin, J.; Yamada, T.; Hamdy, S.; Rao, Satish Sanku Chander.

In: Neurogastroenterology and Motility, Vol. 23, No. 3, 01.03.2011.

Research output: Contribution to journalArticle

Remes-Troche, JM, Tantiphlachiva, K, Attaluri, A, Valestin, J, Yamada, T, Hamdy, S & Rao, SSC 2011, 'A bi-directional assessment of the human brain-anorectal axis', Neurogastroenterology and Motility, vol. 23, no. 3. https://doi.org/10.1111/j.1365-2982.2010.01619.x
Remes-Troche JM, Tantiphlachiva K, Attaluri A, Valestin J, Yamada T, Hamdy S et al. A bi-directional assessment of the human brain-anorectal axis. Neurogastroenterology and Motility. 2011 Mar 1;23(3). https://doi.org/10.1111/j.1365-2982.2010.01619.x
Remes-Troche, J. M. ; Tantiphlachiva, K. ; Attaluri, A. ; Valestin, J. ; Yamada, T. ; Hamdy, S. ; Rao, Satish Sanku Chander. / A bi-directional assessment of the human brain-anorectal axis. In: Neurogastroenterology and Motility. 2011 ; Vol. 23, No. 3.
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