Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
6
pubmed:dateCreated
2001-1-4
pubmed:abstractText
In noncardiac chest pain (NCCP), altered visceral perception may result from abnormal cerebral processing of sensory input rather than abnormalities of afferent pathways. However, the interactions between symptoms, autonomic function and oesophageal stimuli are poorly studied. Oesophageal stimulation elicits reproducible cortical evoked potentials [CEP] and modulates heart rate variability via vagal pathways, as visible on power spectrum analysis of heart rate variability [PS-HRV]. These methods are increasingly used to study the function of visceral afferent neural pathways in human. The aim of this study was to compare EP and PS-HRV during oesophageal stimuli in NCCP and controls. Twelve healthy volunteers (one female, 11 male; aged 24-51 years; mean 32 +/- 8 years), and eight NCCP patients (three female, five male; age range 26-58, mean 40.5 +/- 10 years) were studied. Electrical oesophageal stimulation (EOS; 200 microseconds, 0.2 Hz, 25 stimuli) was applied to the oesophageal wall 5 cm above the lower oesophageal sphincter (LOS), and perception thresholds (measured in mA) determined. EP responses were recorded using 22 standard electroencephalogram scalp electrodes. Autonomic activity was assessed using PS-HRV, before, during, and after oesophageal stimulation. Measured PS-HRV indices included high frequency (HF; 0. 15-0.5 Hz) and low frequency (LF; 0.06-0.15 Hz) power, respectively, assessing vagal and sympathetic activity, and the LF/HF ratio. EOS perception occurred at lower thresholds in NCCP than in controls (3. 6 +/- 1 vs. 7.8 +/- 2 mA, P < 0.05). EP amplitude was greater (13 +/- 2 vs. 6 +/- 1 microV, P < 0.0001), and latency longer in controls vs. NCCP (191 +/- 7 ms vs. 219 +/- 6 ms, P < 0.001). In NCCP, EOS decreased sympathetic outflow (low frequency peak on PS-HRV) and increased cardiovagal activity (high frequency peak, P < 0.02) to a significantly higher degree in comparison with controls. During EOS, heart rate decreased in NCCP from 68 vs. 62 beats min-1 (P < 0.003) but not in controls. In NCCP patients, EOS was perceived at lower intensities and was associated with a greater cardiovagal reflex response. EP responses associated with EOS were smaller in NCCP than in controls, suggesting that an increased perception of oesophageal stimuli results from an enhanced cerebral processing of visceral sensory input in NCCP, rather than from hyperalgesic responses in visceral afferent pathways.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Dec
pubmed:issn
1350-1925
pubmed:author
pubmed:issnType
Print
pubmed:volume
12
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
555-65
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:11123711-Adult, pubmed-meshheading:11123711-Afferent Pathways, pubmed-meshheading:11123711-Brain Stem, pubmed-meshheading:11123711-Chest Pain, pubmed-meshheading:11123711-Electric Stimulation, pubmed-meshheading:11123711-Electroencephalography, pubmed-meshheading:11123711-Esophagus, pubmed-meshheading:11123711-Evoked Potentials, Somatosensory, pubmed-meshheading:11123711-Female, pubmed-meshheading:11123711-Gastroesophageal Reflux, pubmed-meshheading:11123711-Heart Rate, pubmed-meshheading:11123711-Humans, pubmed-meshheading:11123711-Male, pubmed-meshheading:11123711-Middle Aged, pubmed-meshheading:11123711-Perceptual Disorders, pubmed-meshheading:11123711-Reaction Time, pubmed-meshheading:11123711-Reflex, Abnormal, pubmed-meshheading:11123711-Sensory Thresholds, pubmed-meshheading:11123711-Sympathetic Nervous System, pubmed-meshheading:11123711-Vagus Nerve
pubmed:year
2000
pubmed:articleTitle
Abnormal cerebral processing of oesophageal stimuli in patients with noncardiac chest pain (NCCP).
pubmed:affiliation
Department of Medicine, Division of Gastroenterology, Mcmaster University, Hamilton, Ontario, Canada. stephan.hollerbach@ruhr-uni-bochum.de
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't