Investigation of Cortico-Rectal Pathways in Healthy Subjects and Constipated Patients
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Constipation, Healthy Studies |
| Therapuetic Areas: | Gastroenterology, Other |
| Healthy: | No |
| Age Range: | 18 - 85 |
| Updated: | 7/25/2018 |
| Start Date: | August 2005 |
| End Date: | December 2018 |
Biofeedback therapy improves bowel symptoms and anorectal function in patients with
dyssynergic defecation, however its mechanism of action is not known. The investigators
hypothesize that biofeedback therapy enhances gut-brain-gut communication by altering
cortical processing of information and improving cortically mediated neuromuscular function
of the gut. However, in order to better understand these mechanisms in patients, the
investigators need to examine and establish normative data and compare findings with healthy
subjects. The investigators specific aims are to examine and evaluate the following 40 normal
subjects; (1) To evaluate the afferent cortical evoked potentials in response to the
electrical stimulation of the anorectum and (2) To evaluate the corticofugal tracts
(efferent) by recording the anal and rectal electromyographic responses following noninvasive
lumbosacral and transcranial magnetic stimulation.
dyssynergic defecation, however its mechanism of action is not known. The investigators
hypothesize that biofeedback therapy enhances gut-brain-gut communication by altering
cortical processing of information and improving cortically mediated neuromuscular function
of the gut. However, in order to better understand these mechanisms in patients, the
investigators need to examine and establish normative data and compare findings with healthy
subjects. The investigators specific aims are to examine and evaluate the following 40 normal
subjects; (1) To evaluate the afferent cortical evoked potentials in response to the
electrical stimulation of the anorectum and (2) To evaluate the corticofugal tracts
(efferent) by recording the anal and rectal electromyographic responses following noninvasive
lumbosacral and transcranial magnetic stimulation.
1. Cortical evoked potentials:A probe with 2 ring electrodes is placed in anus and rectum.
A small amount of electrical current is passed. The cortical evoked responses to the
anal and rectal electrical stimulation is measured from the scalp using a
neurophysiology recorder.
2. Motor evoked potentials: A magnetic coil is placed on the scalp at the anorectal
cortical site and discharged using magnetic energy. The anal and rectal motor evoked
potentials are then measured using a probe with 2 ring electrodes.
A small amount of electrical current is passed. The cortical evoked responses to the
anal and rectal electrical stimulation is measured from the scalp using a
neurophysiology recorder.
2. Motor evoked potentials: A magnetic coil is placed on the scalp at the anorectal
cortical site and discharged using magnetic energy. The anal and rectal motor evoked
potentials are then measured using a probe with 2 ring electrodes.
Inclusion criteria:
- Right-handed adults between ages 18 years and 99 years, who are free of bowel
disorders or other medical illnesses.
Exclusion Criteria:
- Potential subjects with comorbid illnesses; severe cardiac disease, chronic renal
failure or previous gastrointestinal surgery except cholecystectomy and appendectomy.
- Neurologic diseases e.g.; head injury, epilepsy, multiple sclerosis, strokes, spinal
cord injuries.
- People who have metal in their skull or under the skull, or have metal in the back or
hips.
- People who have a cardiac pacemaker, implanted defibrillator or medication pump.
- Impaired cognizance (mini mental score of < 15) and/or legally blind.
- Pregnant or likely to conceive during the course of the study. Women with potential
for pregnancy must be willing to use contraceptive measures during the study.
- Previous pelvic surgery, rectocele repair, bladder repair, radical hysterectomy.
- Rectal prolapse or anal fissure or anal surgery.
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University of Iowa Hospitals and Clinics University of Iowa Hospitals and Clinics—recognized as one of...
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