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Magnetic pudendal neurostimulation: a novel method for measuring pudendal nerve terminal motor latency.

机译:磁阴神经刺激:一种测量阴神经末梢运动潜伏期的新方法。

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OBJECTIVE: Magnetic stimulation (MS) activates the neuromuscular tissue. This effect was used to develop a novel technique for measuring the pudendal nerve terminal motor latency (PNTML) to the external anal sphincter (EAS) in healthy volunteers and patients with fecal incontinence. METHODS: The PNTML was studied in 42 healthy volunteers (mean age 44.3 years; 30 men, 12 women) and 18 patients with neurogenic fecal incontinence (mean age 42.8 years; 12 men, 6 women) using two techniques in each subject: the conventional intrarectal glove-mounted and MS. In the MS technique, the pudendal nerve was stimulated by a magnetic stimulator and a magnetic coil fixed to the perianal skin at the base of the ischiorectal fossa. Stimulation parameters were set at 70% of maximum intensity, i.e. 175 J/pulse and 40 Hz frequency. The response of EAS to MS was recorded by a surface electrode applied to the perianal skin in the vicinity of the anal orifice. RESULTS: In healthy subjects, the PNTML recorded by MS from the right side (mean 2.2 ms) showed no significant difference from the left PNTML (mean 2.1 ms) and both values did not differ significantly from those recorded by the intrarectal method (right 2.2 ms; left 2.1 ms). In incontinent patients, both the right and left PNTML measured by MS exhibited a significant increase compared to the normal (P<0.05, P<0.05, respectively) but no significant difference if compared to values recorded by the intrarectal route. CONCLUSIONS: The results of measuring the PNTML to the EAS by MS were as accurate as those measured by the intrarectal method. However, the MS method seems to be easier and more convenient to the patient.
机译:目的:磁刺激(MS)激活神经肌肉组织。此作用用于开发一种新技术,用于测量健康志愿者和大便失禁患者的阴部神经末梢运动潜伏期(PNTML)对肛门外括约肌(EAS)的反应。方法:PNTML在42名健康志愿者(平均年龄44.3岁; 30名男性,12名女性)和18名神经源性大便失禁患者(平均年龄42.8岁; 12名男性,6名女性)中使用两种技术进行了研究:常规直肠内手套式和MS。在MS技术中,通过磁刺激器和固定在坐骨直肠窝底部肛周皮肤上的电磁线圈刺激阴部神经。刺激参数设置为最大强度的70%,即175 J /脉冲和40 Hz频率。 EAS对MS的反应是通过在肛门口附近涂在肛周皮肤上的表面电极记录的。结果:在健康受试者中,MS从右侧(平均2.2毫秒)记录的PNTML与左侧PNTML(平均2.1毫秒)无明显差异,并且两个值均与直肠内方法记录的PNTML并无明显差异(右侧2.2毫秒;剩下的2.1毫秒)。在失禁患者中,MS测得的左右PNTML值均比正常人显着增加(分别为P <0.05,P <0.05),但与直肠内途径记录的值相比无显着差异。结论:通过MS测量对EAS的PNTML的结果与通过直肠内方法测量的结果一样准确。但是,MS方法对患者而言似乎更容易,更方便。

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