[A study of cerebral evoked potentials response to esophageal distention in non-erosive gastroesophageal reflux disease].
OBJECTIVE
To study the mechanism of visceral hypersensitivity in patients with non-erosive gastroesophageal reflux disease (NERD) and to get further objective evidence in the abnormal alteration of the afferents involved in mediating esophageal sensation by cerebral evoked potentials (CEP).


METHODS
We recruited 21 NERD patients and 10 normal healthy volunteers for the study. Mechanical distention stimulation was performed using a balloon-affixed polyvinyl multilumen catheter. First, maximally tolerated pain threshold of all subjects were recorded, then esophageal mechanical stimulation at an intensity of 75% maximum tolerated intensity and a frequency of 0.2 Hz was inflated in a total of 64 times by means of a computer-controlled barostat. The alternation of esophageal CEP was recorded before and after acid perfusion with a multi-channel international 10-20 system of electroencephalograph.


RESULTS
Esophageal mucosal distention may evoke recognizable and reproducible multi-peak CEP. CEP morphology of the NERD patients was characterized by randomly distributed patterns and the peak latencies for N1, P1, and N2 were significantly shorter for mechanical stimulation as compared with the control group (respectively, P = 0.016, 0.003, 0.031), and the amplitude of the P1-N2 components was significantly increased in NERD patients (P = 0.03).


CONCLUSIONS
Characterization and alternation of CEP morphology and peak latencies and P1-N2 amplitudes elicited by esophageal distention in NERD patients provides evidence for defective hypersensitivity of afferent neural pathways and cortical processing.
Zou
Duo-wu
DW
Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai 200433, China. dwzou@smmu.edu.cn
Yang
Min
M
Li
Zhao-shen
ZS
Xu
Guo-ming
GM
Xu
Xiao-rong
XR
Tu
Zhen-xing
ZX
Fang
Dian-chun
DC
Sun
Zhen-xing
ZX
D000328:Adult; D000368:Aged; D001921:Brain / Q000503:physiopathology*; D002404:Catheterization; D004569:Electroencephalography; D004947:Esophagus / Q000294:innervation* / Q000503:physiopathology; D005071:Evoked Potentials / Q000502:physiology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017288:Pain Threshold