title: Cortical and spinal evoked potential response to electrical stimulation in human rectum.
abstract: OBJECTIVE
  To study a novel technique to record spinal and cortical evoked potentials (EPs) simultaneously in response to electrical stimulation in the human rectum.
  
  
  METHODS
  Eight male and nine female healthy volunteers participated. Stimulating electrodes were attached to the rectal mucosa at 15 cm and 12 cm above the dentate line. Recording skin electrodes were positioned over vertebrae L4 through S2. The electrical stimulus was a square wave of 0.2 ms duration and the intensity of the stimulus varied between 0 and 100 mA. EP responses were recorded using a Nicolet Viking IV programmable signal conditioner.
  
  
  RESULTS
  Simultaneous recording of cortical and spinal EPs was obtained in > 80% of the trials. The EP responses increased with the intensity of the electrical stimulation, were reproducible overtime, and were blocked by application of Lidocaine jelly at the site of stimulation. The morphology (N1/P1), mean ± SD for latency (spinal N1, 4.6 ± 0.4 ms; P1, 6.8 ± 0.5 ms; cortical N1, 136.1 ± 4.2 ms; P1, 233.6 ± 12.8 ms) and amplitude (N1/P1, spinal, 38 ± 7 μV; cortical 19 ± 3 μV) data for the EP responses were consistent with those in the published literature. Reliable and reproducible EP recordings were obtained with the attachment of the electrodes to the rectal mucosa at predetermined locations between 16 and 8 cm above the anal verge, and the distance between the attachment sites of the electrodes (the optimal distance being approximately 3.0 cm between the two electrodes).
  
  
  CONCLUSIONS
  This technique can be used to assess potential abnormalities in primary afferent neural pathways innervating the rectum in several neurodegenerative and functional pain disorders.
authors.affiliation: Department of Internal Medicine, University of Michigan, Michigan Clinical Research Unit, Level 1, Room 1702, Cardiovascular Center, 1500 E Medical Center Drive, Ann Arbor, MI 48109-5872, United States.
authors.forename: Brian
authors.initials: B
authors.lastname: Garvin
authors.forename: Lisa
authors.initials: L
authors.lastname: Lovely
authors.forename: Alex
authors.initials: A
authors.lastname: Tsodikov
authors.forename: Danielle
authors.initials: D
authors.lastname: Minecan
authors.forename: Shaungson
authors.initials: S
authors.lastname: Hong
authors.forename: John W
authors.initials: JW
authors.lastname: Wiley
mesh_terms: D000328:Adult; D002540:Cerebral Cortex / Q000502:physiology*; D004558:Electric Stimulation / Q000295:instrumentation / Q000379:methods*; D004566:Electrodes; D005071:Evoked Potentials / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D009475:Neurons, Afferent / Q000502:physiology; D011930:Reaction Time / Q000502:physiology; D012007:Rectum / Q000294:innervation* / Q000502:physiology*; D015203:Reproducibility of Results; D013116:Spinal Cord / Q000502:physiology*