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Am J Physiol Gastrointest Liver Physiol 279: G139-G147, 2000;
0193-1857/00 $5.00
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Vol. 279, Issue 1, G139-G147, July 2000

A cortical evoked potential study of afferents mediating human esophageal sensation

Anthony R. Hobson1, Sanchoy Sarkar1, Paul L. Furlong2, David G. Thompson1, and Qasim Aziz3

1 Academic GI Science Unit, University of Manchester, Hope Hospital, Salford, M6 8HD; 2 Clinical Neurophysiology Unit, Aston University, Birmingham B4 7ET; and 3 Neuroimaging Research Group, Institute of Psychiatry, London SE5 8AF, United Kingdom

The aim of this study was to compare the characteristics of esophageal cortical evoked potentials (CEP) following electrical and mechanical stimulation in healthy subjects to evaluate the afferents involved in mediating esophageal sensation. Similarities in morphology and interpeak latencies of the CEP to electrical and mechanical stimulation suggest that they are mediated via similar pathways. Conduction velocity of CEP to either electrical or mechanical stimulation was 7.9-8.6 m/s, suggesting mediation via thinly myelinated Adelta -fibers. Amplitudes of CEP components to mechanical stimulation were significantly smaller than to electrical stimulation at the same levels of perception, implying that electrical stimulation activates a larger number of afferents. The latency delay of ~50 ms for each mechanical CEP component compared with the corresponding electrical CEP component is consistent with the time delay for the mechanical stimulus to distend the esophageal wall sufficiently to trigger the afferent volley. In conclusion, because the mechanical and electrical stimulation intensities needed to obtain esophageal CEP are similar and clearly perceived, it is likely that both spinal and vagal pathways mediate esophageal CEP. Esophageal CEP to both modalities of stimulation are mediated by myelinated Adelta -fibers and produce equally robust CEP responses. Both techniques may have important roles in the assessment of esophageal sensory processing in health and disease.

esophagus; spinal afferents; vagal afferents; electrical stimulation; mechanical stimulation


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