Sacral neuromodulation for fecal incontinence : a review of the central mechanisms of action
| Autor: | Ali Jahanshahi, Paul T.J. Janssen, Stephanie O. Breukink, Niels Komen, Yasin Temel, Jarno Melenhorst, Nicole D. Bouvy |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
STIMULATION
medicine.medical_specialty Sacrum medicine.medical_treatment Central nervous system Urology Electric Stimulation Therapy 030230 surgery sacral neuromodulation 03 medical and health sciences 0302 clinical medicine Medicine Fecal incontinence Humans BRAIN Neurostimulation Pelvic floor business.industry Mechanism (biology) Gastroenterology Spinal cord medicine.disease central nervous system OVERACTIVE BLADDER medicine.anatomical_structure Overactive bladder 030211 gastroenterology & hepatology sacral nerve stimulation Brainstem Human medicine medicine.symptom business Neuroscience Fecal Incontinence mechanism of action |
| Zdroj: | Journal of clinical gastroenterology |
| ISSN: | 0192-0790 |
| Popis: | Objective: Fecal incontinence (FI) has a devastating effect on the quality of life and results in social isolation. Sacral neuro-modulation (SNM) is proven to be an effective, minimal invasive treatment modality for FI. Despite the increasing application of SNM, the exact mechanisms of action remain unclear. The initial assumption of peripheral motor neurostimulation is not supported by increasing evidence, which report effects of SNM outside the pelvic floor. A new hypothesis states that afferent signals to the brain are essential for a successful therapy. This study aimed to review relevant studies on the central mechanism of SNM in FI. Methods: Clinical and experimental studies on the central mechanisms, both brain and spinal cord, of SNM for FI up to December 2015 were evaluated. Results: In total, 8 studies were found describing original data on the central mechanism of SNM for FI. Four studies evaluated the central effects of SNM in a clinical setting and 4 studies evaluated the central effects of SNM in an experimental animal model. Results demonstrated a variety of (sub) cortical and spinal changes after induction of SNM. Conclusion: Review of literature demonstrated evidence for a central mechanism of action of SNM for FI. The corticoanal pathways, brainstem, and specific parts of the spinal cord are involved. |
| Databáze: | OpenAIRE |
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