Relief of Fecal Incontinence by Sacral Nerve Stimulation Linked to Focal Brain Activation
| Autor: | Kim Vang, Lilli Lundby, Arne Møller, Klaus Krogh, Søren Laurberg, Steen Buntzen, Albert Gjedde |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Lumbosacral Plexus Central nervous system Caudate nucleus Electric Stimulation Therapy Stimulation Cerebro Cohort Studies medicine Humans Fecal incontinence Aged business.industry Gastroenterology General Medicine Anatomy Middle Aged Electrodes Implanted Frontal Lobe Radiography Lumbosacral plexus Treatment Outcome medicine.anatomical_structure Cerebral blood flow Frontal lobe Cerebrovascular Circulation Positron-Emission Tomography Anesthesia Female medicine.symptom business Fecal Incontinence |
| Zdroj: | Lundby, L, Møller, A, Buntzen, S, Krogh, K, Vang, K, Gjedde, A & Laurberg, S 2011, ' Relief of fecal incontinence by sacral nerve stimulation linked to focal brain activation ', Diseases of the Colon and Rectum, vol. 54, no. 3, pp. 318-23 . https://doi.org/10.1007/DCR.0b013e31820348ac |
| ISSN: | 0012-3706 |
| Popis: | OBJECTIVE: This study aimed to test the hypothesis that sacral nerve stimulation affects afferent vagal projections to the central nervous system associated with frontal cortex activation in patients with fecal incontinence. PATIENTS: Nine women and one man received temporary sacral nerve stimulation with permanent electrodes as a treatment for fecal incontinence. INTERVENTIONS: We used positron emission tomography to record indices of regional cerebral blood flow before and after 30 minutes of continuous stimulation. We repeated this procedure after 2 weeks of continued stimulation, before and 30 minutes after arrest of the stimulation. RESULTS: The initial stimulation activated a region of the contralateral frontal cortex that normally is active during focused attention. After 2 weeks of stimulation, this activation had been replaced by activity in parts of the ipsilateral caudate nucleus, a region of the brain thought to be specifically involved in learning and reward processing. CONCLUSIONS: Sacral nerve stimulation induces changes in cerebral activity consistent with an effect on afferent projections of the vagus. The initial activation of the frontal cortex may reflect focused attention, whereas the subsequent activation of the caudate nucleus may reflect recruitment of mechanisms involved in learning and reward processing. These changes may contribute to the improved continence, which is an acquired result of the stimulation. |
| Databáze: | OpenAIRE |
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