Gastrointestinal symptoms in type-1 diabetes: Is it all about brain plasticity?
BACKGROUND AND AIMS: Autonomic neuropathy seems to play a central role in the development of gastrointestinal symptoms in diabetes. In order to explore the neuronal mechanisms behind the symptoms we evaluated the brain processing of painful visceral stimuli. METHODS: Evoked brain potentials were rec...
| Publicado en: | European Journal of Pain Vol. 15; no. 3; pp. 249 - 258 |
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| Autores principales: | , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Wiley-Blackwell
Mar2011
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104840889&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104840889 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10903801 8IG jtl: European Journal of Pain issn: 10903801 maglogo: Y pubinfo: dt: Mar2011 vid: 15 iid: 3 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 104840889 2010973595 10.1016/j.ejpain.2010.08.004 NLM20813568 104840889 ppf: 249 ppct: 9 formats: tig: atl: Gastrointestinal symptoms in type-1 diabetes: Is it all about brain plasticity? aug: au: Frøkjær JB Egsgaard LL Graversen C Søfteland E Dimcevski G Blauenfeldt RA Drewes AM affil: Mech-Sense, Department of Gastroenterology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark; Department of Radiology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark. sug: subj: Brain Physiopathology Diabetes Mellitus, Type 1 Physiopathology Esophagus Physiopathology Evoked Potentials Physiology Pain Physiopathology Adult Analysis of Variance Autonomic Nervous System Diseases Diagnosis Autonomic Nervous System Diseases Physiopathology Blood Glucose Diabetic Neuropathies Diagnosis Diabetic Neuropathies Physiopathology Electric Stimulation Electroencephalography Female Gastrointestinal Diseases Diagnosis Gastrointestinal Diseases Physiopathology Male Middle Age Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: BACKGROUND AND AIMS: Autonomic neuropathy seems to play a central role in the development of gastrointestinal symptoms in diabetes. In order to explore the neuronal mechanisms behind the symptoms we evaluated the brain processing of painful visceral stimuli. METHODS: Evoked brain potentials were recorded to assess the response to painful oesophageal electrical stimuli in 15 healthy volunteers and 14 type-1 diabetes patients with autonomic neuropathy and related gastrointestinal symptoms. Source reconstruction analysis (fixed Multiple Signal Classification (MUSIC) algorithm) was applied to estimate the location of the evoked electrical activity in the brain. RESULTS: The patients had increased oesophageal sensory thresholds compared to the controls (P=0.004). The latencies of the evoked brain potentials at vertex (Cz) were increased (P=0.007) and amplitudes reduced (P=0.011) in diabetics. Compared with controls the patients had a posterior shift of the electrical sources in the anterior cingulate cortex at 54ms, and additional sources close to the posterior insula at 95ms and in medial frontal gyrus at 184ms. CONCLUSIONS: There is evidence of altered central processing to visceral stimulation, and both peripheral and central mechanisms seem involved. Central neuronal reorganisation may contribute to our understanding of the gastrointestinal symptoms in patients with diabetic autonomic neuropathy and this may guide development and evaluation of new treatment modalities. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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