Subtle involvement of the parasympathetic nervous system in patients with irritable bowel syndrome

被引:35
作者
van Orshoven, NP
Andriesse, GI
van Schelven, LJ
Smout, AJ
Akkermans, LMA
Oey, PL
机构
[1] Univ Utrecht, Med Ctr, Rudolf Magnus Inst Neurosci, Dept Clin Neurophysiol, NL-3508 GA Utrecht, Netherlands
[2] Univ Utrecht, Med Ctr, Gastrointestinal Res Unit, Dept Gastroenterol, NL-3508 GA Utrecht, Netherlands
[3] Univ Utrecht, Med Ctr, Dept Surg, NL-3508 GA Utrecht, Netherlands
[4] Univ Utrecht, Med Ctr, Dept Biomed Engn, NL-3508 GA Utrecht, Netherlands
关键词
human; autonomic nervous system; irritable bowel; syndrome; heart rate variability; eating; muscle sympathetic nerve activity;
D O I
10.1007/s10286-006-0307-x
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
This study comprises assessment of autonomic function in irritable bowel syndrome (IBS) patients, focusing on meal-related changes. In 18 IBS patients (4 males, mean age 45 +/- 3.0 [SEM] years) and 19 healthy volunteers (6 males, mean age 41 +/- 3.5 years) blood pressure, heart rate, heart rate variability and muscle sympathetic nerve activity (MSNA) were assessed before, during and after consumption of a standardized meal. In pre- and postprandial phase Valsalva maneuver, cold pressor test (CPT) and deep breathing test were carried out and Visual Analog Scale (VAS) scores for nausea, bloating and pain were obtained. In the IBS group, the meal induced significantly higher VAS scores for pain (P = 0.002) and bloating (P = 0.02). During food intake, the increase in blood pressure, heart rate and MSNA was equal in patients and controls, but the increase of LF/HF ratio of heart rate variability was significantly higher in the IBS group (median [quartiles] 2.29 [1.14-3.00] versus 0.77 [0.25-1.81]; P = 0.03). IBS patients scored lower on pre- and postprandial RRmax/RRmin ratio during deep breathing (DB ratio, P = 0.03). The increase in MSNA (burst frequency) in response to CPT tended to be higher in the IBS patients (P = 0.07). We conclude that reactivity to food intake, measured as muscle sympathetic nerve activity, is normal in IBS patients. The lower DB ratio and higher LF/HF ratio during food intake in IBS patients is an indication of a reduced parasympathetic reactivity. These results suggest that reduced baseline activity as well as responsiveness of the parasympathetic system could play a role in the pathogenesis of IBS.
引用
收藏
页码:33 / 39
页数:7
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