Percutaneous nerve evaluation based on electrode placement under control of autonomic innervation
Background Foramen needle electrode placement for percutaneous nerve evaluation (PNE) is currently carried out while observing the somatic motor response. This study investigated electrode placement while observing the autonomic as well as the somatic response. Methods A consecutive series of ten pa...
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| Veröffentlicht in: | Techniques in coloproctology 2014-08, Vol.18 (8), p.725-730 |
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| creator | Kneist, W. Kauff, D. W. Schröder, M. Koch, K. P. Lang, H. |
| description | Background
Foramen needle electrode placement for percutaneous nerve evaluation (PNE) is currently carried out while observing the somatic motor response. This study investigated electrode placement while observing the autonomic as well as the somatic response.
Methods
A consecutive series of ten patients (seven women) with a median age of 51.9 (range 30–75) years undergoing PNE for faecal incontinence (
n
= 6) and obstipation (
n
= 4) were investigated prospectively. Electrode placement was carried out under simultaneous electromyography (EMG) of the external anal sphincter (EAS) and internal anal sphincter (IAS) and cystomanometry.
Results
PNE under control of somatic and autonomic nerve responses was carried out in all patients. In three out of ten patients, initial needle electrode placement showed single evoked EMG signals from the EAS. Final electrode placement resulted in adequate somatic motor and autonomic responses in all patients. Comparison of the increases in IAS EMG amplitude on the right and left stimulation sites for sacral nerves S3 and S4 demonstrated significant differences [S3 right: median 15.3 (interquartile range (IQR) 10.4; 20.1) µV vs. S3 left: median 11.6 (IQR 8.6; 16.0) µV,
p
= 0.034 and S4 right: median 24.1 (IQR 20.1; 37.2) µV vs. S4 left: median 12.0 (IQR 10.7; 13.7) µV,
p
= 0.012]. Stimulation-induced bladder activation was achieved in all seven patients with concomitant urinary dysfunction.
Conclusions
Control of not just the somatic motor response but also the autonomic nerve response during foramen needle electrode placement may objectify PNE. |
| doi_str_mv | 10.1007/s10151-014-1160-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1550076017</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1550076017</sourcerecordid><originalsourceid>FETCH-LOGICAL-c442t-197a8ab9e434a3547908484c8ac2928ea5c9fb47fd548cf3dd1c37b4196bbed43</originalsourceid><addsrcrecordid>eNp1kMtKxTAQhoMo3h_AjQTcuKlmmultKeINBF0ouAtpOpVKmxyTVo5vb45VEcHVDMw3_yQfYwcgTkCI4jSAgAwSAZgA5CJZrrFtgLRMBGZP65-9THIpiy22E8KLEFAUGWyyrRTLHDAX20zfkzfTqC25KXBL_o04vel-0mPnLK91oIbHhnoyo3cN8UWvDQ1kRz7Zhjw3zsZBz13L9TQ664bO8M6uoj4z9thGq_tA-191lz1eXjycXye3d1c352e3iUFMxwSqQpe6rgglaplhUYkSSzSlNmmVlqQzU7U1Fm2TYWla2TRgZFEjVHldU4Nylx3PuQvvXicKoxq6YKjv578pyLLoLI8OInr0B31xk7fxdZHCKsXoR0YKZsp4F4KnVi18N2j_rkColX81-1fRv1r5V8u4c_iVPNUDNT8b38IjkM5AiCP7TP7X6X9TPwAtfJH_</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1549242483</pqid></control><display><type>article</type><title>Percutaneous nerve evaluation based on electrode placement under control of autonomic innervation</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Kneist, W. ; Kauff, D. W. ; Schröder, M. ; Koch, K. P. ; Lang, H.</creator><creatorcontrib>Kneist, W. ; Kauff, D. W. ; Schröder, M. ; Koch, K. P. ; Lang, H.</creatorcontrib><description>Background
Foramen needle electrode placement for percutaneous nerve evaluation (PNE) is currently carried out while observing the somatic motor response. This study investigated electrode placement while observing the autonomic as well as the somatic response.
Methods
A consecutive series of ten patients (seven women) with a median age of 51.9 (range 30–75) years undergoing PNE for faecal incontinence (
n
= 6) and obstipation (
n
= 4) were investigated prospectively. Electrode placement was carried out under simultaneous electromyography (EMG) of the external anal sphincter (EAS) and internal anal sphincter (IAS) and cystomanometry.
Results
PNE under control of somatic and autonomic nerve responses was carried out in all patients. In three out of ten patients, initial needle electrode placement showed single evoked EMG signals from the EAS. Final electrode placement resulted in adequate somatic motor and autonomic responses in all patients. Comparison of the increases in IAS EMG amplitude on the right and left stimulation sites for sacral nerves S3 and S4 demonstrated significant differences [S3 right: median 15.3 (interquartile range (IQR) 10.4; 20.1) µV vs. S3 left: median 11.6 (IQR 8.6; 16.0) µV,
p
= 0.034 and S4 right: median 24.1 (IQR 20.1; 37.2) µV vs. S4 left: median 12.0 (IQR 10.7; 13.7) µV,
p
= 0.012]. Stimulation-induced bladder activation was achieved in all seven patients with concomitant urinary dysfunction.
Conclusions
Control of not just the somatic motor response but also the autonomic nerve response during foramen needle electrode placement may objectify PNE.</description><identifier>ISSN: 1123-6337</identifier><identifier>EISSN: 1128-045X</identifier><identifier>DOI: 10.1007/s10151-014-1160-x</identifier><identifier>PMID: 24861460</identifier><identifier>CODEN: TECOFO</identifier><language>eng</language><publisher>Milan: Springer Milan</publisher><subject>Abdominal Surgery ; Adult ; Aged ; Anal Canal - innervation ; Anal Canal - physiopathology ; Autonomic Nervous System - physiopathology ; Colorectal Surgery ; Defecation - physiology ; Electrodes, Implanted ; Electromyography ; Fecal Incontinence - physiopathology ; Fecal Incontinence - therapy ; Female ; Follow-Up Studies ; Gastroenterology ; Humans ; Lumbosacral Plexus ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Article ; Proctology ; Prospective Studies ; Surgery ; Transcutaneous Electric Nerve Stimulation - methods ; Treatment Outcome</subject><ispartof>Techniques in coloproctology, 2014-08, Vol.18 (8), p.725-730</ispartof><rights>Springer-Verlag Italia 2014</rights><rights>Springer-Verlag Italia Srl 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-197a8ab9e434a3547908484c8ac2928ea5c9fb47fd548cf3dd1c37b4196bbed43</citedby><cites>FETCH-LOGICAL-c442t-197a8ab9e434a3547908484c8ac2928ea5c9fb47fd548cf3dd1c37b4196bbed43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10151-014-1160-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10151-014-1160-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24861460$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kneist, W.</creatorcontrib><creatorcontrib>Kauff, D. W.</creatorcontrib><creatorcontrib>Schröder, M.</creatorcontrib><creatorcontrib>Koch, K. P.</creatorcontrib><creatorcontrib>Lang, H.</creatorcontrib><title>Percutaneous nerve evaluation based on electrode placement under control of autonomic innervation</title><title>Techniques in coloproctology</title><addtitle>Tech Coloproctol</addtitle><addtitle>Tech Coloproctol</addtitle><description>Background
Foramen needle electrode placement for percutaneous nerve evaluation (PNE) is currently carried out while observing the somatic motor response. This study investigated electrode placement while observing the autonomic as well as the somatic response.
Methods
A consecutive series of ten patients (seven women) with a median age of 51.9 (range 30–75) years undergoing PNE for faecal incontinence (
n
= 6) and obstipation (
n
= 4) were investigated prospectively. Electrode placement was carried out under simultaneous electromyography (EMG) of the external anal sphincter (EAS) and internal anal sphincter (IAS) and cystomanometry.
Results
PNE under control of somatic and autonomic nerve responses was carried out in all patients. In three out of ten patients, initial needle electrode placement showed single evoked EMG signals from the EAS. Final electrode placement resulted in adequate somatic motor and autonomic responses in all patients. Comparison of the increases in IAS EMG amplitude on the right and left stimulation sites for sacral nerves S3 and S4 demonstrated significant differences [S3 right: median 15.3 (interquartile range (IQR) 10.4; 20.1) µV vs. S3 left: median 11.6 (IQR 8.6; 16.0) µV,
p
= 0.034 and S4 right: median 24.1 (IQR 20.1; 37.2) µV vs. S4 left: median 12.0 (IQR 10.7; 13.7) µV,
p
= 0.012]. Stimulation-induced bladder activation was achieved in all seven patients with concomitant urinary dysfunction.
Conclusions
Control of not just the somatic motor response but also the autonomic nerve response during foramen needle electrode placement may objectify PNE.</description><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Anal Canal - innervation</subject><subject>Anal Canal - physiopathology</subject><subject>Autonomic Nervous System - physiopathology</subject><subject>Colorectal Surgery</subject><subject>Defecation - physiology</subject><subject>Electrodes, Implanted</subject><subject>Electromyography</subject><subject>Fecal Incontinence - physiopathology</subject><subject>Fecal Incontinence - therapy</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastroenterology</subject><subject>Humans</subject><subject>Lumbosacral Plexus</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Article</subject><subject>Proctology</subject><subject>Prospective Studies</subject><subject>Surgery</subject><subject>Transcutaneous Electric Nerve Stimulation - methods</subject><subject>Treatment Outcome</subject><issn>1123-6337</issn><issn>1128-045X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kMtKxTAQhoMo3h_AjQTcuKlmmultKeINBF0ouAtpOpVKmxyTVo5vb45VEcHVDMw3_yQfYwcgTkCI4jSAgAwSAZgA5CJZrrFtgLRMBGZP65-9THIpiy22E8KLEFAUGWyyrRTLHDAX20zfkzfTqC25KXBL_o04vel-0mPnLK91oIbHhnoyo3cN8UWvDQ1kRz7Zhjw3zsZBz13L9TQ664bO8M6uoj4z9thGq_tA-191lz1eXjycXye3d1c352e3iUFMxwSqQpe6rgglaplhUYkSSzSlNmmVlqQzU7U1Fm2TYWla2TRgZFEjVHldU4Nylx3PuQvvXicKoxq6YKjv578pyLLoLI8OInr0B31xk7fxdZHCKsXoR0YKZsp4F4KnVi18N2j_rkColX81-1fRv1r5V8u4c_iVPNUDNT8b38IjkM5AiCP7TP7X6X9TPwAtfJH_</recordid><startdate>20140801</startdate><enddate>20140801</enddate><creator>Kneist, W.</creator><creator>Kauff, D. W.</creator><creator>Schröder, M.</creator><creator>Koch, K. P.</creator><creator>Lang, H.</creator><general>Springer Milan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20140801</creationdate><title>Percutaneous nerve evaluation based on electrode placement under control of autonomic innervation</title><author>Kneist, W. ; Kauff, D. W. ; Schröder, M. ; Koch, K. P. ; Lang, H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-197a8ab9e434a3547908484c8ac2928ea5c9fb47fd548cf3dd1c37b4196bbed43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Anal Canal - innervation</topic><topic>Anal Canal - physiopathology</topic><topic>Autonomic Nervous System - physiopathology</topic><topic>Colorectal Surgery</topic><topic>Defecation - physiology</topic><topic>Electrodes, Implanted</topic><topic>Electromyography</topic><topic>Fecal Incontinence - physiopathology</topic><topic>Fecal Incontinence - therapy</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastroenterology</topic><topic>Humans</topic><topic>Lumbosacral Plexus</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Article</topic><topic>Proctology</topic><topic>Prospective Studies</topic><topic>Surgery</topic><topic>Transcutaneous Electric Nerve Stimulation - methods</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kneist, W.</creatorcontrib><creatorcontrib>Kauff, D. W.</creatorcontrib><creatorcontrib>Schröder, M.</creatorcontrib><creatorcontrib>Koch, K. P.</creatorcontrib><creatorcontrib>Lang, H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Techniques in coloproctology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kneist, W.</au><au>Kauff, D. W.</au><au>Schröder, M.</au><au>Koch, K. P.</au><au>Lang, H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Percutaneous nerve evaluation based on electrode placement under control of autonomic innervation</atitle><jtitle>Techniques in coloproctology</jtitle><stitle>Tech Coloproctol</stitle><addtitle>Tech Coloproctol</addtitle><date>2014-08-01</date><risdate>2014</risdate><volume>18</volume><issue>8</issue><spage>725</spage><epage>730</epage><pages>725-730</pages><issn>1123-6337</issn><eissn>1128-045X</eissn><coden>TECOFO</coden><abstract>Background
Foramen needle electrode placement for percutaneous nerve evaluation (PNE) is currently carried out while observing the somatic motor response. This study investigated electrode placement while observing the autonomic as well as the somatic response.
Methods
A consecutive series of ten patients (seven women) with a median age of 51.9 (range 30–75) years undergoing PNE for faecal incontinence (
n
= 6) and obstipation (
n
= 4) were investigated prospectively. Electrode placement was carried out under simultaneous electromyography (EMG) of the external anal sphincter (EAS) and internal anal sphincter (IAS) and cystomanometry.
Results
PNE under control of somatic and autonomic nerve responses was carried out in all patients. In three out of ten patients, initial needle electrode placement showed single evoked EMG signals from the EAS. Final electrode placement resulted in adequate somatic motor and autonomic responses in all patients. Comparison of the increases in IAS EMG amplitude on the right and left stimulation sites for sacral nerves S3 and S4 demonstrated significant differences [S3 right: median 15.3 (interquartile range (IQR) 10.4; 20.1) µV vs. S3 left: median 11.6 (IQR 8.6; 16.0) µV,
p
= 0.034 and S4 right: median 24.1 (IQR 20.1; 37.2) µV vs. S4 left: median 12.0 (IQR 10.7; 13.7) µV,
p
= 0.012]. Stimulation-induced bladder activation was achieved in all seven patients with concomitant urinary dysfunction.
Conclusions
Control of not just the somatic motor response but also the autonomic nerve response during foramen needle electrode placement may objectify PNE.</abstract><cop>Milan</cop><pub>Springer Milan</pub><pmid>24861460</pmid><doi>10.1007/s10151-014-1160-x</doi><tpages>6</tpages></addata></record> |
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| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Abdominal Surgery Adult Aged Anal Canal - innervation Anal Canal - physiopathology Autonomic Nervous System - physiopathology Colorectal Surgery Defecation - physiology Electrodes, Implanted Electromyography Fecal Incontinence - physiopathology Fecal Incontinence - therapy Female Follow-Up Studies Gastroenterology Humans Lumbosacral Plexus Male Medicine Medicine & Public Health Middle Aged Original Article Proctology Prospective Studies Surgery Transcutaneous Electric Nerve Stimulation - methods Treatment Outcome |
| title | Percutaneous nerve evaluation based on electrode placement under control of autonomic innervation |
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