A bi-directional assessment of the human brain-anorectal axis

Research output: Contribution to journalArticle

  • External authors:
  • J. M. Remes-Troche
  • K. Tantiphlachiva
  • A. Attaluri
  • J. Valestin
  • T. Yamada
  • S. S C Rao


Background Brain-gut dysfunction has been implicated in gastrointestinal disorders but a comprehensive test of brain-gut axis is lacking. We developed and tested a novel method for assessing both afferent anorectal-brain function using cortical evoked potentials (CEP), and efferent brain-anorectal function using motor evoked potentials (MEP). Methods Cortical evoked potentials was assessed following electrical stimulations of anus and rectum with bipolar electrodes in 26 healthy subjects. Anorectal MEPs were recorded following transcranial magnetic stimulation (TMS) over paramedian motor cortices bilaterally. Anal and rectal latencies/amplitudes for CEP and MEP responses and thresholds for first sensation and pain (mA) were analyzed and compared. Reproducibility and interobserver agreement of responses were examined. Key Results Reproducible polyphasic rectal and anal CEPs were recorded in all subjects, without gender differences, and with negative correlation between BMI and CEP amplitude (r -0.66, P=0.001). Transcranial magnetic stimulation evoked triphasic rectal and anal MEPs, without gender differences. Reproducibility for CEP and MEP was excellent (CV

Bibliographical metadata

Original languageEnglish
Pages (from-to)240-e118
JournalNeurogastroenterology and Motility
Issue number3
Publication statusPublished - Mar 2011