Introduction Visceral pain is a major clinical problem being a primary feature of irritable bowel syndrome (IBS). Treatments for this condition are limited, but there is increasing evidence that neural stimulation may be able to alter pain thresholds in the somatic literature. By contrast, little is known about the role of neurostimulation applied to visceral pain and its ability to alter sensitivity. The aim of this study was to ascertain whether repetitive magnetic stimulation (MS) applied to the lumbosacrum and motor cortex can alter anorectal sensitivity in IBS patients.
Methods Participants: 10 IBS patients (9 females, age range 22 and 54 years). All IBS patients fulfilled Rome III criteria for IBS. Anorectal electrical sensory measurements were performed via a stimulating catheter positioned in the rectum, 10 cm from the anal verge andan anal plug. Sensory and pain thresholds in the rectum and anal sphincter were determined using trains of electrical stimuli, repeated three times. Anorectal sensory and pain thresholds were performed at baseline before intervention and then immediately, 30 and 60 min after each intervention. Interventions comprised 3 neurostimulation paradigms delivered in random order over separate days: repetitive 1 Hz lumbosacral magnetic stimulation (rLSMS), repetitive 10 Hz cortical transcranial magnetic stimulation (rTMS) and sham in the form of tilted coil.
Results Data (mean±SEM) were analysed by two way ANOVA (see Abstract PWE-062 tables 1 and 2) showed a significant increase in sensory (ST) and pain (PT) thresholds immediately, at 30 and 60 min in the rectum following both 1 Hz rLSMS (ST (p=0.015, 0.048 and 0.022, respectively), PT (p=0.014, 0.004 and 0.012, respectively)) and 10 Hz rTMS (ST (p=0.046, 0.041 and 0.017, respectively), PT (p=0.005, 0.02 and 0.007, respectively)). In addition, only 10 Hz rTMS increased anal sphincter pain thresholds immediately, at 30 and 60 min after the intervention (PT (p=0.032, 0.004 and 0.001, respectively)). Sham stimulation had no effect on any of the anorectal sensory parameters.
Conclusion The application of repetitive magnetic stimulation to lumbosacral area and motor cortex is able to modulate human visceral sensitivity in IBS patients and holds promise as a future therapeutic intervention.
Competing interests None declared.
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