Cerebral evoked potentials after endorectal mechanical stimulation in humans

Although numerous clinical studies have proved that impaired rectal sensation is a major factor in fecal continence dysfunctions, objective studies in this field are still lacking. To provide information on normal rectal afferents, a study of cerebral potentials evoked by mechanical stimulation of the rectal wall was carried out in 10 healthy volunteers (5 male, 5 female; age, 33-52 yr). The stimulating device consisted of a rectal balloon rhythmically inflated and deflated by means of an animal breathing ventilator. Recordings were obtained 2 cm behind the vertex (C'z, International system 10-20). The responses were averaged from 300 to 800 sweeps. The average was triggered either on inflation ("on effect") or on deflation ("off effect"). Inflation volume and pressure were adjusted to induce a clear but not painful pulsing sensation. Reproducible responses were recorded by both on and off effects. The evoked potentials were polyphasic with a succession of positive and negative waves (peak latencies between 78 and 310 ms). The shape of the response (morphology, latency, and amplitude) was perfectly reproducible in the same subject. With regard to intrasubject reproducibility, variability was displayed: only the early waves (latency less than 100 ms) were perfectly reproducible; late waves exhibited variable latency and morphology. The present findings are the first demonstration of the possibility of recording an evoked potential on the scalp after a mechanical stimulation of the rectum.