Brief Article
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World J Gastroenterol. Nov 21, 2010; 16(43): 5435-5439
Published online Nov 21, 2010. doi: 10.3748/wjg.v16.i43.5435
Absence of high amplitude propagating contractions in subjects with chronic spinal cord injury
Hanumantha R Ancha, Noel R Fajardo, William A Bauman, Alan S Rosman, Marinella Galea, Graham Creasey, Mark A Korsten
Hanumantha R Ancha, Noel R Fajardo, William A Bauman, Alan S Rosman, Mark A Korsten, Rehabilitation Research and Development Center of Excellence for Medical Consequences of Spinal Cord Injury, James J. Peters VA Medical Center, Bronx, NY 10468, United States
Hanumantha R Ancha, William A Bauman, Alan S Rosman, Mark A Korsten, Medical Service, James J. Peters VA Medical Center, Bronx, NY 10468, United States
Marinella Galea, Spinal Cord Injury Service, James J. Peters VA Medical Center, Bronx, NY 10468, United States
William A Bauman, Alan S Rosman, Mark A Korsten, Department of Medicine, Mount Sinai School of Medicine, NY 10468, United States
William A Bauman, Department of Rehabilitation Medicine, Mount Sinai School of Medicine, NY 10468, United States
Graham Creasey, Spinal Cord Injury Service, VA Medical Center, Palo Alto, CA 94304, United States
Author contributions: Ancha HR assisted in writing the manuscript; Fajardo NR collected the data and helped write the manuscript; Bauman WA helped to generate the protocol and edited the manuscript; Rosman AS performed the statistical analysis; Galea M investigated on the study and performed the procedures for placement of the manometry catheters; Creasey G contributed to the design of the protocol and provided administrative support; Korsten MA was principal investigator on this work, wrote the protocol, and performed the endoscopic procedures.
Supported by The Department of Veterans Affairs Rehabilitation Research and Development Service Center of Excellence for the Medical Consequences of Spinal Cord Injury (B4162C)
Correspondence to: Mark A Korsten, MD, Medical Service, James J. Peters VA Medical Center, Bronx, NY 10468, United States. mark.korsten@va.gov
Telephone: +1-718-5849000 Fax: +1-718-7414233
Received: April 22, 2010
Revised: June 23, 2010
Accepted: June 30, 2010
Published online: November 21, 2010
Abstract

AIM: To investigate the presence or absence of high amplitude propagating contractions (HAPC), as well as the other measures of colonic motility, in persons with spinal cord injury (SCI).

METHODS: Prolonged colonic ambulatory manometric studies were performed on 14 male volunteers: 8 with SCI (mean age, 59 ± 13 years; mean duration of injury, 13 ± 4 years) and 6 healthy able-bodied controls (mean age, 57 ± 10 years). A solid-state manometry catheter was endoscopically clipped to the splenic flexure. Recording was performed for > 24 h after manometric catheter placement.

RESULTS: HAPC were absent in individuals with SCI during pre-sleep, sleep, and post-sleep phases. HAPC were significantly increased after awakening in non-SCI controls (0.8 ± 0.2 HAPC/h vs 10.5 ± 2.0 HAPC/h, P < 0.005). The motility index was lower in those with SCI than in controls pre- and post-sleep (SCI vs non-SCI: Pre-sleep, 2.4 ± 0.4 vs 8.8 ± 1.9, P < 0.01; Post-sleep, 4.3 ± 0.8 vs 16.5 ± 4.5, P < 0.05). However, a sleep-induced depression of colonic motility was observed in both the SCI and non-SCI groups (Pre-sleep vs Sleep, non-SCI: 8.8 ± 1.9 vs 2.1 ± 0.9, P < 0.002; SCI: 2.4 ± 0.4 vs 0.2 ± 0.03, P < 0.001), with the motility index of those with SCI during sleep not significantly different than that of the controls.

CONCLUSION: HAPC were not observed in individuals with SCI pre- or post-sleep. A sleep-induced depression in general colonic motility was evident in SCI and control subjects.

Keywords: Spinal cord injury, Neurogenic bowel, Bowel motility, High amplitude propagating contractions, Motility index