Award: Presidential Poster Award
Yun Yan, PhD1, Xuelian Xiang, MD1, Amol Sharma, MD2, Anam Herekar, MD2, Rachael Parr, MA1, Satish Rao, MD, FACG1
1Augusta University Medical Center, Augusta, GA; 2Augusta University, Augusta, GA
Introduction: Although anal electromyography and pudental nerve latency have been used for assessment of anal neuropathy, neither test is used routinely in clinical practice, because of significant deficiencies with each test and were not endorsed by AGA. Also neither test comprehensively assesses the entire nerves from their origin in spinal cord to anal innervation. Truslumbosacral Anorectal Magnetic Stimulation (TAMS) is a novel, non-invasive test for identifying anorectal neuropathy. It evaluates the neuronal integrity of lumbar and sacral plexus nerves from their origin in spinal cord to their innervation in the rectum and anus by measuring the latencies of motor evoked potentials (MEPs). Our aim was to determine the normal values for TAMS in healthy subjects and evaluate the effects of gender.
Methods: Healthy subjects underwent bilateral translumbar and transacral magnetic stimulation using a 90 mm magnetic coil (Magstim, UK). Motor evoked potentials (MEPs) were recorded simultaneously from the rectum and anus using two pairs of bipolar ring electrodes. The 8 MEP latencies from each healthy subject were measured (mean ± SEM) and gender differences compared
Results: Forth-eight healthy subjects (18-59) years, F/M=32/16) were evaluated. The mean latency of all 8 MEPs, and in men and women are summarized in Table. Although there are small differences in MEP latencies between individual sites, overall there were no differences between the lumbar and sacral nerve latencies or between the right or left side or between the anal and rectal sites (Table 1). Also there were no differences in MEP latencies between men and women for any of the 8 sites. Age is not significantly associated with the anal or rectal MEP latencies (r=0.09 to 0.326), except weak association for right sacro-rectal MEP (r=0.386), p=0.009).
Discussion: This study provides normative values for the bilateral lumbar and sacral-anorectal MEPs in healthy subjects. Neither gender nor age appear to influence the rectal and anal MEP latencies. These data will provide the basis for comparing the novel TAMS test findings in patients with those from suspected anorectal or pelvic neuropathy.
Citation: Yun Yan, PhD; Xuelian Xiang, MD; Amol Sharma, MD; Anam Herekar, MD; Rachael Parr, MA; Satish Rao, MD, FACG. P2160 - TRANSLUMBOSACRAL ANORECTAL MAGNETIC STIMULATION (TAMS): NOVEL ANORECTAL NEUROPHYSIOLOGY TEST, NORMATIVE VALUES, AND EFFECTS OF GENDER. Program No. P2160. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.