PMID- 19071060
OWN - NLM
STAT- MEDLINE
DCOM- 20090408
LR  - 20090112
IS  - 1872-8952 (Electronic)
IS  - 1388-2457 (Linking)
VI  - 120
IP  - 1
DP  - 2009 Jan
TI  - Central nervous system abnormalities in vaginismus.
PG  - 117-22
LID - 10.1016/j.clinph.2008.10.156 [doi]
AB  - OBJECTIVE: To investigate possible altered CNS excitability in vaginismus. 
      METHODS: In 10 patients with primary idiopathic lifelong vaginismus, 10 with 
      vulvar vestibulitis syndrome accompanied by vaginismus and healthy controls we 
      recorded EMG activity from the levator ani (LA) and external anal sphincter (EAS) 
      muscles and tested bulbocavernosus reflex (BCR). Pudendal-nerve somatosensory 
      evoked potentials (SEPs) were tested after a single stimulus. Pudendal-nerve SEP 
      recovery functions were assessed using a paired conditioning-test paradigm at 
      interstimulus intervals (ISIs) of 5, 20 and 40ms. RESULTS: EMG in patients showed 
      muscular hyperactivity at rest and reduced inhibition during straining. The BCR 
      polysynaptic R2 had larger amplitude (p<0.01) and longer duration (p<0.01) in 
      patients from both groups than in controls. In controls, paired-pulse SEPs were 
      suppressed at the 5ms ISI for N35-P40 (p<0.05) and P40-N50 ms (p<0.001) and 
      facilitated at the 20ms ISI for N35-P40 (p<0.05) and P40-N50 (p<0.05). No 
      significant differences were found in the paired-pulse N35-P40 in patients and 
      controls but the cortical P40-N50 at 20 ISI was facilitated in patients (p<0.05). 
      CONCLUSIONS: EMG activity is enhanced and the cortical SEP recovery cycle and BCR 
      are hyperexcitable in vaginismus. SIGNIFICANCE: The neurophysiological 
      abnormalities in patients with vaginismus indicate concomitant CNS changes in 
      this disorder.
FAU - Frasson, Emma
AU  - Frasson E
AD  - Department of Neurology, ULSS15 Cittadella Hospital, Via Riva Ospedale, 
      Cittadella, 35013 Padua, Italy. efrasson@ulss15.pd.it
FAU - Graziottin, Alessandra
AU  - Graziottin A
FAU - Priori, Alberto
AU  - Priori A
FAU - Dall'ora, Elisa
AU  - Dall'ora E
FAU - Didone, Giuseppe
AU  - Didone G
FAU - Garbin, Emilio Luigi
AU  - Garbin EL
FAU - Vicentini, Silvana
AU  - Vicentini S
FAU - Bertolasi, Laura
AU  - Bertolasi L
LA  - eng
PT  - Journal Article
DEP - 20081213
PL  - Netherlands
TA  - Clin Neurophysiol
JT  - Clinical neurophysiology : official journal of the International Federation of 
      Clinical Neurophysiology
JID - 100883319
SB  - IM
MH  - Adult
MH  - Anal Canal/innervation
MH  - Case-Control Studies
MH  - Electric Stimulation
MH  - Electromyography
MH  - Evoked Potentials, Somatosensory/physiology
MH  - Female
MH  - Humans
MH  - Muscle, Skeletal/physiopathology
MH  - Nervous System Malformations/*etiology
MH  - Neural Inhibition/physiology
MH  - Pelvic Floor/innervation
MH  - Reflex/physiology
MH  - Time Factors
MH  - Vaginismus/*complications/pathology
EDAT- 2008/12/17 09:00
MHDA- 2009/04/09 09:00
CRDT- 2008/12/17 09:00
PHST- 2008/03/25 00:00 [received]
PHST- 2008/10/17 00:00 [revised]
PHST- 2008/10/22 00:00 [accepted]
PHST- 2008/12/17 09:00 [entrez]
PHST- 2008/12/17 09:00 [pubmed]
PHST- 2009/04/09 09:00 [medline]
AID - S1388-2457(08)01242-X [pii]
AID - 10.1016/j.clinph.2008.10.156 [doi]
PST - ppublish
SO  - Clin Neurophysiol. 2009 Jan;120(1):117-22. doi: 10.1016/j.clinph.2008.10.156. 
      Epub 2008 Dec 13.