CEREBRAL RESPONSES ELICITED BY STIMULATION OF THE VESICOURETHRAL JUNCTION (VUJ) IN DIABETICS

To investigate the involvement of the visceral afferent nerves in diab etes mellitus, we enrolled 46 male patients in a study, examining the cerebral potentials evoked by stimulation of the vesico-urethral junct ion (VUJ CEP) and the pudendal (penile CEP) and posterior tibial nerve s (tibial CEP). The age range was 23-67 (mean 45.8) years. The epithel ial surface of the vesico-urethral junction was stimulated bipolarly w ith an electrode attached to a specially produced Foley catheter. Cere bral responses were recorded bipolarly at vertex. VUJ CEPs were absent (27 patients) or protracted and/or of low amplitude (4 patients) (tot al 31 patients; 67.8%). Penile CEP and/or tibial CEP could be obtained in all cases; however, protracted P1 peak latencies were detected in 15 (32.8%). The abnormalities of VUJ CEP did not correlate with the pr esence of peripheral neuropathy, while the abnormalities of penile CEP and/or tibial CEP invariably coincided with the presence of periphera l neuropathy. Although neither age nor the duration of diabetes correl ated with abnormal CEPs as determined by any of the tests, insulin dep endence correlated with abnormal penile CEP and to a lesser extent wit h VUJ CEP. We conclude that VUJ CEP is informative in evaluating the p hysiological condition of visceral afferents, and can be used in diagn osis of the early involvement of visceral afferents in diabetes mellit us.