EFFECT OF MENTAL STRESS AND CISAPRIDE ON AUTONOMIC NERVE FUNCTIONS INFUNCTIONAL DYSPEPSIA

Background: Disordered autonomic nerve function is frequently present in patients with functional dyspepsia (FD). In this study we investiga ted whether the prokinetic cisapride, which acts via acetylcholine rec eptors, and stress may modulate these abnormalities. Methods: Nineteen patients (6 men, 13 women) with FD and 10 healthy subjects (3 men, 7 women) were studied after 3 days' treatment with 10 mg cisapride three times daily and placebo in a crossover design. Mental stress was indu ced with a videogame. Sympathetic and vagal nerve functions were asses sed noninvasively by skin conductance and respiratory sinus arrythmia, respectively. Results: Vagal tone was significantly lower in FD patie nts than in controls both before and after mental stress (P < 0.001). Sympathetic tone was higher in patients with FD than in controls (P < 0.03). Generally, stress scores were increased by mental stress in bot h groups (P < 0.001). In FD patients, but not in controls, cisapride s ignificantly increased the sympathetic tone both before (P < 0.05) and after stress (P < 0.05). Conclusions: Patients with FD have lower vag al tone and higher sympathetic tone than healthy controls. Treatment w ith cisapride increased sympathetic tone in the patient group but had no effect on vagal tone.