ニューロメーター(膀胱電気知覚閾値)

The Neurometer

　膀胱知覚神経線維(Aδ線維およびC線維)の病態が，尿失禁，過活動膀胱，間質性膀胱炎などの病態に深いかかわりをもつ多くの証拠が明らかになっており，治療の標的を明らかにするためには下部尿路の求心路の病態の定量的評価が重要である．末梢神経知覚閾値測定装置であるNeurometer^(R)による下部尿路の神経線維選択的知覚機能検査は，異なる種類の神経線維が異なる興奮速度をもつことを利用し，被験者が感知できる最低レベルの刺激量をCPT値(電流知覚閾値)として計測可能とする．

The Neurometer^(R)(Neurotron, Inc. USA) is a commercially available peripheral nerve neuro-selective diagnostic electro-stimulator. Bladder afferent pathways consist of A-delta and C-fibers. C-fiber afferent nerves are involved in neuro-urothelial interactions with various kinds of neuro-inflammatory mediators, and A-delta fibers and bladder urothelium also may act as "mechanical sensors" of bladder distension. The quantitative neuro-selective measure of bladder A-delta and C-fiber afferent pathways by a Neurometer^(R)has a potential role to become a clinical diagnostic tool to clarify bladder afferent dysfunction quantitatively. This article focuses on a review of the recent clinical use of Neurometer^(R), and also on our experience in using a new Foley catheter type electrode for more objective and easy-handling application of this device to assess lower urinary tract afferent dysfunction.