116 – Electrogastography At Baseline and Response to Temporary Gastric Electrical Stimulation – a Comparison of Cutaneous with Mucosal Recordings

Shine, Amal; Ahmed, Shifat; McElmurray, Lindsay; Stocker, Abigail; Pinkston, Christina; Abell, Thomas

doi:10.1016/s0016-5085(19)36850-7

Cited by 3 publications

(3 citation statements)

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“…The anatomic measure of gastric Cajal cells have been reported to effect outcome as measured by full thickness biopsy, although this can now be performed less invasively . Several studies have now shown that baseline gastric electrical activity, particularly when done with multi‐point (low‐resolution) recordings of the gastric mucosa, can predict outcome to temporary and permanent GES …”

Section: Discussionmentioning

confidence: 99%

“…34 Several studies have now shown that baseline gastric electrical activity, particularly when done with multi-point (low-resolution) recordings of the gastric mucosa, can predict outcome to temporary and permanent GES. 11,35,36 One of the other difficulties with device trial for gastroparesis is that the mechanism of action of GES has not been well understood. Besides a documented central effect in several studies, 37,38 recent NIH DiaComp work has reported other mechanisms of a Propensity scores were calculated using logistic regression with the binary indicator for the GES implantation as an outcome.…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness of gastric electrical stimulation in gastroparesis: Results from a large prospectively collected database of national gastroparesis registries

Abell

Yamada

McCallum

et al. 2019

Neurogastroenterology Motil

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Background Gastric electrical stimulation (GES) for treating gastroparesis symptoms is controversial. Methods We studied 319 idiopathic or diabetic gastroparesis symptom patients from the Gastroparesis Clinical Research Consortium (GpCRC) observational studies: 238 without GES and 81 with GES. We assessed the effects of GES using change in GCSI total score and nausea/vomiting subscales between baseline and 48 weeks. We used propensity score methods to control for imbalances in patient characteristics between comparison groups. Key Results GES patients were clinically worse (40% severe vs. 18% for non‐GES; P < .001); worse PAGI‐QOL (2.2. vs. 2.6; P = .003); and worse GCSI total scores (3.5 vs. 2.8; P < .001). We observed improvements in 48‐week GCSI total scores for GES vs. non‐GES: improvement by ≥ 1‐point (RR = 1.63; 95% CI = (1.14, 2.33); P = .01) and change from enrollment (difference = −0.5 (−0.8, −0.3); P < .001). When adjusting for patient characteristics, symptom scores were smaller and not statistically significant: improvement by ≥ 1‐point (RR = 1.29 (0.88, 1.90); P = .20) and change from the enrollment (difference = −0.3 (−0.6, 0.0); P = .07). Of the individual items, the nausea improved by ≥ 1 point (RR = 1.31 (1.03, 1.67); P = .04). Patients with GCSI score ≥ 3.0 tended to improve more than those with score < 3.0. (Adjusted P = 0.02). Conclusions and Inferences This multicenter study of gastroparesis patients found significant improvements in gastroparesis symptoms among GES patients. Accounting for imbalances in patient characteristics, only nausea remained significant. Patients with greater symptoms at baseline improved more after GES. A much larger sample of patients is needed to fully evaluate symptomatic responses and to identify patients likely to respond to GES.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effectiveness of gastric electrical stimulation in gastroparesis: Results from a large prospectively collected database of national gastroparesis registries

Abell

Yamada

McCallum

et al. 2019

Neurogastroenterology Motil

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“…Both of these measures (EGG and mEG) can be done as low-or high-resolution techniques. Frequency, amplitude, and frequency-amplitude-ratio of cutaneous EGG and mucosal (and likely, serosal) electrograms have been shown to be reliable measures of gastric motility [18].…”

Section: Antiarrhythmic Effectmentioning

confidence: 99%

Role of Gastric Electrical Stimulation in the Treatment of Gastroparesis

Shine

Abell

2020

Gastrointestinal Disorders

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Introduction: Gastric electrical stimulation (GES) is a surgically implanted treatment option for drug refractory gastroparesis syndromes. Evidence supporting use of GES and the pathophysiology of gastroparesis syndromes is not widely known. We conducted a descriptive review to elucidate the pathophysiology of gastroparesis syndromes, with particular focus on gastrointestinal neuromodulation and the known mechanisms of action of GES. Methods: A descriptive review of PubMed, Web of Science and Cochrane Library was conducted using the keywords gastric electrical stimulation, gastroparesis, nausea, vomiting, neuromodulation, gastroparesis syndromes, central nervous system, gastric pacing and electrical stimulation. Results: 1040 potentially relevant articles were identified, of which 34 were included. These studies explored various central and peripheral effects of GES, as well as its effect on quality of life, hospital stay, mortality and health-related costs. Conclusion: Although evidence supporting gastrointestinal (GI) electrical stimulation and GI neuromodulation use is not widely known, GES does seem to offer significant improvement in symptom control, quality of life and other effects to many patients. GES exerts its effects through multiple central and peripheral mechanisms and has potential to modify the natural history of disease. Future work on gastroparetic syndromes and their treatment might be better focused in terms of pathophysiologic mechanisms. Improving outcomes with specific neuromodulation therapies, like GES, may offer improvements in health for many patients with refractory upper gastrointestinal symptoms.

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A Deep Convolutional Neural Network Approach to Classify Normal and Abnormal Gastric Slow Wave Initiation From the High Resolution Electrogastrogram

Agrusa¹,

Gharibans²,

Allegra

et al. 2020

IEEE Trans. Biomed. Eng.

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116 – Electrogastography At Baseline and Response to Temporary Gastric Electrical Stimulation – a Comparison of Cutaneous with Mucosal Recordings

Cited by 3 publications

References 0 publications

Effectiveness of gastric electrical stimulation in gastroparesis: Results from a large prospectively collected database of national gastroparesis registries

Effectiveness of gastric electrical stimulation in gastroparesis: Results from a large prospectively collected database of national gastroparesis registries

Role of Gastric Electrical Stimulation in the Treatment of Gastroparesis

A Deep Convolutional Neural Network Approach to Classify Normal and Abnormal Gastric Slow Wave Initiation From the High Resolution Electrogastrogram

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