Body surface mapping of the stomach: New directions for clinically evaluating gastric electrical activity

Abstract

Disorders of gastroduodenal function without an obvious organic cause are common, defined by the Rome IV criteria to include functional dyspepsia, chronic nausea, and vomiting disorders, in addition to belching and rumination disorders. 1 Patients must meet criteria based upon symptoms, along with the requirement that no evidence of organic, systemic, or metabolic disease that is likely to explain their symptoms is found on routine investigations (including at upper endoscopy). 1 However, other gastric disorders, particularly gastroparesis, may have a clinical picture which is indistinguishable from the functional nausea and vomiting disorders, despite being

Validation of non-invasive body-surface gastric mapping for detecting electrophysiological biomarkers by simultaneous high-resolution serosal mapping in a porcine model

“…Nevertheless, it was clearly here shown that robust classification of overall slow direction was achievable, and moreover that it is possible to detect some more complex patterns such as competing pacemakers or colliding waves. Gastric dysrhythmias in patients should therefore also be robustly detectable at the body surface when there is a deviation from antegrade propagation, while potentially also showing corresponding frequency instabilities on spectral analytics (13, 18, 28) .…”

“…While EGG gas revealed consistent frequency abnormalities across several upper gastrointestinal (GI) functional disorders (13)(14)(15), it failed to achieve wide clinical adoption owing to a lack of clinical reliability, sensitivity to noise, and inadequate spatial resolution. More recently, body-surface gastric mapping (BSGM) has been proposed as novel method to detect changes in the spatial propagation of gastric slow waves non-invasively at the epigastrium (13). BSGM overcomes the lack of spatial resolution that critically limited EGG, while also introducing several new spatial biomarkers in addition to more robust frequency, amplitude, and meal response profiling (16).…”

Intraoperative Serosal Extracellular Mapping of the Human Distal Colon: A Feasibility Study

“…The CMP has been successfully recorded and characterised through HR manometry and body surface mapping techniques (7,15) however these are not of the same character and physiology of the slow waves recorded at the serosa (27). Simultaneous recordings using HR manometry and HR electrical mapping techniques, as well as less invasive methods of recording electrical activity may be helpful (16).…”

“…Hyperactive CMPs have previously been observed intra-operatively while patients are under general anaesthesia for abdominal surgery, potentially representing a novel effect of the surgical stress response (13,14). CMPs are also a target of emerging diagnostics such as high-resolution body surface mapping (15,16), and may be a relevant biomarker for therapeutic sacral neuromodulation (17). However, despite a broad emerging diagnostic and therapeutic signi cance, further work is required to better characterise the electrophysiological origins of the CMP.…”

Pancreatic Fibrosis (Early Chronic Pancreatitis) as Emerging Diagnosis in Structural Causes of Dyspepsia: Evidence from Endoscopic Ultrasonography and Shear Wave Elastography

“…The second purpose is to compare gastric emptying between pancreatic fibrosis (including early chronic pancreatitis) and functional dyspepsia in a small case series. Impaired gastric emptying is usually noted in functional dyspepsia and studies are ongoing [ 29 , 30 , 31 ]. However, the percentage of delayed gastric emptying in pancreatic fibrosis (including early chronic pancreatitis) remains unknown.…”