Central neuronal mechanisms of gastric electrical stimulation in diabetic gastroparesis

Frøkjær, Jens Brøndum; Ejskjær, Niels; Rask, Peter; Andersen, Stig Kjær; Gregersen, Hans; Drewes, Asbjørn Mohr; Funch‐Jensen, Peter

doi:10.1080/00365520802028221

Cited by 25 publications

(9 citation statements)

References 40 publications

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“…As gastric emptying is not significantly changed with gastric electrical stimulation [208], central mechanisms were proposed and presumably act though modulation of visceral sensory mechanisms in the brain. While preliminary studies indicate some changes in the activity of thalamus and caudate nucleus [209], gastric electrical stimulation does not affect brain activation during acute visceral stimulation [210]. …”

Section: Treatmentmentioning

confidence: 99%

Gastroparesis: Concepts, Controversies, and Challenges

Bielefeldt

2012

Scientifica

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Patients with gastroparesis often present a challenge to the treating physician. Postprandial symptoms with nausea and vomiting may not only lead to nutritional and metabolic consequences, but also cause significant disruptions to social activities that often center around food. While the definition of gastroparesis focuses on impaired gastric emptying, treatment options that affect gastric function are limited and often disappointing. The female predominance, the mostly idiopathic nature of the illness with a common history of abuse, and coexisting anxiety or depression show parallels with other functional disorders of the gastrointestinal tract. These parallels provided the rationale for some initial studies investigating alternative therapies that target the brain rather than the stomach. This emerging shift in medical therapy comes at a time when clinical studies suggest that gastric electrical stimulation may exert its effects by modulating visceral sensory processing rather than altering gastric motility. Physiologic and detailed anatomic investigations also support a more complex picture with different disease mechanisms, ranging from impaired accommodation to apparent visceral hypersensitivity or decreased interstitial cells of Cajal to inflammatory infiltration of myenteric ganglia. Delayed gastric emptying remains the endophenotype defining gastroparesis. However, our treatment options go beyond prokinetics and may allow us to improve the quality of life of affected individuals.

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Section: Treatmentmentioning

confidence: 99%

Gastroparesis: Concepts, Controversies, and Challenges

Bielefeldt

2012

Scientifica

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“…Gastrointestinal (GI) complications of diabetes mellitus (DM), including diabetic gastroparesis, are commonly observed during the long‐term follow‐up of the disease . Gut motility disorders consisting of delayed gastric emptying, abdominal pain, swelling and constipation have been reported in nearly 75% of diabetic patients .…”

Section: Introductionmentioning

confidence: 99%

Salvianolic acid A improves intestinal motility in diabetic rats through antioxidant capacity and upregulation of nNOS

Zhang

Yang

et al. 2016

J of Digest Diseases

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“…Another commonly used drug is Erythromycin, which is a useful agent for short term treatment in hospital; however, its long term benefit is limited due to the development of tachyphylaxis [18]. Besides, the use of botulinum toxin injection and gastric electric stimulator is still controversial [19–21]. The high recurrence rate leads to the further deterioration of the disease [8].…”

Section: Introductionmentioning

confidence: 99%

Chinese Herbal Medicine Banxiaxiexin Decoction Treating Diabetic Gastroparesis: A Systematic Review of Randomized Controlled Trials

Tian

Liao³

et al. 2013

Evidence-Based Complementary and Alternative Medicine

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Objective. To assess the current clinical evidence of Banxiaxiexin decoction for diabetic gastroparesis (DGP). Methods. Electronic databases were searched until December 2012. No language limitations were applied. We included RCTs using Banxiaxiexin decoction/modified Banxiaxiexin decoction for DGP. No restriction for the control group except acupuncture. Applying clinical effective rate as the main outcome index. Data extraction, analyses and quality assessment were conducted according to the Cochrane review standards. Results. 16 RCTs involving 1302 patients were finally identified, and the methodological quality was evaluated as generally low. The data showed that the effect of Banxiaxiexin decoction (BXXD) for DGP was superior to the control group (n = 1302, RR 1.23, 95% CI 1.17 to 1.29, Z = 8.04, P < 0.00001). Only one trial recorded adverse events, no obvious adverse event occurred. Conclusions. Banxiaxiexin decoction could regain the gastric emptying rate and improve diabetic gastrointestinal symptoms. However, the methodological quality of included studies is low, and long term efficacy and safety are still uncertain, which indicates that the findings above should be read with caution. Thereby, well-designed, large-scale, and high-quality randomized controlled clinical trials with scientific rigor are warranted for stronger evidence in future research.

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Central neuronal mechanisms of gastric electrical stimulation in diabetic gastroparesis

Cited by 25 publications

References 40 publications

Gastroparesis: Concepts, Controversies, and Challenges

Gastroparesis: Concepts, Controversies, and Challenges

Salvianolic acid A improves intestinal motility in diabetic rats through antioxidant capacity and upregulation of nNOS

Chinese Herbal Medicine Banxiaxiexin Decoction Treating Diabetic Gastroparesis: A Systematic Review of Randomized Controlled Trials

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