Efficiency and efficacy of multi‐channel gastric electrical stimulation

Abstract

Gastric electrical stimulation (GES) using single channel has been under investigation for its therapeutic potential for gastroparesis. The aim of this study was to study the efficacy and efficiency of multi-channel GES in accelerating gastric emptying in dogs. The study was performed in eight dogs, and gastric emptying of liquid was assessed in three randomized sessions of control, one-channel GES and four-channel GES. It was found that (i) GES of both one-channel and four-channel was able to completely entrain the slow waves in the entire stomach. However, the stimulation energy required by four-channel GES was only 1% of that required by one-channel GES. (ii) Four-channel, but not one-channel, GES significantly and substantially accelerated gastric emptying. An increase of 121.0 and 93.9% was noted with four-channel GES at 30 and 60 min after the meal, respectively. It was concluded that four-channel GES is substantially more efficient and effective than conventional single-channel GES in improving gastric emptying. It is worthy to explore its therapeutic potential for gastroparesis in clinical settings.

Systematic review: applications and future of gastric electrical stimulation

“…It seems that a single channel GES with long pulses has no effects on gastric emptying in healthy dogs but is capable of improving gastric emptying in a canine model of gastroparesis and a rodent model of diabetes. 29,34,50 Whereas, two-or four-channel GES with long pulses is able to improve gastric emptying in both healthy and diseased model of canines; 21,22 similar results (improvement in liquid and solid gastric emptying) were also observed with a multi-channel sequential GES of trains of pulses with a pulse width in the order of a few milliseconds. 23,24 GES with long pulses showed similar improvement in gastric emptying in patients with gastroparesis.…”

“…Two-to four-channel GES has been proposed in a number of studies. [21][22][23][24] Peripheral effects of GES A number of studies have been performed to investigate the effect of GES on the normalization of gastric myoelectrical dysrhythmias or entrainment of gastric slow waves, fundic/antral tone, antral contractions and gastric emptying. The majority of these studies seems to indicate that GES, depending on the parameters employed and stimulation sites, is able to alter gastric functions.…”

Diabetic Gastrointestinal Neuropathy: Elusive Diagnosis and Difficult Treatment

“…Moreover, the non-responders to GES may have had their devices removed, or may have declined to participate in post-treatment evaluations, leading to a greater representation of responders in the summary statistics. Meanwhile, research continues into other methods of gastric stimulation, and these also hold some promise for the treatment of gastroparesis as shown, for example, by multichannel gastric pacing accelerating gastric emptying in a canine model [49]. There is therefore need to improve the efficiency and protocol designs of such treatments before they become routine procedures.…”

537 Long-Term Effects of Gastric Stimulation on Gastric Electrical Physiology

“…6,[10][11][12][13][14][15][16] Several novel GES methods to improve gastric motility have been introduced over the last 20 years, such as multichannel GES, dual-pulse GES, and synchronized GES. [17][18][19][20][21][22][23][24][25][26] The term "gastric neuromodulation" has been used as a term to describe the antiemetic effect of GES therapy, as the symptom improvement is believed to be mediated through neurons and neuronal connectivity. A number of GES studies have demonstrated that gastric slow-wave pacing has entrained these slow waves with the pulse rates of the GES device.…”

“…A number of GES studies have demonstrated that gastric slow-wave pacing has entrained these slow waves with the pulse rates of the GES device. 17,18,20,[27][28][29] Not much is known about the long-term changes of gastric neurophysiology after chronic GES therapy. It has been shown that GES therapy is not effective in improvement of gastric dysrhythmia.…”