Gastric dysrhythmia in gastroesophageal reflux disease: a systematic review and meta-analysis

Bhat, Sameer; Varghese, Chris; Carson, Daniel; Hayes, Tommy; Gharibans, Armen A.; Andrews, Christopher N.; O’Grady, Gregory

doi:10.1007/s10388-021-00820-6

Cited by 26 publications

(29 citation statements)

References 48 publications

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“…Notably, four meta-analyses recently synthesized >200 EGG studies in adults and children (114)(115)(116)(117), with the key finding that despite a heterogeneity of techniques, frequencydefined gastric dysrhythmias were consistently pervasive across a large range of studies in several disorders of gastric function including functional dyspepsia, GERD and chronic nausea and vomiting / gastroparesis. Interestingly, on pooled analyses, frequency instabilities were most prevalent in nausea and vomiting disorders and GERD, followed by functional dyspepsia (Figure 3).…”

Section: Gastric Dysrhythmia and Electrogastrography (Egg)mentioning

confidence: 99%

“…Interestingly, on pooled analyses, frequency instabilities were most prevalent in nausea and vomiting disorders and GERD, followed by functional dyspepsia (Figure 3). The clear separation between patients and controls indicated that gastric dysrhythmia likely plays some pathophysiological role in all of these disorders (114,115,117). Several questions arise, including whether the gastric dysrhythmias in these distinct but overlapping disorders are the same or different, how dysrhythmias impact motility, what drives them, and how they contribute to gastric symptoms.…”

Section: Gastric Dysrhythmia and Electrogastrography (Egg)mentioning

confidence: 99%

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The gastric conduction system in health and disease: a translational review

O’Grady

Gharibans

et al. 2021

American Journal of Physiology-Gastrointestinal and Liver Physi

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Gastric peristalsis is critically dependent on an underlying electrical conduction system. Recent years have witnessed substantial progress in clarifying the operations of this system, including its pacemaking units, its cellular architecture, and slow wave propagation patterns. Advanced techniques have been developed for assessing its functions at high spatiotemporal resolutions. This review synthesizes and evaluates this progress, with a focus on human and translational physiology. A current conception of the initiation and conduction of slow wave activity in the human stomach is provided first, followed by a detailed discussion of its organisation at the cellular and tissue level. Particular emphasis is then given to how gastric electrical disorders may contribute to disease states. Gastric dysfunction continues to grow in their prevalence and impact, and while gastric dysrhythmia is established as a clear and pervasive feature in several major gastric disorders, its role in explaining pathophysiology and informing therapy is still emerging. New insights from high-resolution gastric mapping are evaluated, together with historical data from electrogastrography, and the physiological relevance of emerging biomarkers from body surface mapping such as retrograde propagating slow waves. Knowledge gaps requiring further physiological research are highlighted.

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Section: Gastric Dysrhythmia and Electrogastrography (Egg)mentioning

confidence: 99%

Section: Gastric Dysrhythmia and Electrogastrography (Egg)mentioning

confidence: 99%

The gastric conduction system in health and disease: a translational review

O’Grady

Gharibans

et al. 2021

American Journal of Physiology-Gastrointestinal and Liver Physi

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“…44 It therefore appears that retrograde wave behavior is part of the normal post-prandial gastric repertoire, which would be an important physiological discovery, 45 but this nding requires further scrutiny in dedicated studies before it can be accepted. Gastric electrophysiology has recently been con rmed by meta-analyses to signi cantly deviate from healthy subjects in FD, CNVS, gastro-esophageal re ux disease, and various pediatric disorders with traditional EGG, [11][12][13]46 indicating priority target groups for future clinical studies using BSGM. Additionally, studies suggest that dysrhythmias may also be implicated in a subset of postoperative gastric dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…8 EGG measures the bioelectrical slow waves that coordinate gastric motility, and also registers gastric contractile activity through an increase in signal power. 9,10 A substantial literature has been generated to show that EGG abnormalities are consistently prevalent in patients with gastric symptoms, [11][12][13] yet EGG failed to achieve common clinical adoption. Limitations to EGG include its focus on frequency as the predominant measure of abnormality, sensitivity to noise that could lead to misinterpretation of data, and an inability to account for a wide variability in gastric anatomical position.…”

Section: Introductionmentioning

confidence: 99%

A novel scalable electrode array and system for non-invasively assessing gastric function using flexible electronics

Gharibans

Hayes

Carson

et al. 2022

Preprint

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Disorders of gastric function are highly prevalent, but diagnosis often remains symptom-based and inconclusive. Body surface gastric mapping is an emerging diagnostic solution, but current approaches lack scalability and are cumbersome and clinically impractical. We present a novel scalable system for non-invasively mapping gastric electrophysiology in high-resolution (HR) at the body-surface. The system comprises a custom-designed flexible HR sensor array and portable data-logger synchronized to an App, with automated analysis and visualization algorithms. The novel system underwent performance testing then validation in 24 healthy subjects. In all subjects, gastric electrophysiology and meal responses were successfully captured and mapped non-invasively (mean frequency 2.9 ± 0.3 cycles per minute; peak amplitude at mean 60 m postprandially with return to baseline in <4 h). Spatiotemporal mapping showed regular and consistent wave activity of mean direction 182.7°±73 (74.7% antegrade, 7.8% retrograde, 17.5% indeterminate). The presented system is a new diagnostic tool for assessing gastric function that is scalable, validated, and ready for clinical applications, offering several biomarkers that are new to gastroenterology practice.

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“…Electrogastrography (EGG) is a clinical test that assesses gastric electrophysiology by employing sparse electrode configurations non-invasively (12). 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).…”

Section: Introductionmentioning

confidence: 99%

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

Calder

Cheng

Andrews

et al. 2021

Preprint

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Gastric disorders are increasingly prevalent, but reliable clinical tools to objectively assess gastric function are lacking. Body-surface gastric mapping (BSGM) is a non-invasive method for the detection of gastric electrophysiological biomarkers including slow wave direction, which have correlated with symptoms in patients with gastroparesis and functional dyspepsia. However, no studies have validated the relationship between gastric slow waves and body surface activation profiles. This study aimed to comprehensively evaluate the relationship between gastric slow waves and body-surface recordings. High-resolution electrode arrays were placed to simultaneously capture slow waves from the gastric serosa (32 x 6 electrodes at 4 mm resolution) and abdominal surface (8x8 at 20 mm inter-electrode spacing) in a porcine model. BSGM signals were extracted based on a combination of wavelet and phase information analyses. A total of 1185 individual cycles of slow waves assessed, out of which 897 (76%) were normal antegrade waves, occurring in 10/14 (71%) subjects studied. BSGM accurately detected the underlying slow wave in terms of frequency (r = 0.99, p = 0.43) as well as the direction of propagation (p = 0.41, F-measure: 0.92). In addition, the cycle-by-cycle match between BSGM and transitions of gastric slow waves in terms either or both temporal and spatial abnormalities was demonstrated. These results validate BSGM as a suitable method for non-invasively and accurately detecting gastric slow wave activation profiles from the body surface.

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Gastric dysrhythmia in gastroesophageal reflux disease: a systematic review and meta-analysis

Cited by 26 publications

References 48 publications

The gastric conduction system in health and disease: a translational review

The gastric conduction system in health and disease: a translational review

A novel scalable electrode array and system for non-invasively assessing gastric function using flexible electronics

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

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