High Frequency Electrical Stimulation of the Stomach is More Effective than Low Frequency Pacing for the Treatment of Postoperative Functional Gastric Stasis in Humans

Abstract

The paper describes an original method of endoluminal electrical stimulation of the stomach developed by authors. The aim of the study was to compare two types of electrical stimulation: low frequency (LF) and high frequency (HF) in human patients. Twenty-three patients with postoperative gastroparesis (after abdominal surgery) were involved in the study and randomized into two groups. Group A consisted of 13 subjects treated by LF stimulation (mean age 52 ± 11; five males, eight females) and group B of 10 patients scheduled for HF stimulation (mean age 61 ± 8; six males, four females). A computer preprogrammable stimulator was used and the following parameters were evaluated: gastric retention every 12 h and symptoms score on the days 0, 1, 3, and 5. Gastric retention decreased in group A on consecutive days of pacing from 1,593 to 623, 407, 315, 246, to 192 ml, and in group B from 1,980 to 570, 218, 80, 15, to 0 ml (p < 0.05). Symptoms score decreased on the consecutive days of pacing from 8.3 to 3.8, 1.3, to 0.9 in the LF group and from 8.2 to 3.1, 1.0, to 0 in the HF group. We conclude that HF is more effective than LF in the treatment of postoperative gastroparetic human patients. No adverse effects of HF and LF were observed in this study.

Abdominal surgery activates nesfatin-1 immunoreactive brain nuclei in rats

“…Recently abdominal surgery was reported to induce strong Fos activation in CRF-containing neurons of the parvicellular PVN as shown by double labeling of Fos and CRF mRNA expression in rats [28]. In addition, gastric electrical stimulation, known to improve ileus-related symptoms in patients [55], is associated with decreased activity of CRF neurons in the PVN in rats [28]. We could recently show that the food intake-reducing effect after intracerebroventricular (icv) injection of nesfatin-1 is mediated by a CRF 2 receptor-dependent pathway as shown by the complete blockade of nesfatin-1’s action using the selective CRF 2 receptor antagonist astressin 2 -B [59].…”

Modulatory effects and afferent pathways of gastric electrical stimulation on rat thoracic spinal neurons receiving input from the stomach

“…Clinically and experimentally, various parameters of GES have been applied for inducing gastric sensory and motor effects (Abell and Minocha 2002;Familoni et al 1997;Forster et al 2001;Lin et al 2002;McCallum et al 1998;Sobocki et al 2003). The majority of these studies seem to indicate that GES with low frequency and high energy is able to entrain gastric slow waves and improve gastric emptying; whereas, GES with high frequency and low energy improves gastroparetic symptoms of nausea and vomiting without obvious improvement in gastric motility (Lin et al 2004).…”

Gastric Electrical Stimulation for the Treatment of Obesity: From Entrainment to Bezoars—A Functional Review

“…Numerous patents followed [115–118], and many scientific papers were published [32, 119–121]. Essentially, the method employs sets of electrode arrangements transverse to the gastric axis, which can be entirely or partially circumferential.…”