The gastric slow wave is originated in the proximal stomach and propagates distally toward the pylorus. It determines the maximum frequency and propagation of gastric contractions. The aim of this study was to detect the propagation of the gastric slow wave from the surface electrogastrogram (EGG). The study was performed in 11 healthy subjects of normal weight. Gastric myoelectrical activity was recorded for 1 h in the fasting state with the use of a specially designed multichannel recording device that was composed of four identical amplifiers with cutoff frequencies of 1.8 and 16.0 cycles/min. Four active electrodes were placed on the abdomen along the gastric axis and were connected to a common reference electrode placed near the xiphoid process, yielding four-channel bipolar EGG signals. Cross-covariance analysis was performed to compute the time lag among the four channels. There was a time lag in EGG waveform between channels 1 and 4 (9.6 ± 1.1 s); the average time during which the time lag was observed (≥3 s) was 89.9 ± 9.0%. There was a significant difference in the time lag among different adjacent channels ( P< 0.04); the time lag observed between channels 3 and 4 was significantly smaller than that between channels 1 and 2( P < 0.03). No correlation was found between the body mass index and the time lag between channels 1 and 4 ( r= −0.31, P = 0.3). It was concluded that, with a multichannel recording device with identical multiamplifiers and an appropriate arrangement of abdominal electrodes, the propagation of the gastric slow wave could be identified from the EGG in healthy subjects. This method may be used to detect the coupling of the gastric slow wave noninvasively.

Gastric pacing has received increasing attention recently. However, few studies have systematically assessed the effect of pacing on gastric dysrhythmias. The aims of this study were to investigate the effect of gastric pacing on gastric dysrhythmia and to explore whether the effect of gastric pacing was mediated via cholinergic nerves. Eight hound dogs implanted with three pairs of serosal electrodes were studied. Three study sessions were performed on each dog. The experiment was conducted sequentially as follows: a 30-min myoelectrical recording immediately after a meal, intravenous injection of atropine or saline, and three sequential 20-min myoelectrical recordings with or without gastric pacing during the second 20-min recording. The percentage of regular slow waves (3.5–7.0 cycles/min) was calculated using spectral analysis. The percentage of the regular slow waves was progressively reduced from 96.7 ± 1.7% at baseline to 29.6 ± 9.0 ( P < 0.001), 23.1 ± 7.1 ( P < 0.001), and 27.3 ± 4.3% ( P < 0.001), respectively, during the first, second, and third 20 min after atropine injection. Normalization of the gastric slow wave was achieved with gastric pacing 2.3 ± 1.0 min after the initiation of pacing. The percentage of regular slow waves was significantly increased both during pacing (93.6 ± 2.4 vs. 23.1 ± 7.1%, P < 0.002) and after pacing (70.9 ± 6.8 vs. 27.3 ± 4.3%, P < 0.003) in comparison with the session without pacing. We conclude that 1) atropine induces gastric myoelectric dysrhythmia in the fed state, 2) gastric pacing is able to normalize gastric postprandial dysrhythmia induced by atropine, and 3) the effect of gastric pacing is not mediated by vagal cholinergic mechanism.

The absence of a standard meal in electrogastrography may limit its clinical significance. Different meals may fail to produce the expected postprandial motility pattern. The aim of this study was to investigate the effect of meal volume and composition on postprandial myoelectrical activity. Fourteen healthy subjects were given four meals that differed from a “reference meal” in one single parameter (volume, calorie, or fiber content). Gastric myoelectrical activity was measured using surface electrogastrography. Spectral and statistical analyses were performed to investigate the effect of food properties on electrogastrogram (EGG) parameters. It was found that the reference meal produced a postprandial increase in the dominant frequency ( P < 0.007), dominant power ( P < 0.04), and percentage of normal 2–4 cycle/min gastric slow waves ( P > 0.05). Similar changes were observed with the low-volume and high-fiber meals but not with the reduced-calorie meal. Fasting EGG parameters in all four sessions showed no significant difference. It was concluded that low-calorie meals do not result in expected postprandial physiological responses and thus are not appropriate for EGG tests. A volume reduction of down to one-half the volume of a regular meal does not affect postprandial changes of the EGG; thus a condensed test meal may be recommended for symptomatic patients.

Dysrhythmia in gastric myoelectrical activity has been frequently observed in patients with gastric motor disorders and gastrointestinal symptoms. The assessment of the regularity of gastric myoelectrical activity is of great clinical significance. The aim of this study was to develop an automated assessment method for the regularity of gastric myoelectrical activity from the surface electrogastrogram (EGG). The method proposed in this paper was based on the filter bank and neural network. First, the EGG signal was divided into frequency subbands using filter bank analysis. Second, a parameter called the subband energy ratio (SER) was computed for each subband signal. A multilayer perceptron neural network was then used to automatically classify the EGG signal into four categories: bradygastria, normal, tachygastria, and arrhythmia, using the SER as the input. The EGG recording was made using the standard method of electrogastrography by placing electrodes on the abdominal surface. The study was performed in 40 patients with various gastric motor disorders, ten healthy adults, and ten healthy children. The neural network was trained and tested using the EGG data obtained from the patients. The regularity of gastric myoelectrical activity was assessed based on the classification of the minute-by-minute EGG segments. Using the running spectral analysis method as a gold standard, the proposed automated method had an accuracy of 100% for the training set and 97% for the test set. It was concluded that the proposed method provides an accurate and automatic assessment of the regularity of gastric myoelectrical activity from the EGG.

The aim of this study was to investigate gastric myoelectrical activity in patients with functional dyspepsia. Thirteen healthy subjects and 14 patients with functional dyspepsia participated in the study. The electrogastrogram (EGG) recording was made in each subject for 30 min in the fasting state and 120 min after a standard test meal of 475 calories. Spectral analysis methods were applied to derive quantitative EGG parameters. There was no difference in the EGG between the patients and controls in the fasting state. However, abnormalities in the postprandial EGG were found in the patients. The percentage of 2-4 cpm waves was significantly lower (74.4+/-4.0% vs 85.7+/-1.6%, P < 0.03) and the postprandial increase in EGG dominant power was significantly less (-0.52+/-0.92 dB vs 2.24+/-0.88 dB, P < 0.03) in patients than in controls. It was also found that the percentage of postprandial 2-4 cpm waves could be used to differentiate the patients with functional dyspepsia from the healthy controls with a specificity of 100% and a sensitivity of 43%. It was concluded that a subset of patients with functional dyspepsia have impaired gastric myoelectrical activity in the fed state.