Abnormalities on Electrogastrography in Nausea and Vomiting Syndromes: A Systematic Review, Meta-Analysis, and Comparison to Other Gastric Disorders

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

doi:10.1007/s10620-021-07026-x

Cited by 41 publications

(56 citation statements)

References 64 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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%

See 1 more Smart Citation

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

Gharibans

Hayes

Carson

et al. 2022

Preprint

Self Cite

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

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

Self Cite

View full text Add to dashboard Cite

show abstract

“…[8][9][10][11][12] The two disorders may therefore be considered together under the umbrella term nausea and vomiting syndromes (NVS). 13 The heterogeneous and unclear pathophysiology of NVS contributes to diagnostic uncertainty and impedes therapeutic progress. Contributing mechanisms may include gastric neuromuscular dysfunction, dysregulation of gut-brain interaction, and pylorospasm, which could represent distinct or overlapping phenotypes.…”

Section: Introductionmentioning

confidence: 99%

“…16,17,20,21 Electrogastrography (EGG) has previously been the only clinical method for evaluating gastric myoelectrical function. EGG has demonstrated consistent abnormalities in NVS, 13 however multiple limitations restricted clinical adoption, including noise susceptibility, low resolution in the face of gastric anatomical variability, inability to evaluate spatial patterns, and low specificity for disease subtypes. 22,23 Body surface gastric mapping (BSGM; also HR-EGG) has recently emerged as a new approach, employing dense fields of electrodes to reliably assess gastric activity at high spatial resolution.…”

Section: Introductionmentioning

confidence: 99%

Gastric dysfunction in patients with chronic nausea and vomiting syndromes defined by a novel non-invasive gastric mapping device

Gharibans

Calder

Varghese

et al. 2022

Preprint

Self Cite

111

View full text Add to dashboard Cite

Importance Chronic nausea and vomiting syndromes (NVS) are prevalent and debilitating disorders. Putative mechanisms include gastric neuromuscular disease and dysregulation of brain-gut interaction, but clinical tests for objectively defining gastric motor function are lacking. Objective A novel medical device enabling non-invasive body surface gastric mapping (BSGM) was developed and applied to evaluate NVS pathophysiology. Design A case-control study where BSGM was performed in NVS patients and matched controls using Gastric Alimetry (Alimetry, New Zealand), comprising a conformable high-resolution array (8x8 electrodes; 20 mm inter-electrode spacing), wearable Reader, and validated symptom logging App. Continuous measurement encompassed a fasting baseline (30 min), 482 kCal meal (10 min), and 4-hr post-prandial recording. Setting Multicenter study in Auckland, New Zealand and Calgary, Canada. Participants 43 NVS patients (gastroparesis and Rome IV chronic NVS) and 43 matched controls. Main outcomes and measures Symptom severity and quality of life were measured using Patient Assessment of Upper Gastrointestinal Disorders-Symptom Severity Index (PAGI-SYM), Gastroparesis Cardinal Symptom Index (GCSI), and Patient Assessment of Upper Gastrointestinal Disorders-Quality of Life (PAGI-QOL) instruments. Health psychology metrics included the State Trait Anxiety Inventory Short Form (STAI-SF) and Patient Health Questionnaire-2 (PHQ-2) questionnaires. Spectral analyses including frequency, amplitude, and fed-fasting power ratio. Spatial biomarker analyses included spatial frequency stability and average spatial covariance. Results Meal responses were impaired in NVS, with reduced amplitudes compared to controls (median 23.3 vs 38.0 microV, p<0.001), impaired fed-fasting power-ratios (1.1 vs 1.6, p=0.02), and disorganized slow-waves (spatial frequency stability 13.6 vs 49.5; p<0.001). However, two distinct NVS subgroups were evident with indistinguishable symptoms (all p>0.05). A majority (62%) had normal BSGM studies (all biomarkers non-significant vs controls) with increased psychological comorbidities (43.5% vs 7.7%; p=0.03) and anxiety scores (median 16.5 vs 13.0; p=0.035). A smaller subgroup (31%) had markedly abnormal BSGM, with test biomarkers correlating with symptoms (nausea, pain, excessive fullness, early satiety, bloating; all r>0.35, p<0.05). Conclusions and Relevance NVS patients share overlapping symptoms, but comprise distinct underlying phenotypes as revealed by a novel BSGM device. These phenotypes correlate with symptoms, which should inform clinical management and allocations into therapeutic trials.

show abstract

“…Medical trials have been carried out to get important information on the mechanism that regulates the activity of stomach muscles and nerves in presence of those disorders, [19]- [21]. So, for example, it can be an helpful technique in understanding the origin of the unexplained contractions which cause vomiting in patients affected by anorexia, [22], [23]. That would allow gastroenterologists to schedule new therapies so to reduce the vomiting stimulus.…”

Section: Introductionmentioning

confidence: 99%

Design of a non-invasive sensing system for diagnosing gastric disorders

et al. 2021

View full text Add to dashboard Cite

Gastric disorders are widely spread among the population of any age. At the moment, the diagnosis is made by using invasive systems that cause several side effects. The present manuscript proposes an innovative non-invasive sensing system for diagnosing gastric dysfunctions. The Electro-GastroGraphy (EGG) technique is used to record myoelectrical signals of stomach activities. Although EGG technique is well known for a long time, several issues concerning the signal processing and the definition of suitable diagnostic criteria are still unresolved. So, EGG is to this day a trial practice. The authors want to overcome the current limitations of the technique and improve its relevance. To this purpose, a smart EGG sensing system has been designed to non-invasively diagnose gastric disorders. In detail, the system records the gastric slow waves by means of skin surface electrodes placed in the epigastric area. Cutaneous myoelectrical signals are so acquired from the body surface in proximity of stomach. Electro-gastrographic record is then processed. According to the diagnostic model designed from the authors, the system estimates specific diagnostic parameters in time and frequency domains. It uses Discrete Wavelet Transform to obtain power spectral density diagrams. The frequency and power of the EGG waveform and the dominant frequency components are so analyzed. The defined diagnostic parameters are put in comparison with the reference values of a normal EGG in order to estimate the presence of gastric pathologies by the analysis of arrhythmias (<em>tachygastria</em>, <em>bradygastria</em> and irregular rhythm). The paper aims to describe the design of the system and of the arrhythmias detection algorithm. Prototype development and experimental data will be presented in future works. Preliminary results show an interesting relevance of the suggested technique so that it can be considered as a promising non-invasive tool for diagnosing gastrointestinal motility disorders.

show abstract

Abnormalities on Electrogastrography in Nausea and Vomiting Syndromes: A Systematic Review, Meta-Analysis, and Comparison to Other Gastric Disorders

Cited by 41 publications

References 64 publications

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

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

Gastric dysfunction in patients with chronic nausea and vomiting syndromes defined by a novel non-invasive gastric mapping device

Design of a non-invasive sensing system for diagnosing gastric disorders

Contact Info

Product

Resources

About