Meal Effects on Gastric Bioelectrical Activity Utilizing Body Surface Gastric Mapping in Healthy Subjects

Huang, I-Hsuan; Calder, Stefan; Gharibans, Armen A.; Schamberg, Gabriel; Varghese, Chris; Andrews, Christopher N.; Tack, Jan; O’Grady, Greg

doi:10.1101/2023.10.31.23296947

Cited by 4 publications

(1 citation statement)

References 43 publications

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“…Although the tests were kept as standardized as possible to control for any variability, there was slight variation in the test timings and three participants switched to alternative meals of equal caloric content. However, research has shown no significant differences in the results of EGG 56 or BSGM 57 for calorie-matched meals with different compositions.…”

Section: Discussionmentioning

confidence: 97%

Short‐ and long‐term reproducibility of body surface gastric mapping using the Gastric Alimetry® system

Law,

Schamberg,

Gharibans

et al. 2024

Neurogastroenterology Motil

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BackgroundMany diagnostic tests for gastroduodenal symptoms, such as gastric emptying scintigraphy (GES), gastric emptying breath tests (GEBT), and electrogastrography (EGG) show variable intra‐individual reproducibility over time. This study investigated the short‐ and long‐term reproducibility of body surface gastric mapping (BSGM), a non‐invasive test for assessing gastric function, in controls and patients with chronic gastroduodenal disorders.MethodsParticipants completed three standardized BSGM tests using Gastric Alimetry® (Alimetry, New Zealand). The test encompassed a fasting baseline (30 min), a 482 kCal standard meal, and a 4 h postprandial recording. The first two tests were >6 months apart and the last occurred ~1 week after the second test, to evaluate long and short‐term reproducibility.ResultsFourteen patients with upper gastrointestinal symptoms and 14 healthy controls were recruited. There were no significant differences in any BSGM metrics between the tests at short and long term (all p > 0.180). Lin's concordance correlation coefficients (CCC) for the primary metrics were high, ranging from 0.58 to 0.96, with intra‐individual coefficients of variance (CVintra) ranging from 0.2% to 1.9%. Reproducibility was higher, and intra‐individual variation lower, than in previous studies of GES (CCC = 0.54–0.83, CVintra = 3%–77%), GEBT (CVintra = 8%–11%), and EGG (CVintra = 3%–78%).ConclusionsBSGM spectral metrics demonstrate high reproducibility and low intra‐individual variation at both short and long term, with superior results to comparable tests. The high reproducibility of Gastric Alimetry supports its role as a diagnostic aid for gastric dysfunction and a reliable tool for evaluating treatment outcomes and disease progression over time.

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Section: Discussionmentioning

confidence: 97%

Short‐ and long‐term reproducibility of body surface gastric mapping using the Gastric Alimetry® system

Law,

Schamberg,

Gharibans

et al. 2024

Neurogastroenterology Motil

Self Cite

View full text Add to dashboard Cite

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Body Surface Gastric Mapping Delineates Specific Patient Phenotypes in Adolescents With Functional Dyspepsia and Gastroparesis

Humphrey,

Keane,

Schamberg

et al. 2024

Preprint

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Importance Persistent upper gastroduodenal symptoms, such as nausea, vomiting, bloating, and abdominal pain, are widespread among pediatric patients. Multiple overlapping symptoms complicate the diagnostic process, necessitating the development of novel gastric function tests with actionable biomarkers. Body Surface Gastric Mapping (BSGM) has emerged as a promising diagnostic tool for gastroduodenal disorders, and this is the first detailed evaluation in adolescents. Objective This study aimed to assess the utility of BSGM in delineating specific patient phenotypes among adolescents with functional dyspepsia (FD) and gastroparesis in order to guide clinical decision-making. Design A prospective cross-sectional study recruited adolescents aged 12 to 21 between 2022 and 2024. Setting Controls were recruited from New Zealand (controls) and Patients from the Children's Hospital of Philadelphia, Pennsylvania, USA. Participants Prospectively recruited participants included controls without gastroduodenal symptoms or motility-related medication usage and patients diagnosed with either gastroparesis (delayed gastric emptying test (GET)) or FD according to ROME IV criteria and a normal GET. Procedures BSGM was performed using a standardized protocol, including simultaneous symptom reporting and the completion of validated symptom, psychometric and physical health questionnaires. Main Outcome The primary outcome was to evaluate if BSGM could delineate specific patient phenotypes and provide clinically meaningful distinctions between gastroparesis and FD diagnoses, utilizing BSGM spectral outcome data. Results Fifty-six subjects were recruited (31 controls, 25 patients); median age 16; 96% of patients were female. Control data showed that adult reference intervals provided an acceptable interpretation framework. Patients with FD (n=10) and gastroparesis (n=15) had common symptoms, mental health, quality of life and functional disability (all p>0.05). Three distinct BSGM phenotypes were identified: BSGM Normal (n=10), BSGM Delay (n=8), and Low Stability/Low Amplitude (n=7), having spectral differences in BMI-Adjusted Amplitude 34.6 vs 39.1 vs 19.9 (p=.01) and Gastric Alimetry Rhythm Index: 0.45 vs 0.45 vs 0.19 (p=.003). BSGM phenotypes demonstrated differences in symptoms (nausea p=0.04), physical health (p=.04) and psychometrics (anxiety p=.03). Conclusion and Relevance Adolescent patients with FD and gastroparesis have overlapping clinical profiles, making individualized treatment challenging. Conversely, employing BSGM to categorize patients into distinct phenotypes revealed clinically relevant differences, offering potential avenues for individualized therapeutic pathways.

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Neuropathic Gastroduodenal Disorders can be Diagnosed by Non-Invasive Body Surface Gastric Mapping: a Comparison with Antroduodenal Manometry

Sadaka,

Xu,

Benitez

et al. 2024

Preprint

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Background Antroduodenal manometry (ADM) is the gold standard for diagnosing myopathy and neuropathy in patients with upper gastrointestinal (GI) disorders. However, ADM is invasive and costly. Body surface gastric mapping (BSGM) has emerged as a non-invasive test to assess gastric function. This study evaluates the correlation between BSGM and ADM in children. Methods Clinically indicated ADM was performed using high-resolution water-perfused motility catheters, with simultaneous BSGM. Real-time symptoms were tracked using a validated symptom logging app at 15-min intervals, and Nausea Severity Scale (NSS) scores recorded. Protocols involved a 2 hour fast, provocative testing, a meal, and over 1 hr of postprandial recordings. ADM tracings were categorized into neuropathy, myopathy, postprandial hypomotility, or normal. BSGM metrics included principal gastric frequency, BMI-adjusted amplitude, and Rhythm Index. Gastric emptying data were also evaluated. Results Fifteen subjects were recruited (13 female; ages 10-19 years, BMI 20.6+/-3.5 kg/m2). ADM results showed neuropathy (n=4), myopathy (n=1), post-prandial hypomotility (n=4), and normal motility (n=6). Patients with neuropathy had lower rhythm stability (0.16+/-0.03 vs 0.38+/-0.17; p=.001), accompanied by higher nausea scores (8.2+/-1.2 vs 3.15+/-2.9; p<.001) and bloating (7.3+/-0.9 vs 2.1+/-2.0; p<.001). ADM neuropathy correlated completely with dysrhythmia on BSGM. Normal ADM were consistent with normal BSGM in 83.3% of cases. Delayed gastric emptying did not correlate with a neuropathic diagnosis. Conclusion: Dysrhythmic BSGM phenotype reliably identified gastrointestinal neuropathy with identical results to ADM, with significant correlations to nausea and bloating severity. This study supports considering BSGM as an actionable biomarker when performing ADM is not feasible.

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Meal Effects on Gastric Bioelectrical Activity Utilizing Body Surface Gastric Mapping in Healthy Subjects

Cited by 4 publications

References 43 publications

Short‐ and long‐term reproducibility of body surface gastric mapping using the Gastric Alimetry® system

Short‐ and long‐term reproducibility of body surface gastric mapping using the Gastric Alimetry® system

Body Surface Gastric Mapping Delineates Specific Patient Phenotypes in Adolescents With Functional Dyspepsia and Gastroparesis

Neuropathic Gastroduodenal Disorders can be Diagnosed by Non-Invasive Body Surface Gastric Mapping: a Comparison with Antroduodenal Manometry

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