Microprocessor-controlled movement of solid gastric content using sequential neural electrical stimulation

Amaris, Manuel A.; Rashev, Peter Z.; Mintchev, Martin P.; Bowes, Kenneth L.

doi:10.1016/s0016-5085(00)70207-1

Cited by 88 publications

(94 citation statements)

References 16 publications

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“…Single-channel GES with long pulses has no effects on gastric emptying in healthy dogs but is capable of improving gastric emptying in a canine model of gastroparesis and a rodent model of diabetes (5,11,22). Whereas two-or four-channel GES with long pulses is able to improve gastric emptying in both healthy and diseased models of canines (8,32), similar results (improvement in liquid and solid gastric emptying) were also observed with multichannel sequential GES of trains of pulses with pulse width in the order of a few milliseconds (25,26). In a noncontrolled clinical study on nine patients with gastroparesis, GES with long pulses has shown promising results, with significant improvement in symptoms and marginal improvement in gastric emptying (23).…”

Section: Discussionmentioning

confidence: 67%

Therapeutic potential of synchronized gastric electrical stimulation for gastroparesis: enhanced gastric motility in dogs

Zhu¹,

Sallam²,

Chen³

et al. 2007

American Journal of Physiology-Regulatory, Integrative and Comp

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The aim of this study was to determine the effects and mechanism of synchronized gastric electrical stimulation (SGES) on gastric contractions and gastric emptying. The first experiment was designed to study the effects of SGES on antral contractions in four randomized sessions. Sessions 1 (control) and 2 (atropine) were performed in the fasting state, composed of three 30-min periods (baseline, stimulation, and recovery). Sessions 3 (control) and 4 (SGES performed during 2nd 20-min period) were performed in the fed state, consisting of two 20-min periods; glucagon was injected after the first 20-min recording. The second experiment was designed to study the effect of SGES on gastric emptying and consisted of two sessions (control and SGES). SGES was delivered with train duration of 0.5–0.8s, pulse frequency of 40 Hz, width of 2 ms, and amplitude of 4 mA. We found that 1) SGES induced gastric antral contractions in the fasting state. The motility index was 1.3 ± 0.5 at baseline and 6.1 ± 0.7 ( P = 0.001) during SGES. This excitatory effect was completely blocked by atropine. 2) SGES enhanced postprandial antral contractions impaired by glucagon. 3) SGES significantly accelerated glucagon-induced delayed gastric emptying. Gastric emptying was 25.5 ± 11.3% without SGES and 38.3 ± 10.7% with SGES ( P = 0.006 vs. control). This novel method of SGES induces gastric antral contractions in the fasting state, enhances glucagon-induced antral hypomotility in the fed state, and accelerates glucagon-induced delayed gastric emptying. The effect of SGES on antral contractions is mediated via the cholinergic pathway.

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Section: Discussionmentioning

confidence: 67%

Therapeutic potential of synchronized gastric electrical stimulation for gastroparesis: enhanced gastric motility in dogs

Zhu¹,

Sallam²,

Chen³

et al. 2007

American Journal of Physiology-Regulatory, Integrative and Comp

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“…29,34,50 Whereas, two-or four-channel GES with long pulses is able to improve gastric emptying in both healthy and diseased model of canines; 21,22 similar results (improvement in liquid and solid gastric emptying) were also observed with a multi-channel sequential GES of trains of pulses with a pulse width in the order of a few milliseconds. 23,24 GES with long pulses showed similar improvement in gastric emptying in patients with gastroparesis. 37 The findings on the effects of GES with trains of short pulses or Enterra Therapy on gastric emptying have been controversial.…”

Section: Gastric Emptyingmentioning

confidence: 75%

“…Two-to four-channel GES has been proposed in a number of studies. [21][22][23][24] Peripheral effects of GES A number of studies have been performed to investigate the effect of GES on the normalization of gastric myoelectrical dysrhythmias or entrainment of gastric slow waves, fundic/antral tone, antral contractions and gastric emptying. The majority of these studies seems to indicate that GES, depending on the parameters employed and stimulation sites, is able to alter gastric functions.…”

Section: Multi-channel Gesmentioning

confidence: 99%

Systematic review: applications and future of gastric electrical stimulation

Zhang

Chen

2006

Aliment Pharmacol Ther

106

114

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“…6,[10][11][12][13][14][15][16] Several novel GES methods to improve gastric motility have been introduced over the last 20 years, such as multichannel GES, dual-pulse GES, and synchronized GES. [17][18][19][20][21][22][23][24][25][26] The term "gastric neuromodulation" has been used as a term to describe the antiemetic effect of GES therapy, as the symptom improvement is believed to be mediated through neurons and neuronal connectivity. A number of GES studies have demonstrated that gastric slow-wave pacing has entrained these slow waves with the pulse rates of the GES device.…”

Section: Introductionmentioning

confidence: 99%