Therapeutic potential of spinal cord stimulation for gastrointestinal motility disorders: a preliminary rodent study

Guan, Song; Sun, Yan; Foreman, Robert D.; Chen, J. D. Z.

doi:10.1111/nmo.12273

Cited by 16 publications

(22 citation statements)

References 55 publications

(95 reference statements)

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“…Whether such effects were mediated by changes in vagal pathways is not known; but, in rats, exercise‐induced gastric antral motility is abolished with vagotomy . Considering exercise promotes a potent sympathetic drive, it is thought that sympathetic activation may delay gastric emptying in response to stress, since reducing sympathetic activity in an animal model of spinal cord injury was associated with an increase in gastric emptying and intestinal transit …”

Section: Exercise and Gastrointestinal Motilitymentioning

confidence: 99%

Systematic review: exercise‐induced gastrointestinal syndrome—implications for health and intestinal disease

Costa

Snipe

Kitic

et al. 2017

Aliment Pharmacol Ther

296

426

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Summary Background “Exercise‐induced gastrointestinal syndrome” refers to disturbances of gastrointestinal integrity and function that are common features of strenuous exercise. Aim To systematically review the literature to establish the impact of acute exercise on markers of gastrointestinal integrity and function in healthy populations and those with chronic gastrointestinal conditions. Methods Search literature using five databases (PubMed, EBSCO, Web of Science, SPORTSdiscus, and Ovid Medline) to review publications that focused on the impact of acute exercise on markers of gastrointestinal injury, permeability, endotoxaemia, motility and malabsorption in healthy populations and populations with gastrointestinal diseases/disorders. Results As exercise intensity and duration increases, there is considerable evidence for increases in indices of intestinal injury, permeability and endotoxaemia, together with impairment of gastric emptying, slowing of small intestinal transit and malabsorption. The addition of heat stress and running mode appears to exacerbate these markers of gastrointestinal disturbance. Exercise stress of ≥2 hours at 60% VO2max appears to be the threshold whereby significant gastrointestinal perturbations manifest, irrespective of fitness status. Gastrointestinal symptoms, referable to upper‐ and lower‐gastrointestinal tract, are common and a limiting factor in prolonged strenuous exercise. While there is evidence for health benefits of moderate exercise in patients with inflammatory bowel disease or functional gastrointestinal disorders, the safety of more strenuous exercise has not been established. Conclusions Strenuous exercise has a major reversible impact on gastrointestinal integrity and function of healthy populations. The safety and health implications of prolonged strenuous exercise in patients with chronic gastrointestinal diseases/disorders, while hypothetically worrying, has not been elucidated and requires further investigation.

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Section: Exercise and Gastrointestinal Motilitymentioning

confidence: 99%

Systematic review: exercise‐induced gastrointestinal syndrome—implications for health and intestinal disease

Costa

Snipe

Kitic

et al. 2017

Aliment Pharmacol Ther

296

426

View full text Add to dashboard Cite

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“…SCS was reported to inhibit sympathetic activity and noted to improve postoperative ileus in rats . Recently, we reported the acceleration of gastric emptying in normal and diabetic rats . To the best of our knowledge, this is the first time to investigate the effects of SCS using a commercially available IPG on gastric slow waves and contractions impaired by glucagon in dogs.…”

Section: Discussionmentioning

confidence: 82%

“…Similar autonomic mechanisms were also reported in previous studies in different clinical settings. Assessed by the same method of spectral analysis of HRV, SCS was found to decrease the sympathovagal ratio in patients with refractory angina and in diabetic rats . Assessed by total body norepinephrine, SCS was also noted to decrease overall sympathetic activity in patients with anginal pectoris .…”

Section: Discussionmentioning

confidence: 86%

“…To the best of our knowledge, this was the first direct evidence showing the prokinetic effect of SCS using a commercially available IPG on gastric motility in large animals. Previously, SCS was reported to accelerate gastric emptying in rodent models of diabetes and postoperative ileus . However, in these rodent studies, SCS was performed using a unipolar ball electrode placed in the spinal cord and an external stimulator; no direct gastric contractions were measured.…”

Section: Discussionmentioning

confidence: 99%

“…Spinal cord stimulation (SCS) using an implantable pulse generator (IPG) has been widely used in treating patients with neuropathic pain and is known to inhibit sympathetic activity . Recently, SCS using an external stimulator was reported to improve emptying in diabetic rats via suppressing sympathetic activity and enhancing vagal activity in a rodent model of type 1 diabetes …”

Section: Introductionmentioning

confidence: 99%

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Prokinetic effects of spinal cord stimulation and its autonomic mechanisms in dogs

Zhang¹,

Feng²,

Tu³

et al. 2019

Neurogastroenterology Motil

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Gastric dysmotility is a major pathophysiology factor in gastroparesis, functional dyspepsia (FD), and postoperative ileus (POI); it includes gastric myoelectric activity (slow wave) dysrhythmia and gastric contractile hypomotility. The prevalence of functional dyspepsia is 10%-40% in Western countries and 5%-30% in Asia. 1 The prevalence of postoperative ileus is between 10% and 30% for Abstract Background: Spinal cord stimulation (SCS) is widely used to treat chronic pain by inhibiting sympathetic activity; however, it is unknown whether it exerts a prokinetic effect on gastric motility. Our aim was to explore effects and possible mechanisms of SCS on glucagon-induced gastric dysmotility and dysrhythmia.Methods: Seven female dogs with electrodes chronically placed on the dorsal column of the spinal cord between T10 and T12 segments were studied in 2 randomized sessions (glucagon + sham-SCS, glucagon + SCS). SCS at T10 using a set of optimized stimulation parameters was performed for 30 minute immediately after glucagon injection. The antral manometry, electrogastrogram, and electrocardiogram were recorded to assess gastric contractions, gastric slow waves (GSW), and autonomic functions, respectively. Key Results: (a) Compared to baseline, glucagon decreased antral motility index (MI) (6315 ± 565 vs 3243 ± 775, P < 0.001), reduced the percentage of normal GSW (89 ± 3% vs 58 ± 3%, P < 0.01), and increased sympathetic activity (0.25 ± 0 0.06 vs 0.60 ± 0.07, P < 0.01). (b) The sympathetic activity was negatively correlated with antral MI (r = −0.558; P < 0.01) and the percentage of gastric normal slow wave (r = −0.616; P < 0.01). (c) SCS prevented the glucagon-induced impairment in antral hypomotility (MI: 5770 ± 927 vs 5521 ± 1238, P > 0.05) and GSW abnormalities (% of normal waves: 84 ± 4% vs 79 ± 6%, P > 0.05) and sympathetic activity (0.27 ± 0.03 vs 0.33 ± 0.07, P > 0.05). Conclusion: Spinal cord stimulation dramatically improves glucagon-induced impairment in gastric contractions and slow waves by inhibiting sympathetic activity. K E Y W O R D S autonomic function, gastric motility, gastric slow waves, neuromodulation, spinal cord stimulation

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Treatment

Jelaković¹,

Čuković‐Čavka²

2018

Clinical Gastroenterology

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Therapeutic potential of spinal cord stimulation for gastrointestinal motility disorders: a preliminary rodent study

Abstract: Spinal cord stimulation accelerates gastric emptying of liquids and solids, and intestinal transit, probably by inhibiting the sympathetic activity. Spinal cord stimulation may have a therapeutic potential for treating GI motility disorders.

Cited by 16 publications

References 55 publications

Systematic review: exercise‐induced gastrointestinal syndrome—implications for health and intestinal disease

Systematic review: exercise‐induced gastrointestinal syndrome—implications for health and intestinal disease

Prokinetic effects of spinal cord stimulation and its autonomic mechanisms in dogs

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