Schiemer Jonas F, Heimann Axel, Somerlik-Fuchs Karin H, Ruff Roman, Hoffmann Klaus-Peter, Baumgart Jan, Berres Manfred, Lang Hauke, Kneist Werner
Department of General, Visceral and Transplant Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Institute for Neurosurgical Pathophysiology, University Medicine of the Johannes Gutenberg-University Mainz, Mainz, Germany.
J Neurogastroenterol Motil. 2019 Jul 1;25(3):461-470. doi: 10.5056/jnm19045.
BACKGROUND/AIMS: Motility disorders are common and may affect the entire gastrointestinal (GI) tract but current treatment is limited. Multilocular sensing of GI electrical activity and variable electrical stimulation (ES) is a promising option. The aim of our study is to investigate the effects of adjustable ES on poststimulatory spike activities in 5 GI segments.
Six acute porcine experiments were performed with direct ES by 4 ES parameter sets (30 seconds, 25 mA, 500 microseconds or 1000 microseconds, 30 Hz or 130 Hz) applied through subserosal electrodes in the stomach, duodenum, ileum, jejunum, and colon. Multi-channel electromyography of baseline and post-stimulatory GI electrical activity were recorded for 3 minutes with hook needle and hook-wire electrodes. Spike activities were algorithmically calculated, visualized in a heat map, and tested for significance by Poisson analysis.
Post-stimulatory spike activities were markedly increased in the stomach (7 of 24 test results), duodenum (8 of 24), jejunum (23 of 24), ileum (18 of 24), and colon (5 of 24). ES parameter analysis revealed that 80.0% of the GI parts (all but duodenum) required a pulse width of 1000 microseconds, and 60.0% (all but jejunum and colon) required 130 Hz frequency for maximum spike activity. Five reaction patterns were distinguished, with 30.0% earlier responses (type I), 42.5% later or mixed type responses (type II, III, and X), and 27.5% non-significant responses (type 0).
Multilocular ES with variable ES parameters is feasible and may significantly modulate GI electrical activity. Automated electromyography analysis revealed complex reaction patterns in the 5 examined GI segments.
背景/目的：运动障碍很常见，可能影响整个胃肠道（GI），但目前的治疗方法有限。胃肠道电活动的多部位感知和可变电刺激（ES）是一种有前景的选择。我们研究的目的是调查可调电刺激对5个胃肠道节段刺激后棘波活动的影响。
进行了6次急性猪实验，通过浆膜下电极在胃、十二指肠、回肠、空肠和结肠施加4组电刺激参数（30秒、25毫安、500微秒或1000微秒、30赫兹或130赫兹）进行直接电刺激。用钩针和钩丝电极记录基线和刺激后胃肠道电活动的多通道肌电图3分钟。通过算法计算棘波活动，在热图中可视化，并通过泊松分析检验其显著性。
刺激后棘波活动在胃（24个测试结果中的7个）、十二指肠（24个中的8个）、空肠（24个中的23个）、回肠（24个中的18个）和结肠（24个中的5个）中显著增加。电刺激参数分析显示，80.0%的胃肠道部位（除十二指肠外的所有部位）需要1000微秒的脉冲宽度，60.0%（除空肠和结肠外的所有部位）需要130赫兹的频率以实现最大棘波活动。区分出五种反应模式，30.0%为早期反应（I型），42.5%为晚期或混合反应（II型、III型和X型），27.5%为无显著反应（0型）。
具有可变电刺激参数的多部位电刺激是可行的，并且可能显著调节胃肠道电活动。自动肌电图分析揭示了5个被检查胃肠道节段中的复杂反应模式。
