Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University of Louisville, Louisville, KY, USA.
Division of Gastroenterology and Hepatology, Department of Medicine, University of Arizona College of Medicine, Phoenix, AZ, USA.
Neuromodulation. 2022 Dec;25(8):1150-1159. doi: 10.1016/j.neurom.2021.12.008. Epub 2022 Feb 17.
Gastric electrical stimulation (GES) is a widely accepted therapy for gastroparesis symptoms, but how a brief cutaneous electrogastrogram (EGG) can be used in conjunction with GES has not been well defined. We evaluated the clinical importance of EGG, its correlation with mucosal electrograms (mEGs), gastric emptying tests (GETs), and gastrointestinal symptoms before and after temporary GES (tGES).
We studied 1345 patients; 991 had complete data. EGG measurements like frequency and amplitude were recorded at baseline and five days post-tGES using short recording periods. A total of 266 participants having additional cutaneous propagation values were separately analyzed. Patients underwent solid GET before and after tGES and self-reported symptoms using standardized traditional patient-reported outcomes (TradPRO) scores. Pearson correlations were assessed at baseline, post-stimulation, and their changes over the follow-up period.
EGG measures correlated with symptoms and GET results. Patients with abnormal baseline cutaneous frequency had higher baseline total symptom scores (p < 0.003). Post-tGES, one-hour gastric emptying was significantly changed (p < 0.0001) and was mainly observed with abnormal baseline cutaneous frequencies (p < 0.0001). Cutaneous frequency significantly increased after tGES (p < 0.0001), correlating positively with TradPRO scores and one-hour gastric emptying. Mucosal and cutaneous measures correlated pre- and post-treatment. Of the 266 patients, 153 changed propagation states between baseline and temporary; changing states from lower at baseline to higher at temporary was more likely than vice versa. Short EGG recording times can demonstrate changes after the bioelectric therapy of GES.
EGG is valuable in the diagnosis of delayed gastric emptying and comparable with mEG. It is less invasive and can identify patients who may require GES. Frequency, amplitude, their ratio (frequency-amplitude ratio), and propagation appear to be reliable measures of EGG. EGG provides cost-effective measurement of electrophysiological properties and significantly correlates with important clinical measures. Shorter EGG recording times may be adequate to see changes from bioelectric therapies.
The Clinicaltrials.gov registration number for the study is NCT03876288.
胃电刺激（GES）是治疗胃轻瘫症状的广泛接受的疗法，但如何结合 GES 使用短暂的皮肤胃电图（EGG）尚未得到很好的定义。我们评估了 EGG 的临床重要性，以及其与黏膜电图（mEG）、胃排空测试（GET）和胃肠症状的相关性，这些都是在临时 GES（tGES）前后进行的。
我们研究了 1345 名患者；其中 991 名患者有完整的数据。使用短期记录期，在基线和 tGES 后五天记录 EGG 测量值，如频率和幅度。另外有 266 名参与者进行了额外的皮肤传播值分析。患者在 tGES 前后进行了固体 GET，并使用标准化的传统患者报告结果（TradPRO）评分报告症状。在基线、刺激后和随访期间评估 Pearson 相关性。
EGG 测量值与症状和 GET 结果相关。基线时皮肤频率异常的患者总症状评分较高（p<0.003）。tGES 后，胃排空 1 小时明显改变（p<0.0001），主要发生在基线时皮肤频率异常的患者中（p<0.0001）。tGES 后皮肤频率显著增加（p<0.0001），与 TradPRO 评分和 1 小时胃排空呈正相关。黏膜和皮肤测量值在治疗前后均相关。在 266 名患者中，有 153 名患者在基线和临时之间改变了传播状态；从基线较低到临时较高的状态改变比相反的状态改变更有可能。短时间的 EGG 记录时间可以显示 GES 生物电治疗后的变化。
EGG 在诊断胃排空延迟方面具有价值，与 mEG 相当。它的侵入性较小，可以识别可能需要 GES 的患者。频率、幅度、它们的比值（频率-幅度比值）和传播似乎是可靠的 EGG 测量值。EGG 提供了一种经济有效的电生理特性测量方法，与重要的临床测量方法显著相关。较短的 EGG 记录时间可能足以观察到生物电治疗的变化。
该研究的 Clinicaltrials.gov 注册号为 NCT03876288。
