Department of Surgery, University of Auckland, Auckland, New Zealand.
Alimetry Ltd, Auckland, New Zealand.
Neurogastroenterol Motil. 2023 Feb;35(2):e14418. doi: 10.1111/nmo.14418. Epub 2022 Jun 14.
Disorders of gastric function are highly prevalent, but diagnosis often remains symptom-based and inconclusive. Body surface gastric mapping is an emerging diagnostic solution, but current approaches lack scalability and are cumbersome and clinically impractical. We present a novel scalable system for non-invasively mapping gastric electrophysiology in high-resolution (HR) at the body surface.
The system comprises a custom-designed stretchable high-resolution "peel-and-stick" sensor array (8 × 8 pre-gelled Ag/AgCl electrodes at 2 cm spacing; area 225 cm ), wearable data logger with custom electronics incorporating bioamplifier chips, accelerometer and Bluetooth synchronized in real-time to an App with cloud connectivity. Automated algorithms filter and extract HR biomarkers including propagation (phase) mapping. The system was tested in a cohort of 24 healthy subjects to define reliability and characterize features of normal gastric activity (30 m fasting, standardized meal, and 4 h postprandial).
Gastric mapping was successfully achieved non-invasively in all cases (16 male; 8 female; aged 20-73 years; BMI 24.2 ± 3.5). In all subjects, gastric electrophysiology and meal responses were successfully captured and quantified non-invasively (mean frequency 2.9 ± 0.3 cycles per minute; peak amplitude at mean 60 m postprandially with return to baseline in <4 h). Spatiotemporal mapping showed regular and consistent wave activity of mean direction 182.7° ± 73 (74.7% antegrade, 7.8% retrograde, 17.5% indeterminate).
BSGM is a new diagnostic tool for assessing gastric function that is scalable and ready for clinical applications, offering several biomarkers that are improved or new to gastroenterology practice.
胃功能障碍的发病率很高，但诊断通常仍基于症状且不确定。体表胃映射是一种新兴的诊断解决方案，但目前的方法缺乏可扩展性，而且繁琐且在临床上不切实际。我们提出了一种新的可扩展系统，用于非侵入性地以高分辨率（HR）在体表上映射胃电生理。
该系统包括一个定制设计的可拉伸高分辨率“剥脱式粘贴”传感器阵列（8×8 个预涂凝胶的 Ag/AgCl 电极，间距为 2 厘米；面积为 225 厘米）、带有定制电子设备的数据记录器，其中包括生物放大器芯片、加速度计和蓝牙，实时同步到具有云连接功能的应用程序。自动化算法可筛选和提取 HR 生物标志物，包括传播（相位）映射。该系统在 24 名健康受试者的队列中进行了测试，以确定可靠性并描述正常胃活动的特征（空腹 30 分钟、标准化餐和餐后 4 小时）。
所有情况下均成功地非侵入性地实现了胃映射（16 名男性；8 名女性；年龄 20-73 岁；BMI 24.2±3.5）。在所有受试者中，均成功地非侵入性地捕获和量化了胃电生理和进餐反应（平均频率为 2.9±0.3 次/分钟；平均餐后 60 分钟时达到峰值幅度，<4 小时内恢复基线）。时空映射显示出规则且一致的波活动，平均方向为 182.7°±73°（74.7%为顺行，7.8%为逆行，17.5%不确定）。
BSGM 是一种用于评估胃功能的新诊断工具，具有可扩展性，准备好应用于临床，提供了一些对胃肠病学实践有改进或新颖的生物标志物。
