Muszynski Nicole D, Somarajan Suseela, Busing Jordan D, Russell Alexandra C, Acra Sari A, Bradshaw Leonard A
Department of General Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee.
Gastro Hep Adv. 2025 Jan 28;4(5):100628. doi: 10.1016/j.gastha.2025.100628. eCollection 2025.
Functional nausea is an idiopathic gastrointestinal disorder that is common in children, carries a substantial health-care cost, and lacks objective diagnostic testing, relying primarily on symptomatology with an otherwise normal diagnostic workup. We hypothesize that high-resolution electrogastrogram (HR-EGG) spatiotemporal gastric slow wave parameters, reflective of known mechanisms of gastric uncoupling, are sensitive to nausea severity and can distinguish children with severe functional nausea when asymptomatic, from healthy pediatric controls.
We compared nonrandomized fasted HR-EGG recordings from control subjects (N = 10; 11-17 years; 3 M/7F) with recordings from functional nausea patients (N = 10; 12-18 years; 1M/9F) with inactive nausea at time of testing but had experienced nausea in the preceding 2 weeks. We used a second-order blind identification algorithm to minimize signal artifacts, identify gastric sources, and calculate spatiotemporal gastric slow wave frequency and propagation dynamics.
Frequency dynamics showed significant differences between controls and patients in dominant frequency (2.7 ± 0.5 cycles per minute vs 2.2 ± 0.5 cycles per minute; < .01), percentage of signal distribution in the normogastric range (59 ± 11.8% vs 46.5 ± 11%; < .001), and bradygastric power percentage (20 ± 10.5% vs 28.1 ± 9.5%; < .01). Propagation dynamics observed in patients were more complex and disordered, with significant differences in mean propagation direction (control: 223° ± 23°; patient: 20° ± 79°; < .05), and propagation speed ( < .01).
We demonstrate that spatiotemporal analysis of HR-EGG propagation profiles differentiates pediatric functional nausea patients from controls. Given the high incidence of anxiety in children with functional nausea, future investigations should explore the influence of state and trait anxiety on HR-EGG parameters via the gut-brain axis.
功能性恶心是一种特发性胃肠疾病，在儿童中很常见，造成了高昂的医疗费用，且缺乏客观的诊断测试，主要依靠症状学，而其他诊断检查结果正常。我们假设，反映已知胃解耦机制的高分辨率胃电图（HR-EGG）时空胃慢波参数对恶心严重程度敏感，并且能够在无症状时区分患有严重功能性恶心的儿童与健康的儿科对照。
我们将对照受试者（N = 10；11 - 17岁；3名男性/7名女性）在禁食状态下的非随机HR-EGG记录与功能性恶心患者（N = 10；12 - 18岁；1名男性/9名女性）的记录进行比较，这些患者在测试时恶心未发作，但在之前2周内曾经历过恶心。我们使用二阶盲识别算法来最小化信号伪迹、识别胃源，并计算时空胃慢波频率和传播动态。
频率动态显示，对照组和患者组在主频（每分钟2.7±0.5次循环 vs 每分钟2.2±0.5次循环；P <.01）、正常胃范围内信号分布百分比（59±11.8% vs 46.5±11%；P <.001）以及胃动力减慢功率百分比（20±10.5% vs 28.1±9.5%；P <.01）方面存在显著差异。在患者中观察到的传播动态更为复杂和紊乱，平均传播方向（对照组：223°±23°；患者组：20°±79°；P <.05）和传播速度（P <.01）存在显著差异。
我们证明，HR-EGG传播图谱的时空分析可区分儿科功能性恶心患者与对照组。鉴于功能性恶心儿童中焦虑的高发病率，未来的研究应通过肠-脑轴探索状态焦虑和特质焦虑对HR-EGG参数的影响。
