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Effects of Gastric Electrical Stimulation Via Proximal Stomach Mucosa on Gastric Tone and Visceral Sensitivity in Healthy Subjects

Author: TuYuJie
Tutor: XuJunYing
School: Huazhong University of Science and Technology
Course: Department of Gastroenterology,
Keywords: GES obesity HRV
CLC: R589.2
Type: Master's thesis
Year: 2013
Downloads: 2
Quote: 0
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Abstract


Background and Aim: Obesity is one of the common public health problems all over theworld. The effect of traditional methods to treat obesity is unsatisfactory. During the pastdecade, there havethe been numerous researches focusing on gastric electric stimulation(GES) which has been considered as a possible treatment for obesity. Although GES showsa certain effect on obesity treatment, it is not satisfactory. We may need to set individualstimulation parameters. Nearly in all previous researches for the treatment of obesity, theparameter is pulse frequency40HZ,duty cycle2s on,3s off,pulse width0.3ms andamplitude5-10mA. The range of stimulation parameter is narrow limited to pulse widthsbelow2.0-ms. Increasing in pulse amplitude and width significantly reduce food intake aswell as body weight. The aim of this study is to investigate the effects of proximal stomachmucosa stimulation using Enterra therapy and varying stimulation parameters on gastrictone in healthy subjects,to find the individual effective stimulation parameters, and observethe relationship between, gastric volume and stimulation energy and symptom score.Methods:12healthy volunteers (6females and6males, average age was23.3±1.5) wereinvolved in this clinical research study. The research included three sessions: Session1,baseline recording: A catheter with the balloon finely folded on its distal was intubated intothe stomach via the mouth, One pair of electrodes was adhere to the balloon. Recordinggastric tone, heart rate variability (HRV) and symptom score for30min. Session2, effectsof Enterra Therapy: GES with the following parameters for30minute:0.1s-on,5.0s-off,14HZ,0.3ms,6mA, HRV, gastric tone and symptom score were recorded in the period. Session3, find effective parameters: Set the parameters at2s-on,3s-off,40HZ,5ms,2mA. Every5min, the amplitude was increased by1-2mA until a stable increase (at least100ml increase) in gastric volume. If the amplitude was increased to15mA but still nochange in gastric volume, we increased the pulse width to10ms and then start amplitudefrom4mA and gradually increased. Once the effective parameters were found, take therecording for at least30min, gastric tone, HRV and symptom score were recorded in theperiod.Results: The gastric volume was significantly increased from118.3±31.6ml at baseline to210.9±33.7ml on Enterra therapy (P=0.04), The volunteers had dyspeptic symptoms, likenausea and bloating. The Enterra therapy could increase vagal tone. Effective stimulationcondition significantly altered the gastric volume, compared with baseline (baseline:118.3±31.6ml VS GES:210.9±33.7ml). The volunteers had dyspeptic symptoms, likenausea and bloating and epigastric pain. It has no effects on autonomic nervous system.There is no correlation between symptom score and gastric volume and gastric stimulationenergy. The individual effective stimulation parameters vary greatly.Conclusions: The result shows that GES via proximal stomach mucosa can significantlyreduce gastric tone and introduce distention of the stomach with appropriate parameters.The individual effects of GES are different.

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CLC: > Medicine, health > Internal Medicine > Endocrine diseases and metabolic diseases > Metabolic diseases > Lipodystrophy
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