Modelling slow wave activity in the small intestine

Gut microbiota-motility interregulation: insights from in vivo, ex vivo and in silico studies

The human gastrointestinal tract is home to trillions of microbes. Gut microbial communities have a significant regulatory role in the intestinal physiology, such as gut motility. Microbial effect on gut motility is often evoked by bioactive molecules from various sources, including microbial break down of carbohydrates, fibers or proteins. In turn, gut motility regulates the colonization within the microbial ecosystem. However, the underlying mechanisms of such regulation remain obscure. Deciphering the inter-regulatory mechanisms of the microbiota and bowel function is crucial for the prevention and treatment of gut dysmotility, a comorbidity associated with many diseases. In this review, we present an overview of the current knowledge on the impact of gut microbiota and its products on bowel motility. We discuss the currently available techniques employed to assess the changes in the intestinal motility. Further, we highlight the open challenges, and incorporate biophysical elements of microbes-motility interplay, in an attempt to lay the foundation for describing long-term impacts of microbial metabolite-induced changes in gut motility.

A literature review on large intestinal hyperelastic constitutive modeling

Impacts, traumas and strokes are spontaneously life-threatening, but chronic symptoms strangle patient every day. Colorectal tissue mechanics in such chronic situations not only regulates the physio-psychological well-being of the patient, but also confirms the level of comfort and post-operative clinical outcomes. Numerous uniaxial and multiaxial tensile experiments on healthy and affected samples have evidenced significant differences in tissue mechanical behavior and strong colorectal anisotropy across each layer in thickness direction and along the length. Furthermore, this study reviewed various forms of passive constitutive models for the highly fibrous colorectal tissue ranging from the simplest linearly elastic and the conventional isotropic hyperelastic to the most sophisticated second harmonic generation image based anisotropic mathematical formulation. Under large deformation, the isotropic description of tissue mechanics is unequivocally ineffective which demands a microstructural based tissue definition. Therefore, the information collected in this review paper would present the current state-of-the-art in colorectal biomechanics and profoundly serve as updated computational resources to develop a sophisticated characterization of colorectal tissues.

Modelling Flow and Mixing in the Proximal Small Intestine

The small intestine is the primary site of enzymatic digestion and nutrient absorption in humans. Intestinal contractions facilitate digesta mixing, transport and contact with the absorptive surfaces. These motility patterns are regulated by an underlying electrical activity, termed slow waves. In this study, we use computational fluid dynamics simulation of flow and mixing of intestinal contents in the human duodenum with anatomically realistic geometry and contraction patterns. Parameters including the amplitude of contraction (10-50% reduction of radius) and the rheology of the digesta (Newtonian vs Non-Newtonian power law fluid) were altered in-order to study their effects on mixing. Interesting flow features such as stagnation points and reversed flow were observed with digesta. Increases in the amplitude of contraction lead to increased propulsion of digesta along the intestine and increased mixing.

On a coupled electro-chemomechanical model of gastric smooth muscle contraction

The stomach is a central organ in the gastrointestinal tract that performs a variety of functions, in which the spatio-temporal organisation of active smooth muscle contraction in the stomach wall (SW) is highly regulated. In the present study, a three-dimensional model of the gastric smooth muscle contraction is presented, including the mechanical contribution of the mucosal and muscular layer of the SW. Layer-specific and direction-dependent model parameters for the active and passive stress-stretch characteristics of the SW were determined experimentally using porcine smooth muscle strips. The electrical activation of the smooth muscle cells (SMC) due to the pacemaker activity of the interstitial cells of Cajal (ICC) is modelled by using FitzHugh-Nagumo-type equations, which simulate the typical ICC and SMC slow wave behaviour. The calcium dynamic in the SMC depends on the SMC membrane potential via a gaussian function, while the chemo-mechanical coupling in the SMC is modelled via an extended Hai-Murphy model. This cascade is coupled with an additional mechano-electrical feedback-mechanism, taking into account the mechanical response of the ICC and SMC due to stretch of the SW. In this way the relaxation responses of the fundus to accommodate incoming food, as well as the typical peristaltic contraction waves in the antrum for mixing and transport of the chyme, have been well replicated in simulations performed at the whole organ level. STATEMENT OF SIGNIFICANCE: In this article, a novel three-dimensional electro-chemomechanical model of the gastric smooth muscle contraction is presented. The propagating waves of electrical membrane potential in the network ofinterstitial cells of Cajal (ICC) and smooth muscle cells (SMC) lead to a global pattern of change in the calciumdynamics inside the SMC. Taking additionally into account the mechanical response of the ICC and SMC due to stretch of the stomach wall, also referred to as mechanical feedback-mechanism, the result is a complex spatio-temporal regulation of the active contraction and relaxation of the gastric smooth muscle tissue. Being a firstapproach, in future view such a three-dimensional model can give an insight into the complexload transferring system of the stomach wall, as well as into the electro-chemomechanicalcoupling process underlying smooth muscle contraction in health and disease.

Electrical stimulation of gut motility guided by an in silico model

OBJECTIVE

Neuromodulation of the central and peripheral nervous systems is becoming increasingly important for treating a diverse set of diseases-ranging from Parkinson's Disease and epilepsy to chronic pain. However, neuromodulation of the gastrointestinal (GI) tract has achieved relatively limited success in treating functional GI disorders, which affect a significant population, because the effects of stimulation on the enteric nervous system (ENS) and gut motility are not well understood. Here we develop an integrated neuromechanical model of the ENS and assess neurostimulation strategies for enhancing gut motility, validated by in vivo experiments.

APPROACH

The computational model included a network of enteric neurons, smooth muscle fibers, and interstitial cells of Cajal, which regulated propulsion of a virtual pellet in a model of gut motility.

MAIN RESULTS

Simulated extracellular stimulation of ENS-mediated motility revealed that sinusoidal current at 0.5 Hz was more effective at increasing intrinsic peristalsis and reducing colon transit time than conventional higher frequency rectangular current pulses, as commonly used for neuromodulation therapy. Further analysis of the model revealed that the 0.5 Hz sinusoidal currents were more effective at modulating the pacemaker frequency of interstitial cells of Cajal. To test the predictions of the model, we conducted in vivo electrical stimulation of the distal colon while measuring bead propulsion in awake rats. Experimental results confirmed that 0.5 Hz sinusoidal currents were more effective than higher frequency pulses at enhancing gut motility.

SIGNIFICANCE

This work demonstrates an in silico GI neuromuscular model to enable GI neuromodulation parameter optimization and suggests that low frequency sinusoidal currents may improve the efficacy of GI pacing.

Multiscale modeling methods in biomechanics

More and more frequently, computational biomechanics deals with problems where the portion of physical reality to be modeled spans over such a large range of spatial and temporal dimensions, that it is impossible to represent it as a single space-time continuum. We are forced to consider multiple space-time continua, each representing the phenomenon of interest at a characteristic space-time scale. Multiscale models describe a complex process across multiple scales, and account for how quantities transform as we move from one scale to another. This review offers a set of definitions for this emerging field, and provides a brief summary of the most recent developments on multiscale modeling in biomechanics. Of all possible perspectives, we chose that of the modeling intent, which vastly affect the nature and the structure of each research activity. To the purpose we organized all papers reviewed in three categories: 'causal confirmation,' where multiscale models are used as materializations of the causation theories; 'predictive accuracy,' where multiscale modeling is aimed to improve the predictive accuracy; and 'determination of effect,' where multiscale modeling is used to model how a change at one scale manifests in an effect at another radically different space-time scale. Consistent with how the volume of computational biomechanics research is distributed across application targets, we extensively reviewed papers targeting the musculoskeletal and the cardiovascular systems, and covered only a few exemplary papers targeting other organ systems. The review shows a research subdomain still in its infancy, where causal confirmation papers remain the most common. WIREs Syst Biol Med 2017, 9:e1375. doi: 10.1002/wsbm.1375 For further resources related to this article, please visit the WIREs website.

Mechanisms of Electrical Activation and Conduction in the Gastrointestinal System: Lessons from Cardiac Electrophysiology

The gastrointestinal (GI) tract is an electrically excitable organ system containing multiple cell types, which coordinate electrical activity propagating through this tract. Disruption in its normal electrophysiology is observed in a number of GI motility disorders. However, this is not well characterized and the field of GI electrophysiology is much less developed compared to the cardiac field. The aim of this article is to use the established knowledge of cardiac electrophysiology to shed light on the mechanisms of electrical activation and propagation along the GI tract, and how abnormalities in these processes lead to motility disorders and suggest better treatment options based on this improved understanding. In the first part of the article, the ionic contributions to the generation of GI slow wave and the cardiac action potential (AP) are reviewed. Propagation of these electrical signals can be described by the core conductor theory in both systems. However, specifically for the GI tract, the following unique properties are observed: changes in slow wave frequency along its length, periods of quiescence, synchronization in short distances and desynchronization over long distances. These are best described by a coupled oscillator theory. Other differences include the diminished role of gap junctions in mediating this conduction in the GI tract compared to the heart. The electrophysiology of conditions such as gastroesophageal reflux disease and gastroparesis, and functional problems such as irritable bowel syndrome are discussed in detail, with reference to ion channel abnormalities and potential therapeutic targets. A deeper understanding of the molecular basis and physiological mechanisms underlying GI motility disorders will enable the development of better diagnostic and therapeutic tools and the advancement of this field.

The virtual intestine: in silico modeling of small intestinal electrophysiology and motility and the applications

The intestine comprises a long hollow muscular tube organized in anatomically and functionally discrete compartments, which digest and absorb nutrients and water from ingested food. The intestine also plays key roles in the elimination of waste and protection from infection. Critical to all of these functions is the intricate, highly coordinated motion of the intestinal tract, known as motility, which is coregulated by hormonal, neural, electrophysiological and other factors. The Virtual Intestine encapsulates a series of mathematical models of intestinal function in health and disease, with a current focus on motility, and particularly electrophysiology. The Virtual Intestine is being cohesively established across multiple physiological scales, from sub/cellular functions to whole organ levels, facilitating quantitative evaluations that present an integrative in silico framework. The models are also now finding broad physiological applications, including in evaluating hypotheses of slow wave pacemaker mechanisms, smooth muscle electrophysiology, structure-function relationships, and electromechanical coupling. Clinical applications are also beginning to follow, including in the pathophysiology of motility disorders, diagnosing intestinal ischemia, and visualizing colonic dysfunction. These advances illustrate the emerging potential of the Virtual Intestine to effectively address multiscale research challenges in interdisciplinary gastrointestinal sciences.

Effects of gap junction inhibition on contraction waves in the murine small intestine in relation to coupled oscillator theory

Waves of contraction in the small intestine correlate with slow waves generated by the myenteric network of interstitial cells of Cajal. Coupled oscillator theory has been used to explain steplike gradients in the frequency (frequency plateaux) of contraction waves along the length of the small intestine. Inhibition of gap junction coupling between oscillators should lead to predictable effects on these plateaux and the wave dislocation (wave drop) phenomena associated with their boundaries. It is these predictions that we wished to test. We used a novel multicamera diameter-mapping system to measure contraction along 25- to 30-cm lengths of murine small intestine. There were typically two to three plateaux per length of intestine. Dislocations could be limited to the wavefronts immediately about the terminated wave, giving the appearance of a three-pronged fork, i.e., a fork dislocation; additionally, localized decreases in velocity developed across a number of wavefronts, ending with the terminated wave, which could appear as a fork, i.e., slip dislocations. The gap junction inhibitor carbenoxolone increased the number of plateaux and dislocations and decreased contraction wave velocity. In some cases, the usual frequency gradient was reversed, with a plateau at a higher frequency than its proximal neighbor; thus fork dislocations were inverted, and the direction of propagation was reversed. Heptanol had no effect on the frequency or velocity of contractions but did reduce their amplitude. To understand intestinal motor patterns, the pacemaker network of the interstitial cells of Cajal is best evaluated as a system of coupled oscillators.

Experimental evidence and mathematical modeling of thermal effects on human colonic smooth muscle contractility

It has been shown, in animal models, that gastrointestinal tract (GIT) motility is influenced by temperature; nevertheless, the basic mechanism governing thermal GIT smooth muscle responses has not been fully investigated. Studies based on physiologically tuned mathematical models have predicted that thermal inhomogeneity may induce an electrochemical destabilization of peristaltic activity. In the present study, the effect of thermal cooling on human colonic muscle strip (HCMS) contractility was studied. HCMSs were obtained from disease-free margins of resected segments for cancer. After removal of the mucosa and serosa layers, strips were mounted in separate chambers. After 30 min, spontaneous contractions developed, which were measured using force displacement transducers. Temperature was changed every hour (37, 34, and 31°C). The effect of cooling was analyzed on mean contractile activity, oscillation amplitude, frequency, and contraction to ACh (10(-5) M). At 37°C, HCMSs developed a stable phasic contraction (~0.02 Hz) with a significant ACh-elicited mean contractile response (31% and 22% compared with baseline in the circular and longitudinal axis, respectively). At a lower bath temperature, higher mean contractile amplitude was observed, and it increased in the presence of ACh (78% and 43% higher than the basal tone in the circular and longitudinal axis, respectively, at 31°C). A simplified thermochemomechanical model was tuned on experimental data characterizing the stress state coupling the intracellular Ca(2+) concentration to tissue temperature. In conclusion, acute thermal cooling affects colonic muscular function. Further studies are needed to establish the exact mechanisms involved to better understand clinical consequences of hypothermia on intestinal contractile activity.

Mapping and modeling gastrointestinal bioelectricity: from engineering bench to bedside

A key discovery in gastrointestinal motility has been the central role played by interstitial cells of Cajal (ICC) in generating electrical slow waves that coordinate contractions. Multielectrode mapping and multiscale modeling are two emerging interdisciplinary strategies now showing translational promise to investigate ICC function, electrophysiology, and contractions in the human gut.

NEW APPROACH IN MODELING PERISTALTIC TRANSPORT OF NON-NEWTONIAN FLUID

Transporting content in most biological systems is done through peristaltic transport phenomenon, examples of which include urine transport from kidney to bladder, swallowing of food through esophagus, the movement of chyme in small intestine, lymph transport in the lymphatic vessels, and in the vasomotion of small blood vessels such as arterioles. The present investigation simulated a transient peristaltic transport by developing a model based on fluid–solid interaction (FSI) method. The conduit in which peristaltic flow occurred was assumed to be axisymmetric. The propagating wave was simulated by prescribing a set of displacements, along the radial direction, on the wall. Both fluid and solid domains underwent large deformations as load applied. Due to large deformations, the adaptive discretization was considered. The ADINA 8.5 software, as finite element analytical software, was applied to study peristaltic transport. The results indicated that the present numerical method can properly introduce the features of the flow. The obtained results reveal that as amplitude ratio increases, axial velocity will increase, resulting in an increase in volume flux. Volume flux fluctuates through the passage of time in a cycle and along a wavelength. An increase in index of non-Newtonian fluid results in a decrease in velocity and increase in wall shear stress. It is observed that by increasing the amplitude of propagating wave, reflux will be increased; meanwhile, peristalsis works as a more efficient pumping process against the pressure applied as a boundary condition. The discussion on reflux according to its physiological importance seems to be helpful, thus the net displacement of the fluid particles after the transit of a single wave was calculated.

Mathematical modeling of transport and degradation of feedstuffs in the small intestine

We describe a mathematical model of digestion in the small intestine. The main interest of our work is to consider simultaneously the different aspects of digestion i.e. transport of the bolus all along the intestine, feedstuffs degradation according to the enzymes and local physical conditions, and nutrients absorption. A system of coupled ordinary differential equations is used to model these phenomena. The major unknowns of this system are the position of the bolus and its composition. This system of equations is solved numerically. We present several numerical computations for the degradation, absorption and transport of the bolus with acceptable accuracy regarding the overall behavior of the model and also when challenged versus experimental data. The main feature and interest of this model are its genericity. Even if we are at an early stage of development, our approach can be adapted to deal with contrasted feedstuffs in non-ruminant animal to predict the composition and velocity of bolus in the small intestine.

Multiscale modeling of gastrointestinal electrophysiology and experimental validation

Normal gastrointestinal (GI) motility results from the coordinated interplay of multiple cooperating mechanisms, both intrinsic and extrinsic to the GI tract. A fundamental component of this activity is an omnipresent electrical activity termed slow waves, which is generated and propagated by the interstitial cells of Cajal (ICCs). The role of ICC loss and network degradation in GI motility disorders is a significant area of ongoing research. This review examines recent progress in the multiscale modeling framework for effectively integrating a vast range of experimental data in GI electrophysiology, and outlines the prospect of how modeling can provide new insights into GI function in health and disease. The review begins with an overview of the GI tract and its electrophysiology, and then focuses on recent work on modeling GI electrical activity, spanning from cell to body biophysical scales. Mathematical cell models of the ICCs and smooth muscle cell are presented. The continuum framework of monodomain and bidomain models for tissue and organ models are then considered, and the forward techniques used to model the resultant body surface potential and magnetic field are discussed. The review then outlines recent progress in experimental support and validation of modeling, and concludes with a discussion on potential future research directions in this field.

An extended bidomain framework incorporating multiple cell types

The muscular layers within the walls of the gastrointestinal tract contain two distinct cell types, the interstitial cells of Cajal and smooth muscle cells, which together produce rhythmic depolarizations known as slow waves. The bidomain model of tissue-level electrical activity consists of single intracellular and extracellular domains separated by an intervening membrane at all points in space and is therefore unable to adequately describe the presence of two distinct cell types in its conventional form. Here, an extension to the bidomain framework is presented whereby multiple interconnected cell types can be incorporated. Although the derivation is focused on the interactions of the interstitial cells of Cajal and smooth muscle cells, the conceptual framework can be more generally applied. Simulations demonstrating the feasibility of the proposed model are also presented.

A model of slow wave propagation and entrainment along the stomach

Interstitial cells of Cajal (ICC) isolated from different regions of the stomach generate spontaneous electrical slow wave activity at different frequencies, with cells from the proximal stomach pacing faster than their distal counterparts. However, in vivo there exists a uniform pacing frequency; slow waves propagate aborally from the proximal stomach and subsequently entrain distal tissues. Significant resting membrane potential (RMP) gradients also exist within the stomach whereby membrane polarization generally increases from the fundus to the antrum. Both of these factors play a major role in the macroscopic electrical behavior of the stomach and as such, any tissue or organ level model of gastric electrophysiology should ensure that these phenomena are properly described. This study details a dual-cable model of gastric electrical activity that incorporates biophysically detailed single-cell models of the two predominant cell types, the ICC and smooth muscle cells. Mechanisms for the entrainment of the intrinsic pacing frequency gradient and for the establishment of the RMP gradient are presented. The resulting construct is able to reproduce experimentally recorded slow wave activity and provides a platform on which our understanding of gastric electrical activity can advance.

Expression and function of 5-HT7 receptors in smooth muscle preparations from equine duodenum, ileum, and pelvic flexure

In horses, gastrointestinal (GI) disorders occur frequently and cause a considerable demand for efficient medication. 5-Hydroxytryptamine receptors (5-HT) have been reported to be involved in GI tract motility and thus, are potential targets for treating functional bowel disorders. Our studies extend current knowledge on the 5-HT(7) receptor in equine duodenum, ileum and pelvic flexure by studying its expression throughout the intestine and its role in modulating contractility in vitro by immunofluorescence and organ bath experiments, respectively. 5-HT(7) immunoreactivity was demonstrated in both smooth muscle layers, particularly in the circular one, and within the myenteric plexus. Interstitial cells of Cajal (ICC), identified by c-Kit labeling, show a staining pattern similar to that of 5-HT(7) immunoreactivity. The selective 5-HT(7) receptor antagonist SB-269970 increased the amplitude of contractions in spontaneous contracting specimens of the ileum and in electrical field-stimulated specimens of the pelvic flexure concentration-dependently. Our in vitro experiments suggest an involvement of the 5-HT(7) receptor subtype in contractility of equine intestine. While the 5-HT(7) receptor has been established to be constitutively active and inhibits smooth muscle contractility, our experiments demonstrate an increase in contractility by the 5-HT(7) receptor ligand SB-269970, suggesting it exerting inverse agonist properties.

Gastrointestinal tract modelling in health and disease

The gastrointestinal (GI) tract is the system of organs within multi-cellular animals that takes in food, digests it to extract energy and nutrients, and expels the remaining waste. The various patterns of GI tract function are generated by the integrated behaviour of multiple tissues and cell types. A thorough study of the GI tract requires understanding of the interactions between cells, tissues and gastrointestinal organs in health and disease. This depends on knowledge, not only of numerous cellular ionic current mechanisms and signal transduction pathways, but also of large scale GI tissue structures and the special distribution of the nervous network. A unique way of coping with this explosion in complexity is mathematical and computational modelling; providing a computational framework for the multilevel modelling and simulation of the human gastrointestinal anatomy and physiology. The aim of this review is to describe the current status of biomechanical modelling work of the GI tract in humans and animals, which can be further used to integrate the physiological, anatomical and medical knowledge of the GI system. Such modelling will aid research and ensure that medical professionals benefit, through the provision of relevant and precise information about the patient’s condition and GI remodelling in animal disease models. It will also improve the accuracy and efficiency of medical procedures, which could result in reduced cost for diagnosis and treatment.

Biomechanical functional and sensory modelling of the gastrointestinal tract

The aim of this review is to describe the biomechanical, functional and sensory modelling work that can be used to integrate the physiological, anatomical and medical knowledge of the gastrointestinal (GI) system. The computational modelling in the GI tract was designed, implemented and evaluated using a series of information and communication technologies-based tools. These tools modelled the morphometry, biomechanics, functions and sensory aspects of the human GI tract. The research presented in this review is based on the virtual physiological human concept that pursues a holistic approach to representation of the human body. Such computational modelling combines imaging data, GI physiology, the gut-brain axis, geometrical and biomechanical reconstruction, and computer graphics for mechanical, electronic and pain analysis. The developed modelling will aid research and ensure that medical professionals benefit through the provision of relevant and precise information about a patient's condition. It will also improve the accuracy and efficiency of the medical procedures that could result in reduced cost for diagnosis and treatment.

Quantitative cellular description of gastric slow wave activity

Interstitial cells of Cajal (ICC) are responsible for the spontaneous and omnipresent electrical activity in the stomach. A quantitative description of the intracellular processes whose coordinated activity is believed to generate electrical slow waves has been developed and is presented here. In line with recent experimental evidence, the model describes how the interplay between the mitochondria and the endoplasmic reticulum in cycling intracellular Ca(2+) provides the primary regulatory signal for the initiation of the slow wave. The major ion channels that have been identified as influencing slow wave activity have been modeled according to data obtained from isolated ICC. The model has been validated by comparing the simulated profile of the slow waves with experimental recordings and shows good correspondence in terms of frequency, amplitude, and shape in both control and pharmacologically altered conditions.

Origin and propagation of individual slow waves along the intact feline small intestine

The pattern of propagation of slow waves in the small intestine is not clear. Specifically, it is not known whether propagation is determined by a single dominant ICC-MP (Interstitial cells of Cajal located in the Myenteric Plexus) pacemaker unit or whether there are multiple active pacemakers. To determine this pattern of propagation, waveforms were recorded simultaneously from 240 electrodes distributed along the whole length of the intact isolated feline small intestine. After the experiments, the propagation patterns of successive individual slow waves were analysed. In the intact small intestine, there was only a single slow wave pacemaker unit active, and this was located at or 6-10 cm from the pyloric junction. From this site, slow waves propagated in the aboral direction at gradually decreasing velocities. The majority of slow waves (73%) reached the ileocaecal junction while the remaining waves were blocked. Ligation of the intestine at one to four locations led to: (a) decrease in the distal frequencies; (b) disappearance of distal propagation blocks; (c) increase in velocities; (d) emergence of multiple and unstable pacemaker sites; and (e) propagation from these sites in the aboral and oral directions. In conclusion, in the quiescent feline small intestine a single pacemaker unit dominates the organ, with occasional propagation blocks of the slow waves, thereby producing the well-known frequency gradient.

Identification of the slow wave component of the electroenterogram from Laplacian abdominal surface recordings in humans

The electroenterogram (EEnG) is a surface recording of the myoelectrical activity of the smooth muscle layer of the small intestine. It is made up of two signals: a low-frequency component, known as the slow wave (SW), and high-frequency signals, known as spike bursts (SB). Most methods of studying bowel motility are invasive due to the difficult anatomic access of the intestinal tract. Abdominal surface EEnG recordings could be a noninvasive solution for monitoring human intestinal motility. However, surface EEnG recordings in humans present certain problems, such as the low amplitude of the signals and the influence of physiological interference such as the electrocardiogram (ECG) and respiration. In this study, a discrete estimation of the abdominal surface Laplacian potential was obtained using Hjorth's method. The objective was to analyze the enhancement given by Laplacian EEnG estimation compared to bipolar recordings. Eight recording sessions were carried out on eight healthy human volunteers in a state of fasting. First, the ECG interference content present in the bipolar signals and in the Laplacian estimation were quantified and compared. Secondly, to identify the SW component of the EEnG, respiration interference was removed by using an adaptive filter, and spectral estimation techniques were applied. The following parameters were obtained: the dominant frequency (DF) of the signals, stability of the rhythm (RS) of the DF detected and the percentage of DFs within the typical frequency range for the SW (TFSW). Results show the better ability of the Laplacian estimation to attenuate ECG interference, as compared to bipolar recordings. As regards the identification of the SW component of the EEnG, after removing respiration interference, the mean value of the DF in all abdominal surface recording channels and in their Laplacian estimation ranged from 0.12 to 0.14 Hz (7.3 to 8.4 cycles min(-1) (cpm)). Furthermore in 80% of the cases, the detected DFs were inside the typical human SW frequency range, and the ratio of frequency change in the surface bipolar and Laplacian estimation signals, in 90% of the cases, was within the frequency change accepted for human SW. Significant statistical differences were also found between the DF of all surface signals (bipolar and Laplacian estimation) and the DF of respiration. In conclusion, it was demonstrated that the discrete Laplacian potential estimation attenuated the physiological interference present in bipolar surface recordings, especially ECG. Furthermore, a slow frequency component, whose frequency, rhythm stability and amplitude fitted with the SW patterns in humans, was identified in bipolar and Laplacian estimation signals. This could be a useful non-invasive tool for monitoring intestinal activity by abdominal surface recordings.

Anatomically realistic multiscale models of normal and abnormal gastrointestinal electrical activity

One of the major aims of the International Union of Physiological Sciences (IUPS) Physiome Project is to develop multiscale mathematical and computer models that can be used to help understand human health. We present here a small facet of this broad plan that applies to the gastrointestinal system. Specifically, we present an anatomically and physiologically based modelling framework that is capable of simulating normal and pathological electrical activity within the stomach and small intestine. The continuum models used within this framework have been created using anatomical information derived from common medical imaging modalities and data from the Visible Human Project. These models explicitly incorporate the various smooth muscle layers and networks of interstitial cells of Cajal (ICC) that are known to exist within the walls of the stomach and small bowel. Electrical activity within individual ICCs and smooth muscle cells is simulated using a previously published simplified representation of the cell level electrical activity. This simulated cell level activity is incorporated into a bidomain representation of the tissue, allowing electrical activity of the entire stomach or intestine to be simulated in the anatomically derived models. This electrical modelling framework successfully replicates many of the qualitative features of the slow wave activity within the stomach and intestine and has also been used to investigate activity associated with functional uncoupling of the stomach.

Computational simulations of the human magneto- and electroenterogram

Many functional pathologies of the small intestine are difficult to diagnose clinically without an invasive surgical intervention. Often such conditions are associated with a disruption of the normal electrical activity occurring within the musculature of the small intestine. The far field electrical signals on the torso surface arising from the electrical activity within the small intestine cannot be reliably measured. However, it has been shown that abnormal electrical activity in the small intestine can be distinguished by recording the magnetic fields of intestinal origin immediately outside the torso surface. We have developed an anatomically-based computational model to simulate slow wave propagation in the small intestine, the resulting cutaneous electrical field and the magnetic field outside the torso. Using both a one-dimensional and a three-dimensional model of the duodenum we investigate the degree of detail that is required to realistically simulate this far field activity. Our results indicate that some of the qualitative behavior in the far field activity can be replicated using a one-dimensional model, although there are clear situations where the greater level modeling detail is required.