Effects of gastrointestinal tissue structure on computed dipole vectors

Transmural recordings of gastrointestinal electrical activity using a spatially-dense microelectrode array

Objective. High-resolution serosal recordings provide detailed information about the bioelectrical conduction patterns in the gastrointestinal (GI) tract. However, equivalent knowledge about the electrical activity through the GI tract wall remains largely unknown. This study aims to capture and quantify the bioelectrical activity across the wall of the GI tract.Approach. A needle-based microelectrode array was used to measure the bioelectrical activity across the GI wallin vivo. Quantitative and qualitative evaluations of transmural slow wave characteristics were carried out in comparison to the serosal slow wave features, through which the period, amplitude, and SNR metrics were quantified and statistically compared.Main results. Identical periods of 4.7 ± 0.3 s with amplitudes of 0.17 ± 0.04 mV versus 0.31 ± 0.1 mV and signal to noise ratios of 5.5 ± 1.3 dB versus 14.4 ± 1.1 dB were observed for transmural and serosal layers, respectively. Four different slow wave morphologies were observed across the transmural layers of the GI wall. Similar amplitudes were observed for all morphology types, and Type 1 and Type 2 were of the highest prevalence, dominating the outer and inner layers. Type 2 was exclusive to the middle layer while Type 4 was primarily observed in the middle layer as well.Significance. This study demonstrates the validity of new methodologies for measuring transmural slow wave activation in the GI wall and can now be applied to investigate the source and origin of GI dysrhythmias leading to dysmotility, and to validate novel therapeutics for GI health and disease.

Polygonally Meshed Dipole Model Simulation of the Electrical Field Produced by the Stomach and Intestines

Cutaneous electrogastrography (EGG) is used in clinical and physiological fields to noninvasively measure the electrical activity of the stomach and intestines. Dipole models that mathematically express the electrical field characteristics generated by the stomach and intestines have been developed to investigate the relationship between the electrical control activity (ECA) (slow waves) shown in EGG and the internal gastric electrical activity. However, these models require a mathematical description of the movement of an annular band of dipoles, which limits the shape that can be modeled. In this study, we propose a novel polygonally meshed dipole model to conveniently reproduce ECA based on the movement of the annular band in complex shapes, such as the shape of the stomach and intestines, constructed in three-dimensional (3D) space. We show that the proposed model can reproduce ECA simulation results similar to those obtained using conventional models. Moreover, we show that the proposed model can reproduce the ECA produced by a complex geometrical shape, such as the shape of the intestines. The study results indicate that ECA simulations can be conducted based on structures that more closely resemble real organs than those used in conventional dipole models, with which, because of their intrinsic construction, it would be difficult to include realistic complex shapes, using the mathematical description of the movement of an annular band of dipoles. Our findings provide a powerful new approach for computer simulations based on the electric dipole model.

Simulation-based Analysis of Magnetogastrography Sensor Configurations for Characterizing Gastric Slow Wave Dysrhythmias

The routine diagnosis of gastric motility disorders represents a significant problem to current clinical practice. Magnetogastrography (MGG) provides a non-invasive option for assessing gastric slow wave (SW) dysrhythmias that are associated with motility disorders. However, its ability to characterize SW propagation is impaired by the limited spatial coverage of existing superconducting quantum interference devices (SQUIDs). Recently developed optically-pumped magnetometers can potentially substitute SQUIDs and enable subject-specific MGG arrays with greater spatial coverage. This study developed simulations of gastric MGG to determine the distribution of the magnetic fields (MFs) generated by SWs above the torso, and investigated the impact of several realistic dysrhythmic patterns of propagation. The distribution of MFs was found to vary significantly for different patterns of SW propagation, with ectopic dysrhythmia displaying the greatest difference from normal. Notably, some important proportion of the MFs lay outside the coverage of an existing experimental SQUID array used in gastrointestinal research for some simulated SW propagation patterns, such as retrograde activity. Results suggest that MGG measurements should be made over the entire frontal face of the torso to capture all of the strongest MFs generated by SWs.Clinical relevance- This provides a guide for the placement of MGG sensors for the capture of both normal and dysrhythmic gastric slow wave propagation.

Consistency of cutaneous electrical activity of the human colon with respect to serosal slow waves: A simulation study

The serosal slow waves in the human colon are complex, since their amplitude and frequency vary over time. Therefore, this study employed a simulation to investigate the consistency between serosal slow waves and cutaneous electrical activity by evaluating whether changes of the cutaneous waveform features due to anatomical and physiological parameters are detectable in the cutaneous electrical activity. The simulation results indicated that (a) changes in the dipole moment involve detectable changes in the amplitude of the cutaneous electrical activity; (b) changes in the annular band velocity induce modifications in the cutaneous signal frequency; and (c) changes in the anatomical factors affect both the amplitude and the frequency of the cutaneous signal. Therefore, we observed that there is consistency between serosal slow waves and cutaneous electrical activity. On these bases, we think that modifications in the cutaneous electrical activity observed in our study could represent the marker of specific physiological motor activity of the colon, and such information can improve the recording of the experimental measurements of the cutaneous electrical activity of the colon in humans.

A Theoretical Analysis of Electrogastrography (EGG) Signatures Associated With Gastric Dysrhythmias

Routine screening and accurate diagnosis of chronic gastrointestinal motility disorders represent a significant problem in current clinical practice. The electrogastrography (EGG) provides a noninvasive option for assessing gastric slow waves, as a means of diagnosing gastric dysrhythmias, but its uptake in motility practice has been limited partly due to an incomplete sensitivity and specificity. This paper presents the development of a human whole-organ gastric model to enable virtual (in silico) testing of gastric electrophysiological dispersion in order to improve the diagnostic accuracy of EGG. The model was developed to simulate normal gastric slow wave conduction as well as three types of dysrhythmias identified in recent high-resolution gastric mapping studies: conduction block, re-entry, and ectopic pacemaking. The stomach simulations were then applied in a torso model to identify predicted EGG signatures of normal and dysrhythmic slow wave profiles. The resulting EGG data were compared using percentage differences and correlation coefficients. Virtual EGG channels that demonstrated a percentage difference over 100% and a correlation coefficient less than ±0.2 (threshold relaxed to ±0.5 for the ectopic pacemaker case) were further investigated for their specific distinguishing features. In particular, anatomical locations from the epigastric region and specific channel configurations were identified that could be used to clinically diagnose the three classes of human gastric dysrhythmia. These locations and channels predicted by simulations present a promising methodology for improving the clinical reliability and applications of EGG.

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.

Gastrointestinal system

The functions of the gastrointestinal (GI) tract include digestion, absorption, excretion, and protection. In this review, we focus on the electrical activity of the stomach and small intestine, which underlies the motility of these organs, and where the most detailed systems descriptions and computational models have been based to date. Much of this discussion is also applicable to the rest of the GI tract. This review covers four major spatial scales: cell, tissue, organ, and torso, and discusses the methods of investigation and the challenges associated with each. We begin by describing the origin of the electrical activity in the interstitial cells of Cajal, and its spread to smooth muscle cells. The spread of electrical activity through the stomach and small intestine is then described, followed by the resultant electrical and magnetic activity that may be recorded on the body surface. A number of common and highly symptomatic GI conditions involve abnormal electrical and/or motor activity, which are often termed functional disorders. In the last section of this review we address approaches being used to characterize and diagnose abnormalities in the electrical activity and how these might be applied in the clinical setting. The understanding of electrophysiology and motility of the GI system remains a challenging field, and the review discusses how biophysically based mathematical models can help to bridge gaps in our current knowledge, through integration of otherwise separate concepts.

Effects of volume conductor and source configuration on simulated magnetogastrograms

Recordings of the magnetic fields (MFs) arising from gastric electrical activity (GEA) have been shown to be able to distinguish between normal and certain abnormal GEA. Mathematical models provide a powerful tool for revealing the relationship between the underlying GEA and the resultant magnetogastrograms (MGGs). However, it remains uncertain the relative contributions that different volume conductor and dipole source models have on the resultant MFs. In this study, four volume conductor models (free space, sphere, half space and an anatomically realistic torso) and two dipole source configurations (containing 320 moving dipole sources and a single equivalent moving dipole source) were used to simulate the external MFs. The effects of different volume conductor models and dipole source configurations on the MF simulations were examined. The half space model provided the best approximation of the MFs produced by the torso model in the direction normal to the coronal plane. This was despite the fact that the half space model does not produce secondary sources, which have been shown to contribute up to 50% of the total MFs when an anatomically realistic torso model was used. We conclude that a realistic representation of the volume conductor and a detailed dipole source model are likely to be necessary when using a model-based approach for interpreting MGGs.

Tissue-specific mathematical models of slow wave entrainment in wild-type and 5-HT(2B) knockout mice with altered interstitial cells of Cajal networks

Gastrointestinal slow waves are generated within networks of interstitial cells of Cajal (ICCs). In the intact tissue, slow waves are entrained to neighboring ICCs with higher intrinsic frequencies, leading to active propagation of slow waves. Degradation of ICC networks in humans is associated with motility disorders; however, the pathophysiological mechanisms of this relationship are uncertain. A recently developed biophysically based mathematical model of ICC was adopted and updated to simulate entrainment of slow waves. Simulated slow wave propagation was successfully entrained in a one-dimensional model, which contained a gradient of intrinsic frequencies. Slow wave propagation was then simulated in tissue models which contained a realistic two-dimensional microstructure of the myenteric ICC networks translated from wild-type (WT) and 5-HT(2B) knockout (degraded) mouse jejunum. The results showed that the peak current density in the WT model was 0.49 muA mm(-2) higher than the 5-HT(2B) knockout model, and the intracellular Ca(2+) density after 400 ms was 0.26 mM mm(-2) higher in the WT model. In conclusion, tissue-specific models of slow waves are presented, and simulations quantitatively demonstrated physiological differences between WT and 5-HT(2B) knockout models. This study provides a framework for evaluating how ICC network degradation may impair slow wave propagation and ultimately motility and transit.

Characterization of gastric electrical activity using magnetic field measurements: a simulation study

Gastric disorders are often associated with abnormal propagation of gastric electrical activity (GEA). The identification of clinically relevant parameters of GEA using noninvasive measures would therefore be highly beneficial for clinical diagnosis. While magnetogastrograms (MGG) are known to provide a noninvasive representation of GEA, standard methods for their analysis are limited. It has previously been shown in simplistic conditions that the surface current density (SCD) calculated from multichannel MGG measurements provides an estimate of the gastric source location and propagation velocity. We examine the accuracy of this technique using more realistic source models and an anatomically realistic volume conductor model. The results showed that the SCD method was able to resolve the GEA parameters more reliably when the dipole source was located within 100 mm of the sensor. Therefore, the theoretical accuracy of SCD method would be relatively diminished for patients with a larger body habitus, and particularly in those patients with significant truncal obesity. However, many patients with gastric motility disorders are relatively thin due to food intolerance, meaning that the majority of the population of gastric motility patients could benefit from the methods developed here. Large errors resulted when the source was located deep within the body due to the distorting effects of the secondary sources on the magnetic fields. Larger errors also resulted when the dipole was oriented normal to the sensor plane. This was believed to be due to the relatively small contribution of the dipole source when compared to the field produced by the volume conductor. The use of three orthogonal magnetic field components rather than just one component to calculate the SCD yielded marginally more accurate results when using a realistic dipole source. However, this slight increase in accuracy may not warrant the use of more complex vector channels in future superconducting quantum interference device designs. When multiple slow waves were present in the stomach, the SCD map contained only one maximum point corresponding to the more dominant source located in the distal stomach. Parameters corresponding to the slow wave in the proximal stomach were obtained once the dominant slow terminated at the antrum. Additional validation studies are warranted to address the utility of the SCD method to resolve parameters related to gastric slow waves in a clinical setting.