[Evaluation of gastric motility using vector analysis of electrogastrography]

Effect of psychological stress on gastric motility assessed by electrical bio-impedance

AIM: To evaluate gastric motility using electrical bio-impedance (EBI) and gastric changes as a result of stress induced by psychological tests.

METHODS: A group of 57 healthy women, aged 40-60 years, was recruited, and a clinical history and physical examination were performed. The women were free from severe anxiety, chronic or acute stress, severe depression, mental diseases and conditions that affect gastric activity. The women were evaluated under fasting conditions, and using a four-electrode configuration, the gastric signals were obtained through a BIOPAC MP-150 system. The volunteers were evaluated using the following paradigm: basal state, recording during the Stroop Test, intermediate resting period, recording during the Raven Test, and a final resting period. We analyzed the relative areas of the frequency spectrum: A1 (1-2 cpm), A2 (2-4 cpm), A3 (4-8 cpm), and A4 (8-12 cpm), as well as the median of area A2 + A3. The data were analyzed by an autoregressive method using a Butterworth filter with MatLab and Origin. Analysis of variance (ANOVA) and Friedman ANOVA (for nonparametric variables) were performed; in addition, pairs of groups were compared using the T dependent and Wilcoxon T tests.

RESULTS: The results of the main values of area A2 were not significantly different comparing the five steps of the experimental paradigm. Nevertheless, there was a tendency of this A2 region to decrease during the stress tests, with recuperation at the final resting step. When an extended gastric region was considered (1-4 cpm), significant differences with the psychological stress tests were present (F = 3.85, P = 0.005). The A3 region also showed significant changes when the stress psychological tests were administered (F = 7.25, P < 0.001). These differences were influenced by the changes in the adjacent gastric region of A2. The parameter that we proposed in previous studies for the evaluation of gastric motility by electrical bio-impedance (EBI) was the median of the area under the region from 2 to 8 cpm (A2 + A3). The mean values of these frequencies (median of the A2 + A3 area) with the stress test showed significant changes (F = 5.5, P < 0.001). The results of the Wilcoxon T test for the A4 area parameter, which is influenced by the breathing response, changed significantly during the Raven stress test (P < 0.05).

CONCLUSION: We confirm that the gastric response to acute psychological stress can be evaluated by short-term EBI.

Electrical bioimpedance and other techniques for gastric emptying and motility evaluation

The aim of this article is to identify non-invasive, inexpensive, highly sensitive and accurate techniques for evaluating and diagnosing gastric diseases. In the case of the stomach, there are highly sensitive and specific methods for assessing gastric motility and emptying (GME). However, these methods are invasive, expensive and/or not technically feasible for all clinicians and patients. We present a summary of the most relevant international information on non-invasive methods and techniques for clinically evaluating GME. We particularly emphasize the potential of gastric electrical bioimpedance (EBI). EBI was initially used mainly in gastric emptying studies and was essentially abandoned in favor of techniques such as electrogastrography and the gold standard, scintigraphy. The current research evaluating the utility of gastric EBI either combines this technique with other frequently used techniques or uses new methods for gastric EBI signal analysis. In this context, we discuss our results and those of other researchers who have worked with gastric EBI. In this review article, we present the following topics: (1) a description of the oldest methods and procedures for evaluating GME; (2) an explanation of the methods currently used to evaluate gastric activity; and (3) a perspective on the newest trends and techniques in clinical and research GME methods. We conclude that gastric EBI is a highly effective non-invasive, easy to use and inexpensive technique for assessing GME.

Vector analysis of electrogastrography during motion sickness

Although the dominant frequency at 3 cpm of electrogastrography (EGG) is reported to shift to a higher frequency during motion sickness (MS), it is unclear whether the normal slow wave (NSW) disappears or not. The authors investigated changes in NSW using vector analysis of EGG. Fourteen subjects were exposed to a Coriolis stimulation to evoke MS. EGG was recorded from two sets of bipolar leads, placed perpendicular to each other representing x and y axes. Trajectories for each frequency were drawn on the x-y plane. The amplitude and phase difference at NSW were compared before, during, and after the stimulus for each subject. In those with a change in phase difference, changes in NSW and tachygastria were negatively correlated (P = -0.048), whereas in those without a change, they were not correlated. This indicated two different kinds of tachygastria due to MS: tachygastria with and without a change in NSW.

The application of electrocecography for evaluation of cecum motility in horses

Electrogastrography (EGG), in which the electrical activity of the smooth muscular layer of the stomach is recorded percutaneously through the abdominal wall, has been applied in recent years to humans as a non-invasive method. In acute abdominal disease in horses, it is considered diagnostically useful to analyze digestive activity using EGG. Electrocecography (ECG) was examined to determine its effectiveness in evaluating equine digestive motility through comparison, after xylazine administration, between the results of the percutaneous ECG method and the results obtained using a strain-gauge force transducer (Force Transducer) chronically attached to the serous membrane of the cecum. As subjects, the test used six male thoroughbreds (average weight: 457.5 +/- 9.2 kg). The test showed a reduction in both the percutaneous electrical potential of the cecum in ECG and in cecal contractions measured with the Force Transducer. After xylazine administration, an average rates of decrease of the amplitude from the control period were 17.8 +/- 3.4% and 20.0 +/- 4.6% respectively, demonstrating a significant correlation (r = 0.90) between the two methods. On the other hand, power distribution centered around 6 cycles per minute in a Fourier transform (FFT) analysis of ECG, thought similar to the contraction frequency of 5.4 +/- 3.0 per minute observed with the Force Transducer. After xylazine administration, the total frequency band (1.8-12 cycle per min) in the running spectrum total power in ECG decreased to 37.0 +/- 5.1% of the pre-xylazine value. Based on these findings, it appears that the ECG potential reflected electrical activity of cecal origin, suggesting high clinical applicability of ECG to the percutaneous evaluation of equine cecal motility.