Baseline predictive factors for foregut and hindgut response to long-term gastric electrical stimulation using augmented energy.
diabetes
gastric electrical stimulation
gastroparesis
nausea
neuromodulation
vomiting
Journal
Neurogastroenterology and motility
ISSN: 1365-2982
Titre abrégé: Neurogastroenterol Motil
Pays: England
ID NLM: 9432572
Informations de publication
Date de publication:
06 2022
06 2022
Historique:
revised:
27
08
2021
received:
17
06
2021
accepted:
19
09
2021
pubmed:
27
10
2021
medline:
28
5
2022
entrez:
26
10
2021
Statut:
ppublish
Résumé
Gastric electrical stimulation (GES) has been recommended for drug refractory patients with gastroparesis, but no clear baseline predictors of symptom response exist. We hypothesized that long-term predictors to GES for foregut and hindgut symptoms exist, particularly when using augmented energies. We evaluated 307 patients at baseline, 1 week post temporary GES, and one year after permanent GES. Baseline measures included upper and lower symptoms by patient-reported outcomes (PRO), solid and liquid gastric emptying (GET), cutaneous, mucosal, and serosal electrophysiology (EGG, m/s EG), BMI, and response to temporary stimulation. Foregut and hindgut PRO symptoms were analyzed for 12-month patient outcomes. All patients utilized a standardized energy algorithm with the majority of patients receiving medium energy at 12 months. Patients were categorized based on change in average GI symptom scores at the time of permanent GES compared to baseline using a 10% decrease over time as the cutoff between improvers versus non-improvers. By permanent GES implant, average foregut and hindgut GI symptom scores reduced 42% in improved patients (n = 199) and increased 27% in non-improved patients (n = 108). Low BMI, baseline infrequent urination score, mucosal EG ratio, and proximal mucosal EG low-resolution amplitude remained significant factors for improvement status. GES, for patients responding positively, improved both upper/foregut and lower/hindgut symptoms with most patients utilizing higher than nominal energies. Low baseline BMI and the presence of infrequent urination along with baseline gastric electrophysiology may help identify those patients with the best response to GES/bio-electric neuromodulation.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e14274Informations de copyright
© 2021 John Wiley & Sons Ltd.
Références
Tack J, Carbone F, Rotondo A. Gastroparesis. Curr Opin Gastroenterol. 2015;31:499-505.
Williams PA, Nikitina Y, Kedar A, Lahr CJ, Helling TS, Abell TL. Long-term effects of gastric stimulation on gastric electrical physiology. J Gastrointest Surg. 2013;17(1):50-56.
Atassi H, Abell TL. Gastric Electrical Stimulator for Treatment of Gastroparesis. Gastrointest Endosc Clin N Am. 2019;29:71-83.
Abidi N, Starkebaum WL, Abell TL. An energy algorithm improves symptoms in some patients with gastroparesis and treated with gastric electrical stimulation. Neurogastroenterol Motil. 2006;18:334-338.
Abell TL, Kedar A, Stocker A, et al. Gastroparesis syndromes: Response to electrical stimulation. Neurogastroenterol Motil. 2019;31:e13534.
Abell TL, Kedar A, Stocker A, et al. Pathophysiology of gastroparesis syndromes includes anatomic and physiologic abnormalities. Dig Dis Sci. 2020;66(4):1127-1141.
Abell TL, Johnson WD, Kedar A, et al. A double-masked, randomized, placebo-controlled trial of temporary endoscopic mucosal gastric electrical stimulation for gastroparesis. Gastrointest Endosc. 2011;74:496-503.e3.
Murray D, Abell T. Neuromodulation for Nausea and vomiting in adult patients. Neuromodulation. 2018;1407-1417.
Gourcerol G, Huet E, Vandaele N, et al. Long term efficacy of gastric electrical stimulation in intractable nausea and vomiting. Dig Liver Dis. 2012;44:563-568.
Abell T, Lou J, Tabbaa M, Batista O, Malinowski S, Al-Juburi A. Gastric electrical stimulation for gastroparesis improves nutritional parameters at short, intermediate, and long-term follow-up. JPEN J Parenter Enteral Nutr. 2003;27:277-281.
Familoni BO, Abell TL, Bhaskar SK, Voeller GR, Blair SR. Gastric electrical stimulation has an immediate antiemetic effect in patients with gastroparesis. IEEE Trans Biomed Eng. 2006;53:1038-1046.
Abell T, McCallum R, Hocking M, et al. Gastric electrical stimulation for medically refractory gastroparesis. Gastroenterology. 2003;125:421-428.
Abell TL, Van Cutsem E, Abrahamsson H, et al. Gastric electrical stimulation in intractable symptomatic gastroparesis. Digestion. 2002;66:204-212.
Burlen J, Runnels M, Mehta M, et al. Efficacy of gastric electrical stimulation for gastroparesis: US/European comparison. Gastroenterology Res. 2018;11:349-354.
Ducrotte P, Coffin B, Bonaz B, et al. Gastric electrical stimulation reduces refractory vomiting in a randomized crossover trial. Gastroenterology. 2020;158:506-514.e2.
Bortolotti M. Gastric electrical stimulation for gastroparesis: a goal greatly pursued, but not yet attained. World J Gastroenterol. 2011;17:273-282.
O'Grady G, Du P, Lammers WJ, et al. High-resolution entrainment mapping of gastric pacing: a new analytical tool. Am J Physiol Gastrointest Liver Physiol. 2010;298:G314-G321.
Gharibans AA, Coleman TP, Mousa H, Kunkel DC et al. Spatial patterns from high-resolution electrogastrography correlate with severity of symptoms in patients with functional dyspepsia and gastroparesis. Clin Gastroenterol Hepatol. 2019;17(13):2668-2677.
Omer E, Kedar A, Nagarajarao HS, et al. Cajal cell counts are important predictors of outcomes in drug refractory gastroparesis patients with neurostimulation. J Clin Gastroenterol. 2019;53:366-372.
Malik Z, Sankineni A, Parkman HP. Assessing pyloric sphincter pathophysiology using EndoFLIP in patients with gastroparesis. Neurogastroenterol Motil. 2015;27:524-531.
Zoll B, Jehangir A, Edwards MA, et al. Surgical treatment for refractory gastroparesis: stimulator, pyloric surgery, or both? J Gastrointest Surg. 2019;24(10):2204-2211.