Principles and clinical methods of body surface gastric mapping: Technical review.


Journal

Neurogastroenterology and motility
ISSN: 1365-2982
Titre abrégé: Neurogastroenterol Motil
Pays: England
ID NLM: 9432572

Informations de publication

Date de publication:
10 2023
Historique:
revised: 29 01 2023
received: 21 10 2022
accepted: 12 02 2023
pmc-release: 01 10 2024
medline: 21 9 2023
pubmed: 30 3 2023
entrez: 29 3 2023
Statut: ppublish

Résumé

Chronic gastric symptoms are common, however differentiating specific contributing mechanisms in individual patients remains challenging. Abnormal gastric motility is present in a significant subgroup, but reliable methods for assessing gastric motor function in clinical practice are lacking. Body surface gastric mapping (BSGM) is a new diagnostic aid, employs multi-electrode arrays to measure and map gastric myoelectrical activity non-invasively in high resolution. Clinical adoption of BSGM is currently expanding following studies demonstrating the ability to achieve specific patient subgrouping, and subsequent regulatory clearances. An international working group was formed in order to standardize clinical BSGM methods, encompassing a technical group developing BSGM methods and a clinical advisory group. The working group performed a technical literature review and synthesis focusing on the rationale, principles, methods, and clinical applications of BSGM, with secondary review by the clinical group. The principles and validation of BSGM were evaluated, including key advances achieved over legacy electrogastrography (EGG). Methods for BSGM were reviewed, including device design considerations, patient preparation, test conduct, and data processing steps. Recent advances in BSGM test metrics and reference intervals are discussed, including four novel metrics, being the 'principal gastric frequency', BMI-adjusted amplitude, Gastric Alimetry Rhythm Index™, and fed: fasted amplitude ratio. An additional essential element of BSGM has been the introduction of validated digital tools for standardized symptom profiling, performed simultaneously during testing. Specific phenotypes identifiable by BSGM and the associated symptom profiles were codified with reference to pathophysiology. Finally, knowledge gaps and priority areas for future BSGM research were also identified by the working group.

Sections du résumé

BACKGROUND AND PURPOSE
Chronic gastric symptoms are common, however differentiating specific contributing mechanisms in individual patients remains challenging. Abnormal gastric motility is present in a significant subgroup, but reliable methods for assessing gastric motor function in clinical practice are lacking. Body surface gastric mapping (BSGM) is a new diagnostic aid, employs multi-electrode arrays to measure and map gastric myoelectrical activity non-invasively in high resolution. Clinical adoption of BSGM is currently expanding following studies demonstrating the ability to achieve specific patient subgrouping, and subsequent regulatory clearances. An international working group was formed in order to standardize clinical BSGM methods, encompassing a technical group developing BSGM methods and a clinical advisory group. The working group performed a technical literature review and synthesis focusing on the rationale, principles, methods, and clinical applications of BSGM, with secondary review by the clinical group. The principles and validation of BSGM were evaluated, including key advances achieved over legacy electrogastrography (EGG). Methods for BSGM were reviewed, including device design considerations, patient preparation, test conduct, and data processing steps. Recent advances in BSGM test metrics and reference intervals are discussed, including four novel metrics, being the 'principal gastric frequency', BMI-adjusted amplitude, Gastric Alimetry Rhythm Index™, and fed: fasted amplitude ratio. An additional essential element of BSGM has been the introduction of validated digital tools for standardized symptom profiling, performed simultaneously during testing. Specific phenotypes identifiable by BSGM and the associated symptom profiles were codified with reference to pathophysiology. Finally, knowledge gaps and priority areas for future BSGM research were also identified by the working group.

Identifiants

pubmed: 36989183
doi: 10.1111/nmo.14556
pmc: PMC10524901
mid: NIHMS1896583
doi:

Types de publication

Journal Article Review Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e14556

Subventions

Organisme : NIDDK NIH HHS
ID : R56 DK126935
Pays : United States

Investigateurs

Jonathan C Erickson (JC)
Daphne Foong (D)
William Jiaen Wang (WJ)
I-Hsuan Huang (IH)
Tim Wang (T)
Stephen Waite (S)
Daniel Carson (D)
Alain Benitez (A)
Timothy R Angeli-Gordon (TR)
Celia Keane (C)
David Kunkel (D)
Chris Cederwall (C)

Informations de copyright

© 2023 The Authors. Neurogastroenterology & Motility published by John Wiley & Sons Ltd.

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Auteurs

Gregory O'Grady (G)

Department of Surgery, The University of Auckland, Auckland, New Zealand.
Alimetry Ltd, Auckland, New Zealand.
Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand.

Chris Varghese (C)

Department of Surgery, The University of Auckland, Auckland, New Zealand.

Gabriel Schamberg (G)

Department of Surgery, The University of Auckland, Auckland, New Zealand.
Alimetry Ltd, Auckland, New Zealand.

Stefan Calder (S)

Alimetry Ltd, Auckland, New Zealand.

Peng Du (P)

Alimetry Ltd, Auckland, New Zealand.
Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand.

William Xu (W)

Department of Surgery, The University of Auckland, Auckland, New Zealand.

Jan Tack (J)

Department of Gastroenterology, University Hospitals, Leuven, Belgium.

Charlotte Daker (C)

Alimetry Ltd, Auckland, New Zealand.

Hayat Mousa (H)

Division of Gastroenterology, Lustgarten Motility Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Thomas L Abell (TL)

Division of Gastroenterology, Hepatology and Nutrition, University of Louisville, Louisville, Kentucky, USA.

Henry P Parkman (HP)

Department of Medicine, Temple University Hospital, Philadelphia, Pennsylvania, USA.

Vincent Ho (V)

Western Sydney University, Sydney, New South Wales, Australia.

L Alan Bradshaw (LA)

Vanderbilt University, Nashville, Tennessee, USA.

Anthony Hobson (A)

Functional Gut Clinic, London, UK.

Christopher N Andrews (CN)

Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada.

Armen A Gharibans (AA)

Department of Surgery, The University of Auckland, Auckland, New Zealand.
Alimetry Ltd, Auckland, New Zealand.
Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand.

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