Diabetic gastroparesis alters the biomagnetic signature of the gastric slow wave.
Diabetic gastroparesis alters the biomagnetic signature of the gastric slow wave.
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DOI：
10.1111/nmo.12780
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发表时间：
2016-06
影响因子：
3.5
通讯作者：
Richards WO
中科院分区：
文献类型：
--
作者：
Bradshaw LA;Cheng LK;Chung E;Obioha CB;Erickson JC;Gorman BL;Somarajan S;Richards WO
胃轻瘫的特征是胃排空延迟，无机械性梗阻，但仍然难以诊断和与其他胃肠道疾病区分。胃轻瘫影响胃慢波，但无创评估仅限于胃电图（EGG），它可靠地表征了时间动态，但不提供空间信息。我们测量了胃轻瘫患者和健康对照者的胃慢波参数，包括EGG和胃磁图（MGG）。除了优势频率（DF）和功率分布百分比（PPD）外，我们还测量了MGG时空模式的传播速度和EGG慢波耦合百分比（%SWC）。患者与对照组间DF无显著差异。胃轻瘫患者餐后正常胃频率的比例较低（60±6%比78±4%，p<0.05），胃轻瘫患者餐后正常胃频率（9±2%比2±1%，p<0.05）和胃过速（31±2%比19±1%，p<0.05）的频率含量较高，说明胃轻瘫患者未偶联。患者的传播模式有很大差异，纵向传播速度为逆行（4.3±2.9 mm/s），对照组为逆行（7.4±1.0 mm/s） （p < 0.01）。与EGG的%SWC没有差异。从MGG记录中获得的胃慢波参数将胃轻瘫患者与对照组区分开来。慢波传播的评估可能对潜在疾病过程的表征至关重要。未来的研究应确定MGG与其他功能性胃疾病相关的病理指标，以及多通道EGG经过适当的信号处理是否也能揭示病理。
Gastroparesis is characterized by delayed gastric emptying without mechanical obstruction, but remains difficult to diagnose and distinguish from other GI disorders. Gastroparesis affects the gastric slow wave, but noninvasive assessment has been limited to the electrogastrogram (EGG), which reliably characterizes temporal dynamics but does not provide spatial information. We measured gastric slow wave parameters from the EGG and magnetogastrogram (MGG) in patients with gastroparesis and in healthy controls. In addition to dominant frequency (DF) and percentage power distribution (PPD), we measured the propagation velocity from MGG spatiotemporal patterns and the percentage of slow wave coupling (%SWC) from EGG. No significant difference in DF was found between patients and controls. Gastroparesis patients had lower percentages of normogastric frequencies (60 ± 6% vs 78 ± 4%, p<0.05), and higher brady- (9 ± 2% vs 2 ± 1%, p<0.05) and tachygastric (31 ± 2 % vs 19 ± 1%, p<0.05) frequency content postprandial, indicative of uncoupling. Propagation patterns were substantially different in patients and longitudinal propagation velocity was retrograde at 4.3 ± 2.9 mm/s vs anterograde at 7.4 ± 1.0 mm/s for controls (p < 0.01). No difference was found in %SWC from EGG. Gastric slow wave parameters obtained from MGG recordings distinguish gastroparesis patients from controls. Assessment of slow wave propagation may prove critical to characterization of underlying disease processes. Future studies should determine pathologic indicators from MGG associated with other functional gastric disorders, and whether multichannel EGG with appropriate signal processing also reveals pathology.