MAPPING NORMAL AND ABNORMAL GASTRIC SLOW WAVES W/ TEMPORARY MUCOSAL ELECTRODES

该子项目是利用 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得主要资金， 因此可以在其他CRISP条目中表示。列出的机构是 中心，不一定是研究者的机构。 背景：和心脏一样，胃也有一个称为慢波的起搏器，它调节胃的收缩。许多引起恶心和呕吐的疾病都与慢波节律紊乱有关，如胃速，这可能导致胃运动功能受损。慢波是最准确地记录使用手术植入电极，一种方法，是不切实际的大多数临床应用。最常见的慢波功能临床测试，胃电描记术（EGG），涉及到在覆盖胃的皮肤上放置电极导线。然而，该方法产生不确定可靠性的低质量信号。我们以前验证了一种技术，涉及记录慢波使用一个单一的粘膜电极施加到胃内的上消化道内窥镜检查。该方法提供了慢波活动的更可靠的记录，但是受限于仅可以在短时间段内记录单个部位。我们还验证了几种可以使用EGG和单粘膜电极系统破坏正常慢波循环的技术。在几个小时内同时测量多个部位的慢波的技术将为正常胃电活动的生理学和可能发生在人类疾病中的慢波中断的病理生理学提供重要的见解。 具体目标：我们提出了一种新的方法来映射胃慢波的验证研究，使用修改后的双极探头连接到12个健康志愿者的胃粘膜上的几个网站。无胃肠道疾病的空腹志愿者将接受清醒镇静，然后进行上消化道内窥镜检查，使用标准止血夹将单独的电极固定到胃粘膜的三个预定区域。将在控制条件下和诱导急性高血糖期间采集不同胃区域的慢波信号，以诱导慢波解偶联和节律紊乱。待测量的参数将包括区域慢波频率和振幅、慢波传播方向、慢波传播速度以及三个记录位点中的每一个之间的慢波耦合百分比。这些记录将与同时进行的EGG进行比较，以比较两种技术的保真度。 重要性：本研究的结果将为胃电活动的生理学和病理生理学提供重要的见解，这将为不明原因的恶心、呕吐和胃动力障碍（如胃轻瘫）患者人群中潜在致病性胃慢波缺陷的研究提供基础。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Background: Like the heart, the stomach has a pacemaker called the slow wave that regulates gastric contractions. Many diseases which produce nausea and vomiting are associated with slow wave rhythm disturbances such as tachygastria which may lead to impaired gastric motor function. Slow waves are most accurately recorded using surgically implanted electrodes, a method that is impractical for most clinical applications. The most common clinical test of slow wave function, electrogastrography (EGG), involves placement of leads on the skin overlying the stomach. However, this method produces low quality signals of uncertain reliability. We previously validated a technique involving recording slow waves using a single mucosal electrode applied to the inside of the stomach during upper endoscopy. This method provides more reliable recordings of slow wave activity, but is limited in that only a single site can be recorded for short periods of time. We have also validated several techniques which can disrupt normal slow wave cycling both using EGG and the single mucosal electrode system. A technique to measure slow waves at multiple sites concurrently over a several hour period would provide important insight into the physiology of normal gastric electrical activity and the pathophysiology of slow wave disruptions which might occur in human disease. Specific aims: We propose a validation study of a new method to map the gastric slow wave using modified bipolar probes attached to several sites on the gastric mucosa in twelve healthy human volunteers. Fasting volunteers without gastrointestinal illness will undergo conscious sedation, then upper endoscopy will be performed to affix separate electrodes to three predetermined regions of the gastric mucosa using standard hemoclips. Slow wave signals in different gastric regions will be acquired under control conditions and during induction of acute hyperglycemia to induce slow wave uncoupling and rhythm disturbances. Parameters to be measured will include regional slow wave frequency and amplitude, direction of slow wave propagation, velocity of slow wave propagation, and percent coupling of the slow wave between each of the three recording sites. These recordings will be compared to a concurrently performed EGG to compare the fidelity of the two techniques. Significance: Findings from this investigation will provide important insight into the physiology and pathophysiology of gastric electrical activity which will provide the foundation for investigation of potentially pathogenic gastric slow wave defects in patient populations with unexplained nausea, vomiting, and conditions of gastric dysmotility such as gastroparesis.