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

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 背景：与心脏一样，胃也有一种名为慢波的起搏器，负责调节胃收缩。许多引起恶心和呕吐的疾病都与慢波节律紊乱有关，例如胃过速，这可能会导致胃运动功能受损。使用外科植入的电极可以最准确地记录慢波，这种方法对大多数临床应用来说是不切实际的。最常见的慢波功能临床测试，胃电(EGG)，涉及在胃上方的皮肤上放置导线。然而，这种方法产生的信号质量低，可靠性不确定。我们之前验证了一种技术，该技术涉及在上内窥镜检查期间使用单个粘膜电极记录胃内侧的慢波。这种方法提供了更可靠的慢波活动记录，但受限于只能在短时间内记录单个地点。我们还验证了几种可以使用EGG和单一粘膜电极系统来扰乱正常慢波循环的技术。一种在几个小时内同时测量多个部位的慢波的技术将为了解正常胃电活动的生理学和人类疾病中可能发生的慢波中断的病理生理学提供重要的见解。 具体目的：我们提出了一种新方法的验证性研究，该方法使用连接在胃粘膜多个部位的改良双极探针对12名健康志愿者进行胃慢波标测。没有胃肠道疾病的空腹志愿者将接受有意识的镇静，然后将进行上内窥镜检查，使用标准的血液夹将单独的电极固定在胃粘膜的三个预定区域。在控制条件下和急性高血糖诱导过程中，胃不同区域的慢波信号会被采集，从而引起慢波解偶联和节律紊乱。要测量的参数将包括区域慢波频率和幅度、慢波传播方向、慢波传播速度以及三个记录点之间的慢波耦合百分比。这些录音将与同时进行的鸡蛋进行比较，以比较两种技术的保真度。 意义：这项研究的发现将为胃电活动的生理学和病理生理学提供重要的洞察力，这将为研究具有不明原因的恶心、呕吐和胃动力障碍(如胃瘫)的患者群体的潜在致病性胃慢波缺陷提供基础。

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.