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Gastric electrical stimulation

Barış Akdemir, David G Benditt
The vagus nerve is a major component of the autonomic nervous system and plays a critical role in many body functions including for example, speech, swallowing, heart rate and respiratory control, gastric secretion, and intestinal motility. Vagus nerve stimulation (VNS) refers to any technique that stimulates the vagus nerve, with electrical stimulation being the most important. Implantable devices for VNS are approved therapy for refractory epilepsy and for treatment-resistant depression. In the case of heart disease applications, implantable VNS has been shown to be beneficial for treating heart failure in both preclinical and clinical studies...
October 2016: Anatolian Journal of Cardiology
John M Wo, Thomas V Nowak, Shamaila Waseem, Matthew P Ward
Gastroparesis is a heterogeneous clinical syndrome. Some patients have debilitating vomiting, weight loss, and dehydration, while others have effortless regurgitation of undigested foods or postprandial distress suggestive of functional dyspepsia. Gastric electrical stimulation (GES) has been proposed as an effective treatment option for patients with gastroparesis refractory to medical therapy. Evidence suggests that the clinically available device, a low-energy high-frequency GES, activates the vagal afferent pathways to influence the central control mechanisms for nausea and vomiting...
September 27, 2016: Current Treatment Options in Gastroenterology
Lara Alex Shaylor, Sung Jin Hwang, Kenton M Sanders, Sean M Ward
Inhibitory motor neurons regulate several gastric motility patterns including receptive relaxation, gastric peristaltic motor patterns and pyloric sphincter opening. Nitric oxide (NO) and purines have been identified as likely candidates that mediate inhibitory neural responses. However, the contribution from each neurotransmitter has received little attention in the distal stomach. The aims of this study were to identify the roles played by NO and purines in inhibitory motor responses in the antrums of mice and monkeys...
September 15, 2016: American Journal of Physiology. Gastrointestinal and Liver Physiology
T Horbach, G Meyer, S Morales-Conde, I Alarcón, F Favretti, M Anselmino, G M Rovera, J Dargent, C Stroh, M Susewind, A J Torres
OBJECTIVE: To compare the weight loss, change in quality of life (QOL) and safety of closed-loop gastric electrical stimulation (CLGES) versus adjustable gastric band (LAGB) in the treatment of obesity. METHODS: This multicenter, randomized, non-inferiority trial randomly assigned the patients in a 2:1 ratio to laparoscopic CLGES versus LAGB and followed them for 1 year. We enrolled 210 patients, of whom 50 were withdrawn preoperatively. Among 160 remaining patients (mean age=39±11 years; 75% women; mean body mass index=43±6 kg m(-)(2)) 106 received CLGES and 54 received LAGB...
October 11, 2016: International Journal of Obesity: Journal of the International Association for the Study of Obesity
Yang Won Min, Yun Soo Hong, Eun-Ju Ko, Ji-Yeon Lee, Ki Duck Ahn, Je Moon Bae, Poong-Lyul Rhee
BACKGROUND: Human gastric fundus relaxation is mediated by intrinsic inhibitory pathway. We investigated the roles of nitrergic and purinergic pathways, two known inhibitory factors in gastric motility, on spontaneous and nerve-evoked contractions in human gastric fundus muscles. METHODS: Gastric fundus muscle strips (12 circular and 13 longitudinal) were obtained from patients without previous gastrointestinal motility disorder who underwent gastrectomy for stomach cancer...
2016: PloS One
Peter L Lu, Carlo Di Lorenzo
PURPOSE OF REVIEW: The use of neurostimulation for treatment of gastrointestinal disorders has been growing over the past two to three decades. Our objective is to review current applications of neurostimulation in the treatment of gastrointestinal disorders with an emphasis on the use of these treatment modalities in children. RECENT FINDINGS: Gastric electrical stimulation can lead to symptomatic improvement in children with chronic nausea and vomiting refractory to conventional treatment, and a recent report of long-term outcomes is encouraging...
October 2016: Current Opinion in Pediatrics
Hamza Shah, Gregg Wendorf, Shifat Ahmed, Lindsay McElmurray, Chris Lahr, Michael Hughes, Brian Beauerle, Ed Miller, Abigail Stocker, Thomas L Abell
PURPOSE: Malignancy-associated gastroparesis (MAG) is a cause of morbidity in cancer patients but therapies are lacking. Gastric electrical stimulation (GES) is a novel treatment for MAG. Here, we describe 19 patients with MAG who underwent temporary GES placement. PATIENTS AND METHODS: Nineteen patients (6 males, 13 females) with various malignancies were reviewed for symptom scores and physiologic measures at baseline and after temporary GES placement. Symptoms were scored by three variables: nausea (N), vomiting (V), and GI total symptom score (TSS)...
August 17, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Alexandra C Russell, Amanda L Stone, Lynn S Walker
Nausea is common amongst children with functional gastrointestinal disorders and is associated with a high burden of somatic and psychosocial comorbidities in both the short and long-term. Current treatments including medications, phytotherapy, stress-reduction techniques, and gastric electrical stimulation for recalcitrant cases, are reviewed. Functional nausea merits its own diagnostic criteria as a pediatric functional gastrointestinal disorder.
2016: Children
Julietta Chang, Mena Boules, John Rodriguez, Matthew Walsh, Raul Rosenthal, Matthew Kroh
BACKGROUND: Superior mesenteric artery syndrome (SMAS) is a rare condition caused by partial obstruction of the third portion of the duodenum by the SMA anteriorly and aorta posteriorly. Laparoscopic duodenojejunostomy has been described as a safe and feasible surgical intervention with favorable short-term outcomes. However, descriptions of intermediate outcomes are lacking in the literature. METHODS: A retrospective chart review was performed on patients who underwent minimally invasive duodenojejunostomy from March 2005 to August 2015 at our healthcare system with greater than 6-month follow-up...
July 12, 2016: Surgical Endoscopy
Bin Li, Qian-Xing Zhuang, He-Ren Gao, Jian-Jun Wang, Jing-Ning Zhu
The cerebellum, a hindbrain motor center, also participates in regulating nonsomatic visceral activities such as feeding control. However, the underlying neural mechanism is largely unknown. Here, we investigate whether the cerebellar medial nucleus (MN), one of the final outputs of the cerebellum, could directly project to and modulate the feeding-related neurons in the ventromedial hypothalamic nucleus (VMN), which has been traditionally implicated in feeding behavior, energy balance, and body weight regulation...
June 24, 2016: Brain Structure & Function
Hai Li, Yan Chen, Shi Liu, Xiao-Hua Hou
AIM: To investigate the effects of different parameters of gastric electrical stimulation (GES) on interstitial cells of Cajal (ICCs) and changes in the insulin-like growth factor 1 (IGF-1) signal pathway in streptozotocin-induced diabetic rats. METHODS: Male rats were randomized into control, diabetic (DM), diabetic with sham GES (DM + SGES), diabetic with GES1 (5.5 cpm, 100 ms, 4 mA) (DM + GES1), diabetic with GES2 (5.5 cpm, 300 ms, 4 mA) (DM + GES2) and diabetic with GES3 (5...
June 21, 2016: World Journal of Gastroenterology: WJG
Samuel Lee, Alaa Abd-Elsayed
INTRODUCTION: Neuromodulation, including cavernous nerve stimulation, gastric electrical stimulation, deep brain stimulation, and vagus nerve stimulation, has been used with success in treating several functional disease conditions. The FDA has approved the use of neuromodulation for a few indications. We discuss in our review article the evidence of using neuromodulation for treating some important disorders involving the autonomic nervous system that are not currently FDA approved. METHODS: This was a review article that included a systematic online web search for human clinical studies testing the efficacy of neuromodulation in treating erectile dysfunction, gastroparesis, gastroesophageal reflux disease, obesity, asthma, and heart failure...
June 24, 2016: Neuromodulation: Journal of the International Neuromodulation Society
Timothy R Angeli, Peng Du, David Midgley, Niranchan Paskaranandavadivel, Shameer Sathar, Christopher Lahr, Thomas L Abell, Leo K Cheng, Gregory O'Grady
BACKGROUND AND AIMS: High-frequency gastric electrical stimulation (GES) has emerged as a therapy for gastroparesis, but the mechanism(s) of action remain unclear. There is a need to refine stimulation protocols for clinical benefit, but a lack of accurate techniques for assessing mechanisms in clinical trials, such as slow wave modulation, has hindered progress. We thereby aimed to assess acute slow wave responses to GES in gastroparesis patients using high-resolution (HR) (multi-electrode) mapping, across a range of stimulation doses achievable by the Enterra stimulation device (Medtronic Inc...
June 10, 2016: Neuromodulation: Journal of the International Neuromodulation Society
Inderpreet Grover, Richard Kim, Danielle C Spree, Christopher J Lahr, Archana Kedar, Shivangi Kothari, David Fleisher, Thomas L Abell
Background/Aims: Cyclic vomiting syndrome (CVS) is a disabling migraine variant manifesting as severe episodes of nausea and vomiting and often refractory to many therapies. Gastric electrical stimulation (GES), which can reduce nausea and vomiting in gastroparesis, may provide symptomatic relief for drug-refractory CVS. This study assessed the utility GES in reducing the symptoms of CVS and improving quality of life. Methods: A one-year, non-randomized, clinical study was conducted...
May 30, 2016: Journal of Neurogastroenterology and Motility
Shiying Li, Jiande D Z Chen
INTRODUCTION: The goals of this experiment were to study therapeutic potential of intestinal electrical stimulation (IES) for obesity, its mechanisms involving gastrointestinal motility and hormones, and role of pulse width in diet-induced obese rats. METHODS: In a 4-week study, rats equipped with one pair of electrodes at the duodenum were assigned to receive either a sham or IES of varied pulse widths in a sequential way. Food intake was measured daily and body weight measured weekly...
May 29, 2016: Obesity Surgery
Dag A Sangnes, Eirik Søfteland, Martin Biermann, Odd Helge Gilja, Hrafnkell Thordarson, Georg Dimcevski
BACKGROUND Gastroparesis is a motility disorder of the stomach. The symptoms are non-specific: nausea and vomiting are most common. Stomach pains, early satiety, postprandial fullness and bloating are also frequent symptoms. Current diagnostic criteria require delayed gastric emptying in the absence of any detectable mechanical obstruction. In this review article we elucidate the causes, assessment and treatment options.MATERIAL AND METHOD Structured article search in Embase and PubMed.RESULTS A number of conditions can lead to gastroparesis...
May 2016: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
Moisés Tolentino Bento da Silva, Rosemarie Brandim Marques, Francisco José Batista-Lima, Marília Almeida Soares, Armênio Aguiar Dos Santos, Pedro Jorge Caldas Magalhães, Francisco de Assis Oliveira, Fernanda Regina de Castro Almeida
α-Terpineol is a monoterpene with smooth muscle relaxant properties. In this study, its effects on the gastric emptying rate of awake rats were evaluated with emphasis on the mode by which it induces gastrointestinal actions. Administered by gavage, α-terpineol (50 mg/kg) delayed gastric emptying of a liquid test meal at 10 min postprandial. Hexamethonium or guanethidine did not interfere with the retarding effect induced by α-terpineol, but atropine and L-N(G)-nitroarginine methyl ester abolished it...
April 28, 2016: Planta Medica
Shishira Bharadwaj, Krishna Meka, Parul Tandon, Abdullah Rathur, John M Rivas, Hiren Vallabh, Andrea Jevenn, John Guirguis, Imran Sunesara, Amy Nischnick, Andrew Ukleja
Gastroparesis (GP) is a chronic debilitating dysmotility characterized by unrelenting nausea, vomiting, bloating, early satiety, postprandial fullness and abdominal pain. Patients with GP experience other associated conditions, including gastroesophageal reflux disease, gastric bezoars and small bowel bacterial overgrowth. Furthermore, GP is associated with poor quality of life, increased emergency room visits, hospitalizations and subsequent increased healthcare costs. Currently, the managements of GP consist of glycemic control, antiemetics, prokinetics and the use of gastric electrical stimulation...
May 2016: Journal of Digestive Diseases
Harold E Lebovitz
Gastric electrical stimulation has been applied to treat human obesity since 1995. Dilatation of the stomach causes a series of neural reflexes which result in satiation and satiety. In non-obese individuals food ingestion is limited in part by this mechanism. In obese individuals, satiation and satiety are defective and unable to limit energy intake and prevent excessive weight gain. Several gastric electrical stimulatory (GES) devices have been developed, tested in clinical trials and even approved for the treatment of obesity...
March 2016: Reviews in Endocrine & Metabolic Disorders
Alison Smith, Robert Cacchione, Ed Miller, Lindsay McElmurray, Robert Allen, Abigail Stocker, Thomas L Abell, Michael G Hughes
We compared outcomes for two gastric electrical stimulation placement strategies, minilaparotomy with adjunctive care (MLAC) versus laparoscopy without adjunctive care (LAPA). For electrode placement, the peritoneal cavity was accessed with either a single 2.5 to 3.0 cm midline incision (MLAC) or three trocar incisions (LAPA). For both groups, generator was placed subcutaneously over the anterior rectus sheath. For MLAC, adjunctive pain control measures were used for placement of both electrode and generator (transversus abdominus plane block)...
April 2016: American Surgeon
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