Search Results (16)

Feeding intolerance (FI) is common in preterm infants and disrupts enteral nutrition. Because clinical signs of FI are nonspecific, objective biomarkers are needed. In this exploratory study, we evaluated whether electrogastrography (EGG) can distinguish infants with FI from those with no FI (NFI) based on their gastric response to feeding. For each infant, the first available weekly EGG recording (postnatal week 1 or, if unavailable, week 2), comprising two consecutive feeding cycles, was analyzed. Each recording included pre-, during-, and post-feed segments. Power spectral density (PSD) was computed over 0.5–9 cycles per minute (cpm) to derive baseline mean PSD (mPSD) and PSD ratios (PSDR) for during/pre- and post/pre-feeding (PSDR_Dur/Pre, PSDR_Post/Pre). Mean power ratios (mPR) were calculated across bradygastria, normogastria, and tachygastria frequency bands. Group differences were assessed using bootstrap resampling. Eighty-four infants were analyzed (75 NFI, 9 FI). Baseline mPSD values were comparable between the two groups. FI infants demonstrated lower PSDR_Dur/Pre values in the bradygastria and tachygastria bands, whereas normogastria responses were similar. No differences were observed in PSDR_Post/Pre. EGG detected attenuated gastric activity specifically during feeding and not after feeding in infants with FI, supporting its potential as a non-invasive physiologic marker that warrants further validation. Full article

Background/Objectives: Stroke survivors with dysphagia are usually fed with different feeding routes ranging from oral to percutaneous endoscopic gastrostomy (PEG). However, the impact of the feeding route on the gastric myoelectric activity (GMA) is little-studied. This work examined the effect of feeding route on GMA changes in stroke survivors with dysphagia. Methods: This study included 50 patients (20% women) who were divided into three groups based on their feeding route: an oral group (n = 20), a nasogastric group (NGT) (n = 20), and a PEG group (n = 10). For all participants, a nutritional assessment was conducted, and the GMA was measured using a transcutaneous multichannel electrogastrogram (EGG) with a water load satiety test before and after water loading. The EGG-related parameters used in the analysis included the average power distribution by frequency region and the average dominant frequency (ADF). Results: The study sample experienced ischemic stroke (66%) or hemorrhagic stroke (34%). At the baseline phase, the PEG group exhibited significantly longer periods of normogastria compared to the NGT and oral groups. Moreover, protein intake was significantly higher in the PEG tube feeding group compared to the other groups. Based on the type of stroke, the ischemic stroke group showed significantly higher tachygastria periods during postprandial EGG recording (p = 0.022). The energy and protein consumptions were significantly higher in the hemorrhagic stroke group (p = 0.001, p = 0.028, respectively). Conclusions: The GMA pattern is distinctive for the type of stroke. The PEG feeding route showed more periods with normogastria and the best protein intake. Full article

Background: Upper gastrointestinal (GI) motility disorders, such as gastroparesis and functional dyspepsia (FD), contribute significantly to morbidity, especially in populations at risk for type 2 diabetes. However, the prevalence and clinical manifestations of these disorders in India, and associated gastric dysrhythmias, are not well studied within this population. Methods: This retrospective, cross-sectional study analyzed 3689 patients who underwent electrogastrography with water load satiety test (EGGWLST) testing across multiple motility clinics in India. The prevalence of gastroparesis and FD-like symptoms, symptom severity, and their association with diabetes and other comorbidities were evaluated. Symptom severity was assessed using the Gastroparesis Cardinal Symptom Index (GCSI). EGGWLST findings were documented, including the gastric myoelectric activity threshold (GMAT) scores. Results: The study population had a mean age of 43.18 years. GCSI scores indicated that patients had symptoms that were mild (55%), moderate (33%), and severe (8%). Compared with the non-diabetic population, diabetic subjects had significantly higher rates of early satiety (56% vs. 45%, p < 0.0001), bloating (73% vs. 67%, p = 0.005), and reflux (28% vs. 24%, p = 0.029). WLST data analysis revealed that significantly more diabetic subjects ingested <350 mL (16% vs. 12%, p = 0.000016). EGG analysis revealed gastric dysthymias in one-third (65%) of patients. Significantly more diabetic subjects (22% vs. 18% p = 0.015) had a GMAT score >0.59. Conclusions: Upper GI motility disorders are prevalent in India, particularly among diabetic patients. EGG is a valuable tool for characterizing these disorders, and may help in personalizing therapeutic approaches. Further research is required to optimize treatment strategies. Full article

Gastroparesis (GP) is a chronic disease characterized by upper gastrointestinal symptoms, primarily nausea and vomiting, and delayed gastric emptying (GE), in the absence of mechanical GI obstruction. The underlying pathophysiology of GP remains unclear, but factors contributing to the condition include vagal nerve dysfunction, impaired gastric fundic accommodation, antral hypomotility, gastric dysrhythmias, and pyloric dysfunction. Currently, gastric emptying scintigraphy (GES) is considered the gold standard for GP diagnosis. However, the overall delay in GE weakly correlates with GP symptoms and their severity. Recent research efforts have focused on developing treatments that address the presumed underlying pathophysiological mechanisms of GP, such as pyloric hypertonicity, with Gastric Peroral Endoscopic Myotomy (G-POEM) one of these procedures. New promising diagnostic tools for gastroparesis include wireless motility capsule (WMC), the 13 carbon-GE breath test, high-resolution electrogastrography, and the Endoluminal Functional Lumen Imaging Probe (EndoFLIP). Some of these tools assess alterations beyond GE, such as muscular electrical activity and pyloric tone. These modalities have the potential to characterize the pathophysiology of gastroparesis, identifying patients who may benefit from targeted therapies. The aim of this review is to provide an overview of the current knowledge on diagnostic pathways in GP, with a focus on the association between diagnosis, symptoms, and treatment. Full article

Women with eating disorders (EDs) often complain of abnormal gastric responses, which may impact their eating patterns and, consequently, their body composition. Binge eating disorder (BED) and bulimia nervosa (BN) have been shown to affect gastric myoelectric activity (GMA), which may provide a basis for the gastric response in this disease population. This study aimed to examine GMA and body composition in patients with an ED compared to age—body mass index (BMI) matched controls. This case—control study included 18 adults diagnosed with BED or BN compared to 19 age—gender-BMI-matched controls. The electrogastrography with water load test was used to measure GMA during fasting and after water loading to satiety. Body composition was measured using a bioelectric impedance analyzer. The results showed that the ED group had a significantly higher water load than the control group and increased percentages of tachygastria times. Comparing the BED and BN subgroups showed differences in body composition status between the subgroups in the form of less fat mass, muscle mass, and total body water in the BN subgroup. In the BN subgroup, fat mass was associated with the average dominant frequency in the EGG. Thus, measuring GMA may be a promising approach to understanding gastric abnormalities in patients with EDs. Therapies targeting improving body composition in women with BED and BN are recommended in future ED management strategies. Full article

The capability of bariatric surgery (BS) and lifestyle intervention (LSI) in ameliorating obesity-associated altered gastric myoelectric activity (GMA) in relation to body composition is underinvestigated. This work studied GMA during weight loss via sleeve gastrectomy and multimodal lifestyle intervention. Seventy-nine participants with morbid obesity were assigned into three groups: bariatric surgery (BS group, n = 27), in which laparoscopic sleeve gastrectomy was performed; lifestyle intervention (LS group, n = 22), in which a calorie-deficit balanced diet with gradual physical activity and personalized behavioral modification were carried out; and waitlist control (C group, n = 30). For all participants, multichannel electrogastrography (EGG) with water-load testing and bioelectric impedance body composition analysis were done at baseline, after three months, and at six months. In the BS group, the water-load volume was decreased but without improvement in the bradygastria. In the LS group, preprandial bradygastria were reduced and some postprandial normogastria were increased throughout the study period. Except for fat-free mass and total body water, the parameters of body composition changes were superior in the BS group. In the LS group, the amount of fat-mass loss was negatively correlated with bradygastria times and positively correlated with preprandial and the early postprandial average dominant frequency (ADF). In addition, in the BS group, fat-mass loss was positively correlated with the ADF at late postprandial times. In conclusion, compared to BS, LS produced moderate normalization of GMA with the preservation of fat-free mass. The GMA changes were significantly associated with the amount of fat loss, regardless of the method of obesity management. Full article

Gastric motility abnormalities are common in patients with disorders of gut-brain interaction, such as functional dyspepsia and gastroparesis. Accurate assessment of the gastric motility in these common disorders can help understand the underlying pathophysiology and guide effective treatment. A variety of clinically applicable diagnostic methods have been developed to objectively evaluate the presence of gastric dysmotility, including tests of gastric accommodation, antroduodenal motility, gastric emptying, and gastric myoelectrical activity. The aim of this mini review is to summarize the advances in clinically available diagnostic methods for evaluation of gastric motility and describe the advantages and disadvantages of each test. Full article

Recent studies, using high resolution magnetoencephalography (MEG) and electrogastrography (EGG), have shown that during resting state, rhythmic gastric physiological signals are linked with cortical brain oscillations. Yet, gut-brain coupling has not been investigated with electroencephalography (EEG) during cognitive brain engagement or during hunger-related gut engagement. In this study in 14 young adults (7 females, mean ± SD age 25.71 ± 8.32 years), we study gut-brain coupling using simultaneous EEG and EGG during hunger and satiety states measured in separate visits, and compare responses both while resting as well as during a cognitively demanding working memory task. We find that EGG-EEG phase-amplitude coupling (PAC) differs based on both satiety state and cognitive effort, with greater PAC modulation observed in the resting state relative to working memory. We find a significant interaction between gut satiation levels and cognitive states in the left fronto-central brain region, with larger cognitive demand based differences in the hunger state. Furthermore, strength of PAC correlated with behavioral performance during the working memory task. Altogether, these results highlight the role of gut-brain interactions in cognition and demonstrate the feasibility of these recordings using scalable sensors. Full article

The rapid development of driving simulators for the evaluation of automated driving experience is constrained by the simulator sickness-related nausea. The electrogastrogram (EGG)-based approach may be promising for immediate, objective, and quantitative nausea assessment. Given the relatively high EGG sensitivity to noises associated with the relatively low amplitude and frequency spans, we introduce an automated procedure comprising statistical analysis and machine learning techniques for EGG-based nausea detection in relation to the noise contamination during automated driving simulation. We calculate the root mean square of EGG amplitude, median and dominant frequencies, magnitude of Power Spectral Density (PSD) at dominant frequency, crest factor of PSD, and spectral variation distribution along with newly introduced parameters: sample and spectral entropy, autocorrelation zero-crossing, and parameters derived from the Poincaré diagram of consecutive EGG samples. Results showed outstanding robustness of sample entropy with moderate robustness of autocorrelation zero-crossing, dominant frequency, and its median. Machine learning reached an accuracy of 88.2% and revealed sample entropy as one of the most relevant and robust parameters, while linear analysis highlighted spectral entropy, spectral variation distribution, and crest factor of PSD. This study clearly indicates the need for customized feature selection in noisy environments, as well as a complementary approach comprising machine learning and statistical analysis for efficient nausea detection. Full article

Obesity can modulate gastric myoelectric activity (GMA); however, the relationship of GMA with nutrient intakes and substrate utilization in adults with obesity is lacking. We examined the association of dietary intakes, energy expenditure, and substrate utilization with the GMA. Participants (n = 115, 18–60 y) were divided into healthy weight (HW, n = 24), overweight (OW, n = 29), obese (OB, n = 41) and morbidly obese (MO, n = 21). Two-day multi-pass 24 h recalls were conducted. The GMA was measured by multichannel electrogastrography (EGG) with water-load (WL) testing. Resting metabolic rate (RMR) and percentages of substrate utilization were measured by indirect calorimetry. In the HW, protein intake was directly correlated with average dominant frequency (ADF) and with WL volume, while in obese participants and the MO subgroup, WL volume correlated with carbohydrate intake. In participants with obesity, ADF was positively correlated with fiber intake. In participants with obesity and the OB subgroup, RMR was positively correlated with water-load volume (r = 0.39 and 0.37, p < 0.05). The ADF showed negative correlations with percent of fat utilization and positive correlations with percent of CHO utilization in non-obese groups. However, protein utilization showed inverse correlation in all obese groups. In conclusion, these distinctive associations suggest that certain dietary compositions and dieting regimens impact GMA patterns. Full article

Nowadays, individuals have very stressful lifestyles, affecting their nutritional habits. In the early stages of life, teenagers begin to exhibit bad habits and inadequate nutrition. Likewise, other people with dementia, Alzheimer’s disease, or other conditions may not take food or medicine regularly. Therefore, the ability to monitor could be beneficial for them and for the doctors that can analyze the patterns of eating habits and their correlation with overall health. Many sensors help accurately detect food intake episodes, including electrogastrography, cameras, microphones, and inertial sensors. Accurate detection may provide better control to enable healthy nutrition habits. This paper presents a systematic review of the use of technology for food intake detection, focusing on the different sensors and methodologies used. The search was performed with a Natural Language Processing (NLP) framework that helps screen irrelevant studies while following the PRISMA methodology. It automatically searched and filtered the research studies in different databases, including PubMed, Springer, ACM, IEEE Xplore, MDPI, and Elsevier. Then, the manual analysis selected 30 papers based on the results of the framework for further analysis, which support the interest in using sensors for food intake detection and nutrition assessment. The mainly used sensors are cameras, inertial, and acoustic sensors that handle the recognition of food intake episodes with artificial intelligence techniques. This research identifies the most used sensors and data processing methodologies to detect food intake. Full article

Analysis of biomedical signals is a very challenging task involving implementation of various advanced signal processing methods. This area is rapidly developing. This paper is a Part III paper, where the most popular and efficient digital signal processing methods are presented. This paper covers the following bioelectrical signals and their processing methods: electromyography (EMG), electroneurography (ENG), electrogastrography (EGG), electrooculography (EOG), electroretinography (ERG), and electrohysterography (EHG). Full article

Galantamine has been used as a treatment for Alzheimer disease. It has a unique, dual mode of action (inhibitor of acetylcholinesterase and allosteric modulator of nicotinic acetylcholine receptors). Nausea (in about 20%), vomiting (10%) and diarrhoea (5–7%) are the most common side effects. The aim of this study was to assess the effect of galantamine on porcine gastric myoelectric activity without (Group A) and with (Group B) dextran sodium sulphate (DSS)-induced gastrointestinal injury. Galantamine hydrobromide was administrated to twelve pigs as a single intragastric dose (24 mg). Gastric myoelectric activity was investigated by electrogastrography (EGG). Basal (15 min before galantamine administration) and study recordings after galantamine administration (300 min) were evaluated using a running spectral analysis. Results were expressed as dominant frequency of gastric slow waves and power analysis (areas of amplitudes). Altogether, 3780 one-minute EGG recordings were evaluated. In Group A, power was steady from basal values for 180 min, then gradually decreased till 270 min (p = 0.007). In Group B, there was a rapid gradual fall from basal values to those after 120 min (p = 0.007) till 300 min (p ˂ 0.001). In conclusion, galantamine alone revealed an unfavourable effect on porcine myoelectric activity assessed by gastric power. It can be a plausible explanation of galantamine-associated dyspepsia in humans. DSS caused further profound decrease of EGG power. That may indicate that underlying inflammatory, ischaemic or NSAIDs-induced condition of the intestine in humans can have aggravated the effect of galantamine on gastric myoelectric activity. Full article

Gastrointestinal side effects of donepezil, including dyspepsia, nausea, vomiting or diarrhea, occur in 20–30% of patients. The pathogenesis of these dysmotility associated disorders has not been fully clarified yet. Pharmacokinetic parameters of donepezil and its active metabolite 6-O-desmethyldonepezil were investigated in experimental pigs with and without small intestinal injury induced by dextran sodium sulfate (DSS). Morphological features of this injury were evaluated by a video capsule endoscopy. The effect of a single and repeated doses of donepezil on gastric myoelectric activity was assessed. Both DSS-induced small intestinal injury and prolonged small intestinal transit time caused higher plasma concentrations of donepezil in experimental pigs. This has an important implication for clinical practice in humans, with a need to reduce doses of the drug if an underlying gastrointestinal disease is present. Donepezil had an undesirable impact on porcine myoelectric activity. This effect was further aggravated by DSS-induced small intestinal injury. These findings can explain donepezil-associated dyspepsia in humans. Full article

Autonomous vehicles are expected to take complete control of the driving process, enabling the former drivers to act as passengers only. This could lead to increased sickness as they can be engaged in tasks other than driving. Adopting different sickness mitigation techniques gives us unique types of motion sickness in autonomous vehicles to be studied. In this paper, we report on a study where we explored the possibilities of assessing motion sickness with electrogastrography (EGG), a non-invasive method used to measure the myoelectric activity of the stomach, and its potential usage in autonomous vehicles (AVs). The study was conducted in a high-fidelity driving simulator with a virtual reality (VR) headset. There separate EGG measurements were performed: before, during and after the driving AV simulation video in VR. During the driving, the participants encountered two driving environments: a straight and less dynamic highway road and a highly dynamic and curvy countryside road. The EGG signal was recorded with a proprietary 3-channel recording device and Ag/AgCl cutaneous electrodes. In addition, participants were asked to signalize whenever they felt uncomfortable and nauseated by pressing a special button. After the drive they completed also the Simulator Sickness Questionnaire (SSQ) and reported on their overall subjective perception of sickness symptoms. The EGG results showed a significant increase of the dominant frequency (DF) and the percentage of the high power spectrum density (FSD) as well as a significant decrease of the power spectrum density Crest factor (CF) during the AV simulation. The vast majority of participants reported nausea during more dynamic conditions, accompanied by an increase in the amplitude and the RMS value of EGG. Reported nausea occurred simultaneously with the increase in EGG amplitude. Based on the results, we conclude that EGG could be used for assessment of motion sickness in autonomous vehicles. DF, CF and FSD can be used as overall sickness indicators, while the relative increase in amplitude of EGG signal and duration of that increase can be used as short-term sickness indicators where the driving environment may affect the driver. Full article