A Novel Approach in Spinal Cord Stimulation for Enhancing Gastric Motility: A Preliminary Study on Canines

Lei Tu; Payam Gharibani; Yi Yang; Bo Zhang; Feng Ji; Jieyun Yin; Jiande D Z Chen

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자료유형: 학술저널

저자정보: Lei Tu (Division of Gastroenterology and Hepatology Department of Medicine Johns Hopkins University School) Payam Gharibani (Division of Gastroenterology and Hepatology Department of Medicine Johns Hopkins University School) Yi Yang (Division of Gastroenterology and Hepatology Department of Medicine Johns Hopkins University School) Bo Zhang (Division of Gastroenterology and Hepatology Department of Medicine Johns Hopkins University School) Feng Ji (Division of Gastroenterology and Hepatology Department of Medicine Johns Hopkins University School) Jieyun Yin (Division of Gastroenterology and Hepatology Department of Medicine Johns Hopkins University School) Jiande D Z Chen (Division of Gastroenterology and Hepatology Department of Medicine Johns Hopkins University School)

저널정보: 대한소화관운동학회(현 대한소화기능성질환.운동학회) Journal of Neurogastroenterology and Motility (JNM) Journal of Neurogastroenterology and Motility (JNM) Vol.26 No.1

발행연도: 2020.1

수록면: 147 - 159 (13page)

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Background/Aims: Gastroparesis is commonly seen in patients with diabetes and functional dyspepsia with no satisfactory therapies. Dysautonomia is one of the main reasons for the imbalanced motility. We hypothesized that spinal cord stimulation (SCS) is a viable therapy for gastroparesis via the autonomic modulation to improve gastric motility. The aim is to find an optimal method of SCS for treating gastroparesis. Methods: Eight healthy-female dogs were implanted with a gastric cannula, a duodenal cannula, 2 multi-electrode spinal leads, and an implantable pulse generator. Gastric motility index (MI) was used to determine the best stimulation location/parameters of SCS. Optimized SCS was used to improve glucagon-induced gastroparesis. Results: With fixed parameters, SCS at Thoracic 10 (T10) was found most effective for increasing gastric MI (37.8%, P = 0.013). SCS was optimized with different parameters (pulse width: 0.05–0.6 msec, frequency: 5–500 Hz, motor threshold: 30–90%) on T10. Our findings revealed that 0.5 msec, 20 Hz with 90% motor threshold at T10 were the best parameters in increasing MI. Glucagon significantly delayed gastric emptying, and this inhibitory effect was partially blocked by SCS. Gastric emptying at 120 minutes was 25.6% in the control session and 15.7% in glucagon session (P = 0.007 vs control), while it was 22.9% with SCS session (P = 0.041 vs glucagon). SCS with the optimal parameters was found to maximally enhance vagal activity and inhibit sympathetic activity assessed by the spectral analysis of heart rate variability. Conclusions: SCS with optimized stimulation location and parameters improves gastric motility in healthy-dogs and accelerates gastric emptying impaired by glucagon via enhancing vagal activity.

#Gastric emptying #Gastrointestinal motility #Gastroparesis #Spinal cord stimulation #Vagal activity

참고문헌 (66)

참고문헌 신청

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