![]() While the individual and societal burden of gastroparesis are substantial, currently limited treatment options are available with no satisfactory outcomes. 5, 6 Gastric motility includes gastric pace-making activity (gastric slow waves regulated by interstitial cells of Cajal) as well as antral contraction (peristalsis mediated through smooth muscle cells). 4 Main pathophysiological factors of gastroparesis include decreased or impaired gastric motility, reduced gastric accommodation and gastric hypersensitivity. 2 While the main etiology of gastroparesis is idiopathic, 3 diabetes, postoperative ileus, connective tissue diseases, and neurological disorders are the other causes of gastroparesis. 1 Gastroparesis is a neuromuscular disorder of the upper gastrointestinal tract which is accompanied by nausea, vomiting, epigastric pain or discomfort, early satiety, abdominal bloating, postprandial fullness, and weight loss. Keywords: Gastric emptying Gastrointestinal motility Gastroparesis Spinal cord stimulation Vagal activityĭelay in gastric emptying in the absence of mechanical obstruction is a common complication of gastroparesis. SCS with optimized stimulation location and parameters improves gastric motility in healthy-dogs and accelerates gastric emptying impaired by glucagon via enhancing vagal activity. 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. 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). Glucagon significantly delayed gastric emptying, and this inhibitory effect was partially blocked by SCS. Our findings revealed that 0.5 msec, 20 Hz with 90% motor threshold at T10 were the best parameters in increasing MI. SCS was optimized with different parameters (pulse width: 0.05–0.6 msec, frequency: 5–500 Hz, motor threshold: 30–90%) on T10. With fixed parameters, SCS at Thoracic 10 (T10) was found most effective for increasing gastric MI (37.8%, P = 0.013). ![]() Optimized SCS was used to improve glucagon-induced gastroparesis. ![]() ![]() Gastric motility index (MI) was used to determine the best stimulation location/parameters of SCS. MethodsĮight healthy-female dogs were implanted with a gastric cannula, a duodenal cannula, 2 multi-electrode spinal leads, and an implantable pulse generator. The aim is to find an optimal method of SCS for treating gastroparesis. We hypothesized that spinal cord stimulation (SCS) is a viable therapy for gastroparesis via the autonomic modulation to improve gastric motility. Dysautonomia is one of the main reasons for the imbalanced motility. Gastroparesis is commonly seen in patients with diabetes and functional dyspepsia with no satisfactory therapies. ![]()
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