Chanelle K. Benjamin, MD1, Abigail Stocker, MD1, Lindsay McElmurray, PA-C2, Thomas Abell, MD1; 1University of Louisville, Louisville, KY; 2University of Louisville Physicians, Louisville, KY
Introduction: Measurements of gastric electrical activity for functional GI symptoms, although promising, have yet to fulfill their potential. In the last few decades, low resolution electrogastrogram (LR-EGG), using more than one set of electrodes and measuring both frequency and amplitude of electrogastrogram (EGG) signals, have become available for clinical use (NGM, 2019:31(3)e13534). More recently, high-resolution (HR- EGG) recordings, using an array of electrodes for frequency determination have been developed. We aimed to compare both LR and HR recordings Vs. GI symptoms and gastric emptying and hypothesized that the measurements of not only the frequency, but also of the electrical amplitude, will yield useful information. Methods: We conducted a pilot study of 12 patients with the symptoms (Sx) of gastroparesis (Gp): 12 females, mean age 50 years; 10 with diagnosis of (ID) idiopathic gastroparesis and 2 with (DM) diabetes mellitus. LR-EGG (Sandhill/Diversatek, Inc) was performed with 2 sets of electrodes and HR-EGG (Laborie, Inc) was recorded in the same epigastric location but with an array of 6 electrodes. LR-EGG was analyzed by computerized signal averaging for mean +/- SD frequency and amplitudes. HR-EGG was analyzed by fast Fourier analysis for mean frequency +/- SD. GI Symptoms were quantified by both traditional (Trad) PRO of upper and lower GI Sx and GSCI scores (of upper Sx) and gastric emptying (GET) by 4-hour studies (NGM above). Results were compared by correlations and p values reported as significant if < /= 0.05 or borderline if > 0.05 and < 0.15. Results: We found that both LR-EGG and HR-EGG frequencies correlate with several PRO GI symptom measures (Table 1). The EGG frequency results were most significant for Trad PRO bloating and GCSI retching. LR-EGG amplitudes also correlated with Trad PRO GI and CGSI symptoms. The EGG amplitude results were most significant for vomiting. (Table 2). None of the EGG methods (frequency or amplitude) correlated significantly with GET results in this patient sample. Discussion: In this pilot study, both low- and high-resolution EGG frequency values correlate with patient reported outcome symptoms, and the measurement of EGG amplitude gave additional important information related to both upper and lower GI symptoms. Future development of high-resolution EGG should include measurement of amplitude, as well as frequency, to maximize clinical usefulness.
Disclosures: Chanelle Benjamin indicated no relevant financial relationships. Abigail Stocker indicated no relevant financial relationships. Lindsay McElmurray indicated no relevant financial relationships. Thomas Abell: ADEPT-GI – Stockholder/Ownership Interest (excluding diversified mutual funds), Other Financial or Material Support, Founder. Allergan – Other Financial or Material Support, Investigator. Alnylam – Other Financial or Material Support, Investigator. Censa – Other Financial or Material Support, Investigator and Consultant. Cindome – Other Financial or Material Support, Investigator. MedStudy – Other Financial or Material Support, Writer. Neuromodulation – Other Financial or Material Support, GES Editor. NIH GpCRC – Grant/Research Support. Nuvaira – Other Financial or Material Support, Consultant. UpToDate – Other Financial or Material Support, Reviewer. Vanda – Other Financial or Material Support, Investigator. WikiStim – Other Financial or Material Support, GES Editor.