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

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)147-159
Number of pages13
JournalJournal of Neurogastroenterology and Motility
Volume26
Issue number1
DOIs
StatePublished - 2020

Keywords

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

ASJC Scopus subject areas

  • Clinical Neurology
  • Gastroenterology

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