Elevation of Lower Esophageal Sphincter Pressure With Acute Transcutaneous Electrical Acustimulation Synchronized With Inspiration

Zhaoxiu Liu, Dewen Lu, Jie Guo, Yanmei Liu, Zhaohong Shi, Feng Xu, Lin Lin, Jiande Chen

Research output: Contribution to journalArticle

Abstract

Background: Gastroesophageal reflux disease (GERD) is a common esophageal disorder. Transcutaneous electrical acustimulation (TEA), as a needleless method of electroacupuncture (EA) has been reported to improve hypotensive lower esophageal sphincters pressure (LESP) in GERD. Synchronized TEA (STEA) with inspiration has been revealed to be more effective than TEA in enhancing vagal tone. Aim: To explore the effect of STEA on LESP in GERD and possible mechanisms involving autonomic functions. Methods: Sixty patients were randomly allocated into a STEA group (45 patients) and sham-TEA group (15 patients). The ECG was recorded for the assessment of the autonomic function, followed with an esophageal high-resolution manometry (HRM) test. When the test was completed, the STEA or sham-TEA treatment was performed for 30 minutes. Then the HRM test was repeated. Results: STEA increased LESP from 21.9 to 31.9 mmHg in GERD patients (p < 0.001). A negative correlation between the percentage of STEA-induced increase in LESP and basal LESP was observed (R = −0.471, p = 0.001). STEA reduced the number of ineffective esophageal contractions (p < 0.05). STEA rather than sham-TEA increased vagal activity (0.27 ± 0.14 vs. 0.36 ± 0.18, p < 0.001) and decreased sympathetic activity (0.73 ± 0.14 vs. 0.64 ± 0.18, p < 0.001). Conclusions: Acute STEA augments LESP in GERD and the percentage of the increase in LESP was negatively correlated with basal LESP. The effect of STEA on LESP might be mediated via autonomic function. Conflict of Interest: The authors reported no conflict of interest.

Original languageEnglish (US)
Pages (from-to)586-592
Number of pages7
JournalNeuromodulation
Volume22
Issue number5
DOIs
StatePublished - Jul 1 2019

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Keywords

  • Autonomic nerve system
  • gastroesophageal reflux disease
  • high-resolution manometry
  • lower esophageal sphincters
  • synchronized transcutaneous electroacupuncture

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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