Mechanisms of Action for the Enterra Medical Gastric Electrical Stimulator

Sponsor
University of Aarhus
Study ID
NCT06582576
Status
Recruiting
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Conditions

  • Gastroparesis
  • Nausea
  • Vomiting

Eligibility Criteria

Sex
ALL
Age
18 Years - N/A
Healthy Volunteers
Not accepted

Interventions

  • Effect of different gastric electrical stimulator stimulation paragdimes on brain, heart, and stomach. — DIAGNOSTIC_TEST
    Measuring EEG, ECG, and ultrasound in both groups during different stimulation intensities provided by the previously implanted gastric electrical stimulator.

Study Details

Background: Gastric electrical stimulation applied by a surgically implanted device effectively alleviates upper gastrointestinal symptoms in the majority of individuals with medically refractory gastroparesis. Despite its efficacy, the mechanisms of action have been minimally explored in previous studies, and it is unknown why some individuals experience limited symptom-lowering effects. Aim: The investigators aim to investigate two of the potential mechanisms of action leading to symptom-reducing effects of gastric electrical stimulation: 1) possible central effects in the brainstem and brain by enhanced parasympathetic vagal activity, and 2) peripheral effects in the stomach by improved gastric accommodation. Methods: Up to thirty individuals with drug-refractory gastroparesis having an implanted gastric electrical stimulator will be enrolled in this cross-sectional and observational study. Of these, 15 will be responders (substantial symptomatic improvement) and 15 non-responders (minor symptomatic improvement). Electroencephalography (EEG) will evaluate the stimulation-induced activity in the brain and brainstem to assess whether the gastric stimulation generates evoked potentials. Electrocardiography (ECG) will investigate stimulation-induced changes in the autonomic regulation of the heart. Gastric ultrasound will investigate the effect of stimulation on stomach accommodation, contractions, and wall tension. These central and peripheral measures will be assessed during one study day before and after activating the gastric electrical stimulator, following an increase in stimulation intensity and post-meal consumption. Furthermore, results will be compared between responders and non-responders. Perspectives: Adjusting the parameters of gastric electrical stimulation based on objective markers in the brain, heart, or stomach, rather than relying on symptom fluctuations, may enhance the effectiveness of symptom improvement. In the future, these objective markers may aid in differentiating between responders and non-responders, which may lead to optimised selection criteria for surgery.

Key Dates

First listed
Sep 3, 2024
Start date
Sep 2, 2024
Status verified
Aug 2024
Primary completion
Oct 1, 2025
Completion
Oct 1, 2025

Study Design

Enrollment
30 participants (estimated)

Arms

  • Arm: Responders
    Individuals who have a gastric pacemaker for treating gastroparesis and have experienced a "substantial or full" symptomatic improvement after the implantation.
  • Arm: Non-responders
    Individuals who have a gastric pacemaker for treating gastroparesis and answered have experienced "some or none" symptomatic improvement after the implantation.

Primary Outcome Measure

Evoked brain potentials [ Time Frame: 5min during maximum stimulation intensity ]

Central Contacts

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