Clinical Autonomic Research

, Volume 23, Issue 2, pp 73–80

Abnormal gastric myoelectrical activity in postural tachycardia syndrome

  • William H. Seligman
  • David A. Low
  • Masato Asahina
  • Christopher J. Mathias
Research Article

DOI: 10.1007/s10286-012-0185-3

Cite this article as:
Seligman, W.H., Low, D.A., Asahina, M. et al. Clin Auton Res (2013) 23: 73. doi:10.1007/s10286-012-0185-3

Abstract

Objective

Postural tachycardia syndrome (PoTS) is an important cause of orthostatic intolerance resulting from cardiovascular autonomic dysfunction. In addition to postural symptoms, PoTS patients may have allied features, including gastrointestinal (GI) symptoms, which have not yet been thoroughly investigated. We evaluated gastric myoelectrical activity in PoTS patients.

Methods

Using cutaneous electrogastrography (EGG), we recorded gastric myoelectrical activity before and after standard liquid meal ingestion in 15 PoTS patients (age 27 ± 4 years); including 7 with and 8 without GI symptoms, and in 11 healthy individuals (age 23 ± 7 years). We performed spectral analysis of EGG recordings to obtain the dominant frequency of gastric pacemaker rhythm (DF), instability coefficient of DF (ICDF), and low (LFR%), normal (NFR%), and high (HFR%) range power percentages of the total power.

Results

Instability coefficient of DF, an index of variability of gastric pacemaker rhythm, was significantly elevated both pre- and post-prandially (30–45 min after the meal) in the PoTS group (8.8 ± 6, 10.0 ± 8 %) compared with controls (4.0 ± 3, 4.0 ± 3 %; both p < 0.05). Patients with GI symptoms had significantly higher post-prandial ICDF (15.0 ± 5 %) than those without GI symptoms (5.6 ± 4 %; p < 0.05). There were no significant differences in DF, LFR%, NFR% and HFR% before and after the meal between the PoTS and control groups, or between PoTS patients with and without GI symptoms.

Interpretation

Our study revealed increased variability of gastric pacemaker rhythm in PoTS, and these findings might be related to pathophysiology of functional GI symptoms in PoTS.

Keywords

Orthostatic intoleranceAutonomic nervous systemElectrogastrographyGastric motility

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • William H. Seligman
    • 1
    • 2
  • David A. Low
    • 1
    • 3
  • Masato Asahina
    • 4
  • Christopher J. Mathias
    • 1
    • 3
  1. 1.Department of Medicine, Autonomic and Neurovascular Medicine UnitImperial College LondonLondonUK
  2. 2.Department of Physiology, Anatomy and GeneticsUniversity of OxfordOxfordUK
  3. 3.Autonomic Unit National Hospital for Neurology & Neurosurgery Queen Square/ Division of Clinical Neurology Institute of Neurology University College LondonLondonUK
  4. 4.Department of NeurologyChiba University School of MedicineChibaJapan